Enterosorbents in modern medicine: mechanisms of action, effectiveness and clinical application
DOI:
https://doi.org/10.15574/SP.2025.2(146).6977Keywords:
enterosorbents, silicon dioxide, toxins, intoxication, treatmentAbstract
The use of enterosorbents is widespread in modern medical practice — both in emergency care for acute intoxications and in the treatment of chronic diseases, including disorders of the digestive and urinary systems, helminthiases, and allergic conditions.
Aim - to analyze current scientific data on enterosorbents; assess their effectiveness and safety, and provide recommendations on the choice of drugs for clinical use.
Deterioration of the ecological situation and increasing environmental pollution contribute to the accumulation of exotoxins in the human body, overwhelming natural detoxification systems and leading to increased morbidity and mortality. Therefore, the search for effective and safe preparations with high sorption capacity and selectivity remains highly relevant. The administration of enterosorbents should take into account their efficacy, safety, and pharmacological properties. This article reviews current scientific data on the mechanisms of action of enterosorbents, their clinical application, efficacy, and criteria for selecting an appropriate preparation for medical use.
Conclusions. The most effective today are silicon-containing enterosorbents of the IV generation based on highly dispersed silicon dioxide, which have high sorption activity, demonstrate selectivity of action - bind toxins without affecting vitamins and trace elements, have cytoprotective and bacteriostatic effects, are completely excreted from the body, and are approved for use in pregnant women, breastfeeding women, and children.
The authors declare no conflict of interest.
References
Aguilar F, Charrondiere UR, Dusemund B, Galtier P, Gilbert J, Gott DM et al. (2009). Scientific opinion of the panel on food additives and nutrient sources added to food on calcium silicate, silicon dioxide and silicic acid gel added for nutritional purposes to food supplements following a request from the European Commission. EFSA J. 1132: 1-24. https://doi.org/10.2903/j.efsa.2009.1132
Amirah MN, Afiza AS, Faizal WIW, Nurliyana MH, Laili S. (2013). Human health risk assessment of metal contamination through consumption of fish, J. Environ. Pollut. Human Health. 1: 1-5: https://doi.org/10.12691/jephh-1-1-1.
Ayangbenro AS, Babalola OO. (2017). A new strategy for heavy metal polluted environments: a review of microbial biosorbents, Int. J. Environ. Res. Public Health. 14: 94. https://doi.org/10.3390/ijerph14010094; PMid:28106848 PMCid:PMC5295344
Basaleh AA, Al-Malack MH, Saleh TA. (2021, Nov). Polyamide-baghouse dust nanocomposite for removal of methylene blue and metals; characterization, kinetic, thermodynamic and regeneration, Chin. J. Chem. Eng. 39: 112-125. https://doi.org/10.1016/j.cjche.2020.08.050
Batool A, Saleh TA. (2020). Removal of toxic metals from wastewater in constructed wetlands as a green technology; catalyst role of substrates and chelators, Ecotoxicol. Environ. Saf. 189: 109924. https://doi.org/10.1016/j.ecoenv.2019.109924; PMid:31759740
Berezhnoy VV, Korneva VV, Kozachuk VG, Kurylo LV et al. (2012). Acetonemic syndrome of children - tactical steps of a practitioner. Sovremennaya pediatriya. 2(42): 1-7.
Bezdetko TV, Khokhuda ON. (2013). Evaluation of the efficacy and safety of the enterosorbent Atoxil in the complex treatment of urticaria. Clinical immunology. Allergology. Infectology. 5(64): 37-39.
Bobyr VV, Stechenko LO, Shirobokov VP, Nazarchuk OA, Rymsha OV. (2020). The role of sorbents and probiotics in prevention of structural and morphological disorders in the small intestine of animals developing in dysbiosis. Rep Morphol. 26(2): 45-50. https://doi.org/10.31393/morphology-journal-2020-26(2)-07
Briffa J, Sinagra E, Blundell R. (2020). Heavy metal pollution in the environment and their toxicological effects on humans. Heliyon. 6: e04691. https://doi.org/10.1016/j.heliyon.2020.e04691; PMid:32964150 PMCid:PMC7490536
Budnyak TM, Vlasova NN, Golovkova LP, Slabon A, Tertykh VA. (2019). Bile acids adsorption by chitoan-fumed silica enterosorbent, Colloid Interface Sci. Commun. 32: 100194. https://doi.org/10.1016/j.colcom.2019.100194
Chuiko AA. (2003). Medicinal chemistry and clinical use of silicon dioxide. Kyiv: Izdatelstvo Naukova Dumka: 416.
