Document Detail

A tannic acid-based medical food, Cesinex(®), exhibits broad-spectrum antidiarrheal properties: a mechanistic and clinical study.
MedLine Citation:
PMID:  21748285     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The purpose of this investigation was to evaluate the efficacy and tolerability of a tannic acid-based medical food, Cesinex(®), in the treatment of diarrhea and to investigate the mechanisms underlying its antidiarrheal effect.
METHODS: Cesinex(®) was prescribed to six children and four adults with diarrhea. Patient records were retrospectively reviewed for the primary outcome. Cesinex(®) and its major component, tannic acid, were tested for their effects on cholera toxin-induced intestinal fluid secretion in mice. Polarized human gut epithelial cells (HT29-CL19A cells) were used to investigate the effects of tannic acid on epithelial barrier properties, transepithelial chloride secretion, and cell viability.
RESULTS: Successful resolution of diarrheal symptoms was reported in nine of ten patients receiving Cesinex(®). The treatment of HT29-CL19A cells with clinically relevant concentrations of tannic acid (0.01-1 mg/ml) significantly increased transepithelial resistance (TER) and inhibited the cystic fibrosis transmembrane conductance regulator (CFTR)-dependent or the calcium-activated Cl(-) secretion. Tannic acid could also improve the impaired epithelial barrier function induced by tumor necrosis factor alpha (TNFα) and inhibited the disrupting effect of TNFα on the epithelial barrier function in these cells. Cholera toxin (CTX)-induced mouse intestinal fluid secretion was significantly reduced by the administration of Cesinex(®) or tannic acid. Cesinex(®) has high antioxidant capacity.
CONCLUSIONS: Cesinex(®) demonstrates efficacy and a good safety profile in the treatment of diarrhea. The broad-spectrum antidiarrheal effect of Cesinex(®) can be attributed to a combination of factors: its ability to improve the epithelial barrier properties, to inhibit intestinal fluid secretion, and the high antioxidant capacity.
Aixia Ren; Weiqiang Zhang; Hugh Greg Thomas; Amy Barish; Stephen Berry; Jeffrey S Kiel; Anjaparavanda P Naren
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-07-12
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  57     ISSN:  1573-2568     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-09     Completed Date:  2012-02-28     Revised Date:  2014-09-14    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  99-108     Citation Subset:  AIM; IM    
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MeSH Terms
Administration, Oral
Antidiarrheals / administration & dosage,  pharmacology*,  therapeutic use*
Cell Line
Cell Membrane Permeability / drug effects*
Child, Preschool
Chlorides / metabolism
Cholera Toxin / adverse effects
Diarrhea / chemically induced,  drug therapy*,  metabolism
Disease Models, Animal
Dose-Response Relationship, Drug
Epithelial Cells / drug effects,  metabolism,  pathology
Gastrointestinal Tract / drug effects,  metabolism,  pathology*
HT29 Cells
Intestinal Secretions / drug effects
Mice, Inbred C57BL
Middle Aged
Retrospective Studies
Tannins / administration & dosage,  pharmacology*,  therapeutic use*
Treatment Outcome
Grant Support
Reg. No./Substance:
0/Antidiarrheals; 0/Chlorides; 0/Tannins; 9012-63-9/Cholera Toxin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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