Digestive Diseases and Sciences

, Volume 57, Issue 1, pp 99–108 | Cite as

A Tannic Acid-Based Medical Food, Cesinex®, Exhibits Broad-Spectrum Antidiarrheal Properties: A Mechanistic and Clinical Study

  • Aixia Ren
  • Weiqiang Zhang
  • Hugh Greg Thomas
  • Amy Barish
  • Stephen Berry
  • Jeffrey S. Kiel
  • Anjaparavanda P. Naren
Original Article

Abstract

Background

The purpose of this investigation was to evaluate the efficacy and tolerability of a tannic acid-based medical food, Cesinex®, in the treatment of diarrhea and to investigate the mechanisms underlying its antidiarrheal effect.

Methods

Cesinex® was prescribed to six children and four adults with diarrhea. Patient records were retrospectively reviewed for the primary outcome. Cesinex® and its major component, tannic acid, were tested for their effects on cholera toxin-induced intestinal fluid secretion in mice. Polarized human gut epithelial cells (HT29-CL19A cells) were used to investigate the effects of tannic acid on epithelial barrier properties, transepithelial chloride secretion, and cell viability.

Results

Successful resolution of diarrheal symptoms was reported in nine of ten patients receiving Cesinex®. The treatment of HT29-CL19A cells with clinically relevant concentrations of tannic acid (0.01–1 mg/ml) significantly increased transepithelial resistance (TER) and inhibited the cystic fibrosis transmembrane conductance regulator (CFTR)-dependent or the calcium-activated Cl secretion. Tannic acid could also improve the impaired epithelial barrier function induced by tumor necrosis factor alpha (TNFα) and inhibited the disrupting effect of TNFα on the epithelial barrier function in these cells. Cholera toxin (CTX)-induced mouse intestinal fluid secretion was significantly reduced by the administration of Cesinex® or tannic acid. Cesinex® has high antioxidant capacity.

Conclusions

Cesinex® demonstrates efficacy and a good safety profile in the treatment of diarrhea. The broad-spectrum antidiarrheal effect of Cesinex® can be attributed to a combination of factors: its ability to improve the epithelial barrier properties, to inhibit intestinal fluid secretion, and the high antioxidant capacity.

Keywords

Diarrhea Cesinex® Tannic acid Intestinal barrier Intestinal fluid secretion Chloride channels 

Abbreviations

ADO

Adenosine

BM

Bowel movement

CaCC

Calcium-activated chloride channel

CFTR

Cystic fibrosis transmembrane conductance regulator

CTX

Cholera toxin

FSK

Forskolin

NFA

Niflumic acid

TA

Tannic acid

TEAC

Trolox® equivalent antioxidant capacity

TER

Transepithelial resistance

TNFα

Tumor necrosis factor alpha

Notes

Acknowledgments

This work is supported by the US National Institutes of Health (NIH) (DK074996 and DK080834 to A.P.N.). Hall Bioscience partially funded the mechanistic studies (for purchasing the reagents and materials needed for the experiments).

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Aixia Ren
    • 1
  • Weiqiang Zhang
    • 1
  • Hugh Greg Thomas
    • 2
  • Amy Barish
    • 2
  • Stephen Berry
    • 2
  • Jeffrey S. Kiel
    • 2
  • Anjaparavanda P. Naren
    • 1
  1. 1.Department of PhysiologyUniversity of Tennessee Health Science CenterMemphisUSA
  2. 2.Hall Bioscience CorporationFlowery BranchUSA

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