Fatullayeva S, Tagiyev D, Zeynalov N. (2021). A review on enterosorbents and their application in clinical practice: Removal of toxic metals. Colloid and Interface Science Communications. 45: 1-11. https://doi.org/10.1016/j.colcom.2021.100545
Fruijtier-Pölloth C. (2016). The safety of nanostructured synthetic amorphous silica (SAS) as a food additive (E 551). Arch Toxicol. 90: 2885-2916. https://doi.org/10.1007/s00204-016-1850-4; PMid:27699444 PMCid:PMC5104814
Gerashchenko I. (2018). Comparative assessment of the ability of enterosorbents to bind substances of protein nature. Modern pharmacy. 9: 28-34.
Gmoshinski IV, Shipelin VA, Shumakova AA, Trushina EN, Mustafina OK, Safenkova IV et al. (2020). Toxicity evaluation of nanostructured silica orally administered to rats: influence on immune system function. Nanomaterials 10: 2126. https://doi.org/10.3390/nano10112126; PMid:33114664 PMCid:PMC7693904
Howell CA, Markaryan EN, Mikhalovsky SV. (2020). Oral intestinal adsorbents - are they the next therapy for acute diarrhea in children: A mini review. Ann Pediatr Child Health. 8(8): 1202.
Jaishankar M, Tseten T, Anbalagan N, Mathew BB, Beeregowda KN. (2014). Toxicity, mechanism and health effects of some heavy metals, Interdiscip. Toxicol. 7: 60-72. https://doi.org/10.2478/intox-2014-0009; PMid:26109881 PMCid:PMC4427717
Janczura M, Lulinski P, Sobiech M. (2021). Imprinting technology for effective sorbent fabrication: current state-of-art and future prospects. Materials. 14(8): 1850. https://doi.org/10.3390/ma14081850; PMid:33917896 PMCid:PMC8068262
Kemppinen A, Howell C, Allgar V, Dodd M, Gregson J, Knowles C et al. (2020). Randomised, double- blind, placebo controlled multi-centre study to assess the efficacy, tolerability and safety of Enterosgel® in the treatment of irritable bowel syndrome with diarrhoea (IBS-D) in adults. Trials. 21: 132. https://doi.org/10.1186/s13063-020-4069-x; PMid:32000822 PMCid:PMC6993329
Korneva VV, Kurylo LV, Kozachuk VG. (2011). Evaluation of efficacy of atoxil enterosorbent in complex treatment of ascoridosis in children. Sovremennaya pediatriya. 3(37): 1-4.
Kucher SV, Lototsk OV. (2021). Inclusion of enterosorbents in anti-inflammatory therapy improve treatment effectiveness in copd patients during exacerbations, Ukr. Biochem. J. 2(93): 107-114. https://doi.org/10.15407/ubj93.02.107
Li X, Zhang Z, Fakhri A, Gupta V, Agarwal S. (2019). Adsorption and photocatalysis assisted optimization for drug removal by chitosan-glyoxal/ polyvinylpyrrolidone/MoS2 nanocomposites. Int. J. Biol. Macromol. 136: 469-475. https://doi.org/10.1016/j.ijbiomac.2019.06.003; PMid:31216449
Lototska CB. (2015). Justification of the use of enterosorbents in the treatment of endogenous intoxication syndrome in various diseases (literature review). Bukovyns′ kyy Medychnyy Visnyk. 19(1): 222-226. https://doi.org/10.24061/2413-0737.XIX.1.73.2015.52
Markovinovic' L, Knezovic' I, Kniewald T, Maric' LS, Trkulja V, Tesǒvic' G. (2020). Enteroadsorbent Polymethylsiloxane Polyhydrate vs. Probiotic Lactobacillus reuteri DSM 17938 in the Treatment of Rotaviral Gastroenteritis in Infants and Toddlers, a Randomized Controlled Trial. Front Pediatr. 8: 553960. https://doi.org/10.3389/fped.2020.553960; PMid:33409259 PMCid:PMC7781153
Mavumengwana V. (2020). Toxic metal implications on agricultural soils, plants, animals, aquatic life and human health, Int. J. Environ. Res. Public Health. 17: 2204. https://doi.org/10.3390/ijerph17072204; PMid:32218329 PMCid:PMC7178168
Morais S, Costa FG, Pereira ML. (2012). Heavy Metals and Human Health, Environmental Health - Emerging Issues and Practice. IntechOpen. https://doi.org/10.5772/29869
Nadraga OB, Lytvyn GO, Potsiluyko NM. (2011). The effectiveness of the use of the sorbent 'Atoxil' in the complex treatment of rotavirus gastroenteritis in young children. Sovremennaya pediatriya. 2(36): 138-142.
OECD. (2016). Silicon dioxide: summary of the dossier. OECD environment, health and safety publications. Series on the safety of manufactured nanomaterials. URL: https://www.oecd.org/en/publications/silicon-dioxide-summary-of-the-dossier_a8f621a4-en.html. https://doi.org/10.1787/a8f621a4-en
Okhotnikova EN, Mellina KV. (2012). The place of modern enterosorbtion in the treatment of children with allergic dermatoses. Sovremennaya pediatriya. 3(43): 1-5.
