By Rebecca Campbell-Smith BAppSc (Nat), GradDip (Nat) from the BioMedica Nutraceuticals Technical Support Team

The functional integrity of the gastrointestinal mucosa relies on the coordinated regulation of mucus layers, the intracellular tight junctions, epithelial cells, and the host’s innate and adaptive immune response which serve as protective barriers from external insults.¹ Alterations or damage to the various components of the intestinal barrier can have significant consequences contributing to the incidence of infection and inflammation.² Inadequate intake of certain nutrients particularly amino acids, have been shown to impair the physical integrity and growth of the intestinal epithelium and alter immune response.³ During times of increased stress, physical trauma, severe infection or other pathological conditions, there may be an increase in tissue requirements and therefore the need for supplementation.^3,4

Understanding the Intricacies of GAGs and the Extracellular Matrix

Abundant in the intestinal mucin and the mucosa, including the basement membrane, lamina propria and submucosa; glycosaminoglycan’s (GAGs) are components of glycoproteins and proteoglycans.⁵ The specific GAGs of physiological significance are hyaluronic acid, dermatan sulfate, chondroitin sulfate, heparin, heparan sulfate, and keratan sulfate.⁶

Proteoglycans and GAGs are critical to support and organise the extracellular matrix; participating in cell-cell and cell-matrix interactions, cellular proliferation, cellular migration and cytokine and growth factor signalling associated with wound healing.⁷ With a high negative charge, GAGs function as an electrostatic and mechanical barrier involved in the regulation of vascular and extracellular matrix permeability, defence against the penetration of infective agents, antigenic protein moieties, toxins and extravasation of fluids.^8,9

Due to their hydrophilic nature, GAGs form a highly hydrated gel like substance in which fibrous proteins such as collagen, elastin, fibronectin and laminin are embedded. GAGs are important for the maintenance of tissue turgor and the structural integrity of the intestine.^8,10 GAGs present in the mucin glycoproteins are responsible for viscous gel-like properties of the mucus.¹¹

Supporting GAGs with Supplementation

N-acetyl glucosamine (NAG) is an acetylated derivative of glucosamine and an essential precursor in the synthesis of GAGs.¹² As the degradation of GAGs has been associated with inflammatory bowel disease (IBD), studies have looked into the use of NAG supplementation as a potential therapy.⁸ Preliminary evidence to support the benefit of oral NAG as an adjuvant therapy

for paediatric chronic IBD has been demonstrated in a pilot study.¹³ At 3-6g daily given in three divided doses, subjects experienced significant improvement in symptoms and histology with an increase of epithelial and lamina propria GAGs as well as intracellular NAG.¹³ Further to this, a 2015 pragmatic open-label clinical trial in adults with IBD also found significant improvement in symptoms of abdominal pain, diarrhoea, nausea, passage of mucus, and rectal bleeding, following four weeks of oral NAG supplementation at 2g three times daily.¹⁴ The results of this trial are promising, however further placebo controlled trials are required to confirm these findings.

Beyond Glutamine: Amino acid prescribing considerations

The intestines are a major site for amino acid utilisation and metabolism accounting for 25-50% of whole protein turnover.⁴ Amino acids of particular importance to the structure and function of the intestinal mucosa are presented in the table below.

Threonine	•An essential amino acid required to support the structural integrity and function of the intestinal mucosa4,15 •A major component of mucin, the key component of intestinal mucus, along with serine and proline4,15
Glutamine	•Supports the structural integrity of the small intestine epithelium by stimulating enterocyte proliferation, supporting cell survival and serving as an important fuel source for rapidly dividing epithelial and immune cells17 •Aids the production of glutathione and heat shock proteins in the small intestine which both support intestinal homeostasis17
Proline	•A major component of both intestinal mucin and collagen; the main fibrous protein found in the extracellular matrix
Serine	•A major component of the protein backbone of mucin15
Glycine	•A component of the fibrous proteins found in the extracellular matrix tissue and a precursor for the production of glutathione in the small intestine mucosa15,16

References available on request.

About BioMedica Nutraceuticals

BioMedica is an Australian company synonymous with exceptionally high quality nutraceuticals developed by practitioners for practitioners. Now also based in the UK, BioMedica’s growing reputation is founded upon quality, efficacy, and unique no to low excipient formulations. Our products are produced to pharmaceutical standards enforced by Australia’s GMP and TGA guidelines. GMP quality controls ensure what’s on the label, is what’s in the formula.

Australia’s fastest growing ‘Practitioner Only’ Nutraceutical company, BioMedica’s ‘Strictly Practitioner Only’ products are only available to qualified healthcare practitioners in a clinical setting.

BioMedica offers a comprehensive selection of core dispensary formulas, as well as those developed specifically to support various common clinical presentations. Our products feature in Australian clinics specialising in fertility, adrenal health, gastrointestinal health, and oncology support. Our unique clinical range is available in the UK from The Natural Dispensary.

Tanya Kwiez Circosta (MSc-Nut, BHSc, ND) is the UK Practitioner Consultant for BioMedica Nutraceuticals

Tanya is a qualified Nutritionist and Naturopath with over 9 years’ experience consulting within the healthcare industry. Tanya has a Masters of Human Nutrition and Masters in International Development. Highly dedicated to the natural therapies industry, Tanya is excited to be bringing BioMedica’s ‘Strictly Practitioner Only’ product range to UK practitioners.

To arrange a visit from our qualified technical representative please contact Tanya:

Phone: 07511 533 979 or
[email protected]
www.biomedica.uk.com