Investigation of the adsorption capacity of the enterosorbent Enterosgel for a range of bacterial toxins, bile acids and pharmaceutical drugs

Sci Rep. 2019 Apr 4;9(1):5629. doi: 10.1038/s41598-019-42176-z.

Abstract

Oral intestinal adsorbents (enterosorbents) are orally administered materials which pass through the gut where they bind (adsorb) various substances. The enterosorbent Enterosgel (Polymethylsiloxane polyhdrate) is recommended as a symptomatic treatment for acute diarrhoea and chronic diarrhoea associated with irritable bowel syndrome (IBS). Since 1980's there have been many Enterosgel clinical trials, however, the detailed mechanism of Enterosgel action towards specific toxins and interaction with concomitantly administered medications has not been fully investigated. Our in vitro study assessed the adsorption capacity of Enterosgel for bacterial enterotoxins and endotoxin, bile acids and interaction with the pharmaceutical drugs; Cetirizine and Amitriptyline hydrochloride. Our data demonstrate the good adsorption capacity of Enterosgel for bacterial toxins associated with gastrointestinal infection, with a lower than the comparator charcoal Charcodote capacity for bile acids whose levels can be raised in IBS patients. Adsorption capacity for the two drugs varied but was significantly lower than Charcodote. These findings suggest that the mechanism of Enterosgel action in the treatment of gastrointestinal infection or IBS is adsorption of target molecules followed by removal from the body. This therapy offers a drug free approach to prevention and treatment of infectious and chronic non-infectious diseases, where intestinal flora and endotoxemia play a role.

MeSH terms

  • Adsorption
  • Amitriptyline / metabolism
  • Bacterial Toxins / metabolism
  • Bile Acids and Salts / metabolism
  • Cetirizine / metabolism
  • Charcoal
  • Diarrhea / drug therapy
  • Enterosorption / methods*
  • Gastrointestinal Diseases / drug therapy
  • Gastrointestinal Microbiome / drug effects
  • Irritable Bowel Syndrome / drug therapy
  • Silicones / chemistry*
  • Silicones / pharmacology*

Substances

  • Bacterial Toxins
  • Bile Acids and Salts
  • Silicones
  • polymethylsiloxane
  • Charcoal
  • Amitriptyline
  • Cetirizine