title: 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.
authors.affiliation: Department of Gastroenterology, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London W120NN, UK. r.playford@ic.ac.uk
authors.forename: R J
authors.initials: RJ
authors.lastname: Playford
authors.forename: C E
authors.initials: CE
authors.lastname: MacDonald
authors.forename: D P
authors.initials: DP
authors.lastname: Calnan
authors.forename: D N
authors.initials: DN
authors.lastname: Floyd
authors.forename: T
authors.initials: T
authors.lastname: Podas
authors.forename: W
authors.initials: W
authors.lastname: Johnson
authors.forename: A C
authors.initials: AC
authors.lastname: Wicks
authors.forename: O
authors.initials: O
authors.lastname: Bashir
authors.forename: T
authors.initials: T
authors.lastname: Marchbank
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D002417:Cattle; D003126:Colostrum; D018592:Cross-Over Studies; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000009:adverse effects; D007408:Intestinal Absorption / Q000187:drug effects; D007410:Intestinal Diseases / Q000139:chemically induced / Q000517:prevention & control*; D007413:Intestinal Mucosa / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010539:Permeability / Q000187:drug effects
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007213:Indomethacin