A multi-mineral intervention is associated with improved intestinal permeability in patients with ulcerative colitis: results from a pilot trial.

INTRODUCTION

Previous studies have shown that Aquamin®, a multi-mineral extract from red marine algae, enhances gut barrier protein expression in the human colon. Here we carried out an exploratory study aimed at generating support for Aquamin® 's ability to affect gastrointestinal permeability.

METHODS

Subjects with mild ulcerative colitis (UC) or UC in remission and healthy controls were enrolled in an open-label, pilot-phase trial and received Aquamin® capsules (800 mg calcium/day) for 90 days. Intestinal permeability was evaluated before and after the 90-day intervention by urinary mannitol excretion after ingestion of a 5 g mannitol solution, with collections across several time intervals (pre-drink, 0-2 h, 2-8 h, and 8-24 h). The primary outcome was the change in mannitol excretion. Serum samples were also collected to assess liver and renal function.

RESULTS

In this pilot study (NCT04855799), which included UC patients and healthy controls (n = 8 per group), baseline urine mannitol levels in the 0-2 h sample were 54% higher in UC patients compared to healthy subjects (p = 0.006). Following 90 days of Aquamin® supplementation, urinary mannitol levels in UC patients decreased by 28, 26, and 41% at the 0-2 h, 2-8 h, and 8-24 h time points, respectively; the reduction at the 0-2 h interval reached statistical significance (p = 0.015). Overall, Aquamin® supplementation reduced total post-intervention mannitol excretion by 29% (p = 0.024). Aquamin® was well tolerated, with no serious adverse events reported. Consistent with our earlier findings, the serum metabolic panel revealed a modest but statistically significant reduction in alkaline phosphatase levels after 90 days of intervention.

CONCLUSION

Results from this exploratory study provide preliminary evidence that Aquamin® supplementation is associated with improved gut barrier function in UC patients. These findings support further investigation of Aquamin® as a safe and promising adjunct to current UC management strategies, with potential utility as a barrier therapy in UC.

CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/study/NCT04855799, identifier NCT04855799.