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.
Histochemical Analysis
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 | |
|---|---|---|---|
| Pre treatment | Post-treatment | ||
| 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.