N-acetyl Glucosamine

The protective mucus in the gastrointestinal tract consists of glycoproteins, a protein backbone with carbohydrate side chains. Half of these carbohydrate side chains consist of N-acetyl glucosamine (NAG). Glucosamine synthetase is the rate-limiting enzyme in NAG synthesis. Decreased glucosamine synthetase activity has been noted in biopsy tissue from IBD patients -- both Crohn's Disease and Ulcerative Colitis -- only in inflamed tissue with loss of epithelial cells. In patients with Crohn's Disease, elevated levels of glucosamine synthetase were found in nondiseased tissue, providing a diagnostic tool when involved tissue is not viewable on colonoscopy.²⁵²

A phase 1, open-label trial was conducted on 12 children with IBD (10 with Crohn's Disease; 2 with Ulcerative Colitis). Oral doses of NAG ranged from 3-6 g daily in three divided doses. The children had severe disease, some refractory to conventional treatments. Six Crohn's Disease patients and two Ulcerative Colitis patients responded favorably to treatment and were followed for as long as three years. Improvements included marked clinical, histological, and stricture improvements, with establishment and maintenance of remission.²⁵³



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