UW spinoff company trying to help diet of patients on feeding tubes

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Feeding tubes are lifesavers — literally.

When someone loses the ability to swallow, these life-giving devices provide essential nourishment to the body. More than 437,000 people in the U.S. depend on these, according to a recent Mayo Clinic study.

However, the therapy isn’t without side effects. In addition to losing the social element to ingestion,|component|element patients may experience cramping bloating and GI tract infection. The problems can range from bothersome to life threatening.

Now a startup firm, working to advance research performed at the University of Wisconsin-Madison, may provide a way to alleviate these symptoms with plant extracts — or more specifically the tannins they contain.

Tannins are found in nuts, grains, teas and especially fruits. Cranberries and grapes are especially|are rich in tannins, which can be realized by the puckering, drying feeling in your mouth|rich when you bite into fruit skin or drink wine|drink red wine or bite into fruit skin. A single fruit contains many distinct types of tannins.

Fruits and vegetables are a part of a healthy diet but are lacking in the liquid diets used in tube feeding formulas, said Christian Krueger, a co-founder of the business, Synesis. “We believe that adding tannin is a major step toward that more complete diet.”

Interestingly, tannins are categorized as “non-nutritive” because the body can’t break them down and absorb them. But like fiber, which is known to protect against cardiovascular disease, non-nutritive components in food may still provide health benefits.

The company’s current efforts expand on a 2013 study from UW-Madison that assessed the effects of tube feeding and cranberry tannins on the small intestines of mice. The intestines were of interest because they absorb nutrients and function within the immune system|serve as part of the system and absorb nutrients.

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“It’s probably pretty underappreciated that greater than 70 percent of the body’s immune system is connected with the digestive system,” said Krueger.

In healthy mice (and humans), the plump fingerlike villi that carpet the interior of the small intestines remain packed close together and coated in a thick layer of mucus. The mucus forms a physical and chemical barrier against the 100 trillion naturally occurring gut bacteria, food and some other pathogens passing through.

At the end of the UW-Madison experiment, the intestines of mice which were tube-fed formula had been compromised. Gaps had formed between the mucus and villi production. These changes diminished the organ response by decreasing its capacity to function as an effective barrier|ability|capacity|The immune response of the organ was diminished by these structural changes by reducing its ability to be an effective barrier|ability|capacity|By decreasing its capacity to function as an effective 19, the immune reaction of the organ was diminished by these structural changes|These changes impaired the immune reaction of the organ by decreasing its ability to function as an effective barrier|ability|capacity|By decreasing its ability to be an effective 19, these modifications impaired the immune reaction of the organ.

On the other hand, the small intestines of mice that were tube-fed formulas containing tannins looked almost indistinguishable from the healthful intestines of mice fed strong food.

More research has to be performed to understand exactly how tannins stimulate the small intestine and keep it functioning properly, though Krueger supposes that the result is partially due to the diversity of tannins found in plants.

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“The plant-derived tannin extract is causing the intestine to go on alert,” said Krueger. If the intestine sees the identical set of simple nutrients every day, as occurs with conventional formulas, it is not ready for a challenge|It’s not ready for a challenge as happens with conventional formulas if the intestine sees the same set of nutrients daily|It is not ready for a challenge if the intestine sees the same set of simple nutrients daily, as occurs with formulas|It’s not ready for a challenge, as happens with conventional formulas if the intestine sees the identical set of simple nutrients every day|It is not ready for a challenge, as happens with formulas, if the intestine sees the same set of nutrients daily. “If it sees novel things, the guards must pay attention.”

Since obtaining patent approval at the conclusion of 2016, Synesis has started designing a trial to check the effectiveness of tannin extracts in humans who use feeding tubes.

Positive results will allow tannins to be categorized as a “medical food” from the U.S. Food and Drug Administration. Medical foods are prescribed by a physician but are less regulated than drugs since they’re already “generally recognized as safe.”

Even if the trial results are promising, Lynn Koepke, a registered dietitian nutritionist in Home Care Medical Inc., cautions that insurance policy could limit accessibility to the product. Koepke has worked with patients who require tube feeding for over 25 years.

Medicare and Medicaid base reimbursement on the calories a remedy supplies. Since tannins are not digested and don’t provide calories|Tannins aren’t digested and don’t provide calories, since|Tannins aren’t digested and do not provide calories since, reimbursement could be insufficient to promote its use.

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Private insurance coverage can vary, said Koepke. Although some plans may treat formula as a medical expense, others “may consider formula no different that markets.”

Rather than being offered as a stand-alone item, “it would be optimal if the study results provided adequate clinical justification to have the tannins added to commercially-prepared formulas,” Koepke said. Maintaining manufacturing costs will inspire formula manufacturers to embrace the extract.

For now, Krueger is optimistic and expects to have a marketable product in another 18 months. “We aim to create results which are better than what’s on the market. Our objective is to improve health and quality of life.”

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