A Pediatric Clinical Trial in Treatment Resistant IBD
Evidence supporting the use of N-acetylglucosamine in inflammatory bowel disease comes from a human clinical study. In this study N-acetylglucosamine at a total daily dose of 3 to 6 g was administered orally as adjunctive therapy to patients with severe treatment-resistant inflammatory bowel disease; (Crohn’s disease and ulcerative colitis patients). Histochemical assessment of epithelial and matrix glycosaminoglycans and N-acetylglucosamine content was made in pre-and post treatment intestinal biopsies from three quarters of the study subjects.
At the mucosal level there was enhanced expression of sulphated glucosaminoglycans (GAGs), particularly within the extracellular matrix. Intracellular N-acetylglucosamine levels were also elevated. Enhanced goblet cell mucus production was notable feature.
Increase before and after treatment with N-acetylglucosamine
|Carbohydrate Type & Location||Optical Density||Significance|
|Matrix GAGs||98.6 ± 13.1||171.8 ± 19.6||P< 0.01|
|Epithelium GAGs||79.7 ± 9.9||142.8 ± 20.4||P< 0.05|
|Lamina Propria NAG||40.1 ± 5.6||71.1 ± 7.3||P< 0.01|
|Epithelium NAG||31.9 ± 3.2||57.4 ± 5.5||P< 0.01|
That the enhancement of glycosaminoglycans (GAGs) is specifically due to the exogenous administration of N-acetylglucosamine is evidenced by the fact that the N acetylglucosamine content of the complex saccharides of mucin was simultaneously increased.
Biopsy results also showed a reduction in inflammation and a restoration of normal intestinal epithelial architecture.
Ref: Salvatore 2000, Aliment Pharmacol Ther 14:1567 – 1579.