CharXgen-Activated Bamboo Charcoal Encapsulated in Sodium Alginate Microsphere as the Absorbent of Uremic Toxins to Retard Kidney Function Deterioration

Abstract

Indoxyl sulphate (IS) and p-cresyl sulphate (PCS) are two protein bound uraemic toxins accumulated in chronic kidney disease (CKD) and associated with adverse outcomes. The purpose of this study isto evaluate the effect of the new activated charcoal, CharXgen, on renal function protection and lowering serum uraemic toxins in CKD animal model. The physical character of CharXgen was analyzed before and after activation procedure by Scanning Electron Microscope (SEM) and X-ray diffractometer (XRD). The effect of CharXgen on biochemistry and lowering uremic toxins was evaluated by in vitro binding assay and CKD animal model. CharXgen have high interior surface area analyzed by SEM and XRD and have been produced from local bamboo after an activation process. CharXgen was able to effectively absorb IS, p-cresol and phosphate in an in vitro gastrointestinal tract simulation study. The animal study showed that CharXgen did not cause intestine blackening. Serum albuminand liver function did not change after feeding with CharXgen. Moreover, renal function was improved in CKD rats fed with CharXgen as compared to the CKD group, and there were no significant differences in the CKD and the CKD + AST-120 groups. Serum IS and PCS were higher in the CKD group and lower in rats treated with CharXgen and AST-120. In rats treated with CharXgen, Fibroblast growth factor 23 was significantly decreased as compared to the CKD group. This change cannot be found in rats fed with AST-120.It indicates that CharXgen is a new safe and non-toxic activated charcoal having potential in attenuating renal function deterioration and lowering protein-bound uraemic toxins. Whether the introduction of this new charcoal could further have renal protection in CKD patients will need to be investigated further.

How renal toxins respond to renal function deterioration and oral toxic adsorbent in pH‐controlled releasing capsule

“…21 Other toxin adsorbents are bare particles exposed to the digestive tract and cannot completely avoid the adsorption of small nutrient elements. 17 Second, the capsules ensure that this absorption extends not just to small molecules but also to larger substances bound to proteins, which are hard to remove. This broad-spectrum absorption can potentially play a pivotal role in mitigating the toxic accumulation often observed in CKD patients.…”

“…15 In addition to showing promise as better uremic markers, oral toxin adsorbents have shown some promise in mitigating the deleterious effects of accumulated toxins in CKD patients. 16,17 Recent studies have been aimed toward the development of drugs that have the potential to preserve renal function. These studies represent a significant shift from traditional symptomatic treatments for patients not undergoing dialysis to interventions that aim to address the underlying progression of the disease.…”

“…However, data on human trials are limited. 17 Despite the potential benefits of these adsorbents, their adoption has been constrained by several limitations. Both activated carbon adsorbents are uncoated and travel approximately 6-7 m through the oral cavity, esophagus, stomach, and small intestine until they reach the colon.…”

Intestinal microbiota dysbiosis in acute kidney injury: novel insights into mechanisms and promising therapeutic strategies

“…AST-120 reduces the level of IS-derived from tryptophan metabolism in plasma and uric levels and ameliorates CKD-induced endotoxemia and systemic inflammation [ 42 , 102 ]. Furthermore, CharXgen is a new activated and safe charcoal that lowers the level of protein-bound uremic toxins [ 103 ]. Thus, the application of carbon adsorbent might slow the chronic process of AKI.…”

Aromatic polypeptide amphiphiles for drug adsorption: a new approach for drug overdose treatment

“…For example, AC has been chemically modified to prevent accumulation in the gastrointestinal tract and to increase its adsorption capacity as a strategy to lower the effective dose. 25 Researchers have also investigated the adsorption properties of other highly porous natural materials, including smectite clays, zeolites, and mesoporous silica. 26–30 Furthermore, new macromolecular systems using nanocellulose, 31–33 genomic DNA-coated substrates, 34,35 or charged block copolymers 36–38 have been developed for drug adsorption applications, particularly with the goal of preventing off-target effects of chemotherapy drugs.…”