Protsak VV. (2019). The effectiveness of the use of enteroclin enterosorbent in combination with standard therapy in patients with atopic dermatitis in the stage of exacerbation with wetting. Visnyk ProblemBiolohiyi i Medytsyny 3(152): 177-180. https://doi.org/10.29254/2077-4214-2019-3-152-177-181
Saleh TA. (2020). Nanomaterials: classification, properties, and environmental toxicities, Environ. Technol. Innov. 20: 101067. https://doi.org/10.1016/j.eti.2020.101067
Sarnatskaya V, Mikhailenko V, Prokopenko I, Gerashchenko B, Shevchuk O, Yushko L et al. (2020). The effect of two formulations of carbon enterosorbents on oxidative stress indexes and molecular conformation of serum albumin in experimental animals exposed to CCl4, Heliyon. 6: e03126. https://doi.org/10.1016/j.heliyon.2019.e03126; PMid:32042939 PMCid:PMC7002792
Seisenbaeva GA, Ali LMA, Vardanyan A, Gary-Bobo M, Budnyak TM, Kessler VG et al. (2021). Mesoporous silica adsorbents modified with amino polycarboxylate ligands - functional characteristics, health and environmental effects. J Hazardous Materials. 406: 124698. https://doi.org/10.1016/j.jhazmat.2020.124698; PMid:33321316
Shadrin OG, Chernega NF, Lenchenko AV. (2011). Features of diagnostics and treatment of congenital liver diseases in young children. Neonatology, surgery and perinatal medicine. 1(2): 113-117. URL: http://nbuv.gov.ua/UJRN/Nkhpm_2011_1_2_28.
Shichkin VP, Kurchenko OV, Okhotnikova EN, Chopyak VV, Delfino DV. (2023, Oct 13). Enterosorbents in complex therapy of food allergies: a focus on digestive disorders and systemic toxicity in children. Front Immunol. 14: 1210481. https://doi.org/10.3389/fimmu.2023.1210481; PMid:37901242 PMCid:PMC10611465
Slavova TG, Radulova GM, Kralchevsky PA, Danov KD. (2020). Encapsulation of fragrances and oils by core-shell structures from silica nanoparticles, surfactant and polymer: Effect of particle size. Colloids Surfaces A: Physicochemical Eng Aspects. 606: 125558. https://doi.org/10.1016/j.colsurfa.2020.125558
Slowing I, Viveroescoto J, Wu C, Lin V. (2008). Mesoporous silica nanoparticles as controlled release drug delivery and gene transfection carriers. Adv Drug Delivery Rev. 60(11): 1278-1288. https://doi.org/10.1016/j.addr.2008.03.012; PMid:18514969
Teryoshin VA, Kruglova OV. (2015). Evaluation of the efficiency of enterosorbent White Coal® in patients with the diseases of hepatobiliary system. URL: http://www.pancreatology.com.ua/dat/var/journal/2015-3/09.pdf.
Tieroshyn V, Moroz L, Prishliak O, Shostakovich-Koretska L, Kruglova O, Gordienko L. (2020). Colloidal silicon dioxide in tablet form (Carbowhite) efficacy in patients with acute diarrhea: results of randomized, double-blind, placebo-controlled, multi- center study. Sci Rep. 10(1): 6344. https://doi.org/10.1038/s41598-020-62386-0; PMid:32286322 PMCid:PMC7156649
Tunakova YA, Faizullin RI, Valiev VS, Gabdrakhmanova GN. (2018) Creation of optimal combinations of biosorbents to eliminate excessive amounts of metals from the human body. BioNanoScience. 8: 574-580. https://doi.org/10.1007/s12668-018-0511-x
Vazquez M, Calatayud M, Piedra C, Chiocchetti G, Velez D, Devesa V. (2015): Toxic trace elements at gastrointestinal level, Food Chem. Toxicol. 86: 163-175. https://doi.org/10.1016/j.fct.2015.10.006; PMid:26482641
Younes M, Aggett P, Aguilar F, Dusemund B, FilipičM, Frutos MJ et al. (2018). EFSA Panel on Food Additives and Nutrient Sources added to Food (ANS). Re-evaluation of silicon dioxide (E 551) as a food additive. EFSA J. 16(1): 5088. https://doi.org/10.2903/j.efsa.2018.5088; PMid:32625658 PMCid:PMC7009582
Zuev N, Bukhanov V, Kuzubova E, Krut U, Shaydorova G et al. (2021). Enterosorbent based on montmorillonite as a promising tool in the treatment and prevention of intestinal disorders in pigs. BIOWeb of Conferences. 30: 02012. https://doi.org/10.1051/bioconf/20213002012
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