Enterosgel for treatment of diseases of gastro-intestinal tract

In the work of L.G. Nikolaeva (1993) Enterosgel, along with carbon enterosorbent КАU and lignin enterosorbent Polyphepane, has demonstrated an ability to accelerate the regression of symptoms of acute intestinal infection, decrease the expression of endogenous intoxication, and reduce by 2-3 days the period of seeding of enteric pathogens in patients with Flexner dysenteriae and salmonellosis. In Table 4, impressing data on the influence of Enterosgel administration (1-1.5 g/kg body weight per day) on clinical course of rotaviral infection (intestinal influenza) in 50 newborns, are presented.

Table 4. Clinical and laboratory indexes of efficacy of Enterosgel in treatment of rotaviral infection in newborns (by I.V. Dzublik et al., 1997)

* - significant compared to the control

This result is of special importance if one takes into account an extreme spreading of rotaviral infection of newborns in third world countries.

L.А. Volynskaya et al. (1997) have shown that in children suffering from dysenteriae, Enterosgel administration improves assimilation of maltose studied by the method of carbohydrate burden. V.М. Semenova et al. (1999) and О.А. Putilinaetal. (2000) reported about positive experience of Enterosgel use for treatment of dysenteria and salmonellosis in adults and children, in parallel noting a significant reduction of period of intestinal malfunction.

By the data of Yu.A. Sukhov et al. (2007), administration of Enterosgel to the patients with acute intestinal infections led to significant decrease of plasma concentration of proinflammatory cytokines TNF-a and IL-2. In the work of M.N. Andreytchin et al. (2009) Enterosgel was administered to with acute intestinal infection (AII) patients caused by opportunistic flora and Sonne Shigella; it has been shown that enterosorption promoted regression of pathogenic symptoms, decrease of integral indexes of endogenous intoxication as well as normalization of such indexes of intestinal mucosa injury as the presence of I-FABP protein in blood plasma, and content of lyzozyme in fecal masses. Furthermore, a number of positive consequences of Enterosgel use was detected in patients-reconvalescents, during the study of the parameters of their intestinal microbiocenosis. In general, it has been shown that enterosorption significantly elevates the number of reconvalescents with minimal disbiosis of grade I along with simultaneous decrease of the number of cases of 3-4 grade disbiosis. The same researchers have found that 10-days administration of Enterosgel by 20 clinically healthy individuals resulted in positive alterations of intestinal microflora via increase of titers of bifidobacteria and lactobacilli, and decrease of present opportunistic microorganisms. Analogous result has been received also during the study of Enterosgel in rats: 90-days administration of enterosorbent led to improvement of the state of microflora of experimental animals with disappearance of bacteria, noncharacteristic for intestinal ecotopes, and predominance of lactobacilli in small intestine (V.G. Nikolaev, 2009). These experimental-clinical results open doubtless perspectives for use of Enterosgel in prophylaxis of disbiosis and treatment of its widespread sublinical forms. V.N. Chornobryviy and I.G. Paliy (2007) have noted that introduction of Enterosgel in traditional scheme of therapy of intestinal disbacteriosis allows obtain marked positive alterations in indexes of microbiocenosis in 98% patients. Positive influence of Enterosgel on enteric microflora has been observed also upon administration of this preparation to patients with viral hepatitis (L.V. Moroz, I.G. Paliy, 2007), and children with severe burns (А.М. Boyarskaya et al, 2007).

Of undoubtful interest is an attempt of Enterosgel use (А.B. Petukhov et al, 2000) for therapy of chronic hard-to-treat diseases of gastro-intestinal tract (malabsorption syndrome, gluten entheropathy, exacerbation of chronic enteritis, postresection syndrome, syndrome of irritated large bowel).

Table 5. Dynamics (days) of the main clinical manifestations in patients with chronic diseases of  digestive system organs

As it follows from Table 5, Enterosgel administration significantly accelerates entry into remission of these patients compared to the patients from control group.

By the data of S.O. Yastremskaya et al. (2009, a,b) prophylactic and therapeutic administration of Enterosgel to rats with peptic ulcer and ulcerative colitis models significantly decreased the number and surface of lesions on GIT mucosa and exacerbates the course of syndrome of endogenous intoxication that accompanies these injuries. The first evidence on clinical use of Enterosgel in combined therapy of peptic gastric ulcer and duodenum one may found in an article of S.М. Tkach (2006), who had noted that upon influence of enterosorption, the rate of side effects of therapy decreased significantly, and the rate of successful eradication of Helicobacter elevated from 83.3 to 93.3%.

Some preliminary data exist also concerning Enterosgel use in the treatment of nonspecific ulcerative colitis in clinic. Let’s note that this autoimmune disease in whose pathogenesis local imbalance of immune system of gastro-intestinal tract plays a significant role, by description is a perspective object for use enterosorption. The said statement is supported, in particular, by results obtained by O.I.Osadchaya and A.M.Boyarskaya (2009), who have studied the influence of Enterosgel on activity of humoral chain of immunity, some indexes of lipid peroxidation, and level of endogenous intoxication. Significant positive influence of Enterosgel administration was detected in such indexes as content of diene conjugates, Schiff’s bases, CIC, percent of patients with positive test on serum cryoglobulines, plasma concentration of cryoglobulines, plasma concentration of IL-10. These shifts were of moderate character and did not provide significant normalization of altered parameters. A tendency for improvement compared to control group have been revealed in many other parameters, such as content of C-reactive protein and ceruloplasmin, degree of  oxidative damage of blood plasma proteins, concentration of sodium nitrite, binding ability of blood plasma proteins,  ethanol test, ratio of content of immunoglobulins of different classes, effective concentration of serum albumincontent of compounds of medium molecular weight, and also of proinflammatory cytokines TNF-a, IL-1 and IL-6. All these shifts, being moderate in absolute value, are of monodirectional character and could be interpreted as a result of positive modification of natural course of nonspecific ulcerative colitis, upon the influence of Enterosgel.