Co-administration of the health food supplement, bovine colostrum, reduces the acute non-steroidal anti-inflammatory drug-induced increase in intestinal permeability

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are effective analgesics but cause gastrointestinal injury. Present prophylactic measures are suboptimal and novel therapies are required. Bovine colostrum is a cheap, readily available source of growth factors, which reduces gastrointestinal injury in rats and mice. We therefore examined whether spray-dried, defatted colostrum could reduce the rise in gut permeability (a non-invasive marker of intestinal injury) caused by NSAIDs in volunteers and patients taking NSAIDs for clinical reasons. Healthy male volunteers (n=7) participated in a randomized crossover trial comparing changes in gut permeability (lactulose/rhamnose ratios) before and after 5 days of 50 mg of indomethacin three times daily (tds) per oral with colostrum (125 ml, tds) or whey protein (control) co-administration. A second study examined the effect of colostral and control solutions (125 ml, tds for 7 days) on gut permeability in patients (n=15) taking a substantial, regular dose of an NSAID for clinical reasons. For both studies, there was a 2 week washout period between treatment arms. In volunteers, indomethacin caused a 3-fold increase in gut permeability in the control arm (lactulose/rhamnose ratio 0.36+/-0.07 prior to indomethacin and 1.17+/-0.25 on day 5, P<0.01), whereas no significant increase in permeability was seen when colostrum was co-administered. In patients taking long-term NSAID treatment, initial permeability ratios were low (0.13+/-0.02), despite continuing on the drug, and permeability was not influenced by co-administration of test solutions. These studies provide preliminary evidence that bovine colostrum, which is already currently available as an over-the-counter preparation, may provide a novel approach to the prevention of NSAID-induced gastrointestinal damage in humans.

Recombinant human lactoferrin ingestion attenuates indomethacin-induced enteropathy in vivo in healthy volunteers

“…Colostrum supplementation during 7 days inhibited the indomethacin-induced hyperpermeability of the small intestine seen after 5 days of indomethacin intake compared to placebo. The placebo solution was an isoproteinaceous whey solution free of a number of growth factors that are present in the colostrum (Playford et al, 2001). No information was available about lactoferrin contents of the solutions used in this study.…”

Potential benefits of colostrum in gastrointestinal diseases

“…Some authors have reported lactose intolerance, nausea, flatulence, transient diarrhoea and unspecified abdominal discomfort as possible side effects while other studies specifically reported the absence of side effects (83,128,129,165,137,143,189,190). However, further research is required in order to confirm these data, and, more importantly, to evaluate the effects of colostrum when used for a prolonged periods of time and during pregnancy.…”

“…Colostrum reduces gastric and intestinal lesions, permeability of the intestinal wall, bacterial translocation and shortening of villi (124,137,138). In human volunteers, the co-administration of BC and indomethacin reduced gut permeability in respect to the control group that only received the anti-inflammatory drug (137). Kim et al, showed that the combined administration of BC and diclofenac in rats reduced the increase in intestinal permeability, changes of microbiota and villous damage caused by diclofenac (138).…”

“…Furthermore, an in vitro study showed that BC increased proliferation and cell migration of RIE-1 and HT-29 cells (136). Colostrum reduces gastric and intestinal lesions, permeability of the intestinal wall, bacterial translocation and shortening of villi (124,137,138). In human volunteers, the co-administration of BC and indomethacin reduced gut permeability in respect to the control group that only received the anti-inflammatory drug (137).…”

Nutritional and Physical Activity Interventions to Improve Immunity

“…[141][142][143][144][145][146][147] Bovine colostrum supplementation has also be shown to reduce or blunt the increase in intestinal permeability induced by heat stress or the administration of non-steroidal antiinflammatory drugs (NSAIDs, which are known to have detrimental effects on the gut). [148][149][150] As previously mentioned, in vitro (and ex vivo) markers of immune function are valuable to help identify potential mechanisms of action but in vivo and clinically relevant markers are more valuable. 59,60 In two comprehensive reviews on the assessment of immune functions in healthy human subjects (in nutrition and immunity studies) by Albers et al 59,60 a general consensus was that challenge-type tests, including vaccine-specific antibody production, are the most highly rated (and valuable) measures, considering biological relevance, sensitivity and feasibility.…”