As it follows from abovementioned, Enterosgel, as well as other enterosorbents, especially carbon ones, possesses extremely wide spectrum of useful clinical applications.
The magnitude of this list has certain explanations. Firstly, Enterosgel, as all other enterosorbents, is not a pharmacologic preparation in a classical meaning of word, but is related to a category of biomaterials, like, for example, membrane for plasmapheresis that is also used by numerous different indications. Secondly, there is a number of stereotype responses of organism on Enterosgel use that are surprisingly constantly being repeated in experiment and in clinic at various pathological states. To these reactions are related normalization of intestinal microbiocenosis, suppression of lipid peroxidation processes and activation of antioxidant defense, improved indexes of lipidogramme, decreased plasma concentration of molecules with medium molecular weight or their separate fractions, decreased plasma content of CIC and proinflammatory cytokines, and also positive immunomodification by many parameters of cellular and humoral immunity.
One should add also improvement of detoxicating and synthetic functions of liver and restoration of properties of hepatocyte membranes, improved renal functions, and elevation of regenerative-reparative potential of a number of organs and tissues in general. Many of these phenomena are of «distant» character and are poorly corresponding to the properties of Enterosgel shown in vitro, and this fact once more time points on the complexity and depth of mechanisms of therapeutic action of enterosorption.
So, by its therapeutic action, Enterosgel is a classic enterosorbent possessing definite therapeutic efficacy. Among the most important patterns of Enterosgel use, linked to the spectrum of its adsorbing activity, is a possibility to prescribe it in parallel with administration of practically all oral pharmacological preparations. This pattern is based on a low (compared to carbon sorbents) sorption ability of Enterosgel toward compounds with molecular weight below 1500 Da, to which the large majority of medicinal compounds administered per os, are related.
In Table 8 comparative data on sorption of some antituberculosis and antiretroviral preparations by Enterosgel and modern carbon enterosorbent Carboline, are presented.
Table 8. Adsorptive ability of Enterosgel and carbon enterosorbent Carboline toward some antituberculosis and antiretroviral preparations.
| А Preparation | Molecular weight, Da | Enterosgel, mg/g | Carboline, mg/g |
| Isoniazide | 137.1 | 0.02±0.01 | 9.11±0.41 |
| Pyrazinamide | 123.1 | 0.15±0.02 | 9.94±0.48 |
| Rifampicine | 823.0 | 1.50±0.18 | 19.77±0.72 |
| Stavudin | 224.2 | 0.00±0.00 | 25.14±0.01 |
|
lamivudin |
229.3 |
0.96±0.01 |
140.78±0.00 |
As it follows from Table 8, in contrary to carbon enterosorbent, even at direct contact between Enterosgel and medicinal preparations it is not adsorbing them practically. It doesn’t mean that carbon sorbents shouldn’t be used for elimination of toxic effects of prolonged drug therapy – for this purpose one could «separate» drug administrations by time, «introduce» meal consumption between them etc, however, in such case surely Enterosgel is more suitable.
Mentioned above facts opens practically unlimited perspectives for use of Enterosgel for therapy of iatrogenic intoxications and other side effects of prolonged pharmacotherapy in combined treatment of such diseases as tuberculosis, HIV-infection and AIDS, rheumatoid arthritis, unspecific ulcerative colitis, Crohn’s disease, some forms of syphilis and leprosy, and upon complications of decholesteroling therapy. In all mentioned cases, the other important element of Enterosgel use is its ability to interfere with pathogenesis of these diseases based on the complex of listed higher useful effects, characteristic to it as an enterosorbent .
These specific properties of Enterosgel are of great interest for treatment of HIV-infected patients. In Table 9 the preliminary results of Enterosgel use for treatment of diarrheal syndrome in HIV-infected patients cured with highly active antiretroviral therapy are presented (А.V. Yurchenko et al. 2009).
Table 9. Influence of Enterosgel on the rate of disappearance of clinical symptoms in HIV-infected patients with diarrheal syndrome.
| Group | Normalization of performance status | Dissapearance ofabdominal distension | Pain relief | Double decrease of number of stools | Normalization of stools |
| Main | 3.67±1.12 | 4.28±1.93 | 4.56±2.66 | 3.47±1.25 | 6.03±1.71 |
|
Control
|
5.35±2.21
|
5.36±2.31
|
4.94±2.49
|
5.15±2.18
|
8.00±3.32
|
|
Statistical significance
|
р < 0.005
|
p < 0.2
|
p > 0.5
|
p < 0.005
|
p < 0.02
|
As it follows from Table 9, Enterosgel certainly accelerates the reduction of clinical symptoms in HIV-infected patients with diarrheal syndrome.
Let’s note that presently diarrheal syndrome in HIV-infected patients is considered to be linked to the development of malabsorbtion syndrome and general nutrition malfunction, and also with decreased efficacy of antiretroviral preparations toward HIV, persistent immunocompetent cells of intestine, which makes an important impact in disease progression (M. Guadalupe et al., 2003, 2006).
Apart from mitigation of various types of toxicity that are characteristic for antiretroviral preparations, and jugulation of diarrheal syndrome, Enterosgel may be useful for treatment of HIV-infected patients as means of maintenance of cure programs for treatment of concominant diseases in HIV-infected patients, namely, tubrculosis, viral hepatitis, acute pneumonia, and malignant neoplasm.