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Abstract: FR-PO122

Superiority of ACF-TEI, a Novel Uremic Toxin Adsorbent, to Classical Oral Adsorbent in In Vitro and In Vivo Adsorption Profiles

Session Information

Category: CKD (Non-Dialysis)

  • 1903 CKD (Non-Dialysis): Mechanisms


  • Shirakura, Takashi, TEIJIN Pharma Limited, Hino, Tokyo, Japan
  • Shimoyama, Hiroshi, TEIJIN Pharma Limited, Hino, Tokyo, Japan
  • Nishiwaki, Yasumi, TEIJIN Pharma Limited, Hino, Tokyo, Japan
  • Hase, Kumiko, TEIJIN Pharma Limited, Hino, Tokyo, Japan
  • Takahashi, Yoshimasa, TEIJIN Pharma Limited, Hino, Tokyo, Japan
  • Nomura, Johji, TEIJIN Pharma Limited, Hino, Tokyo, Japan
  • Kobayashi, Tsunefumi, TEIJIN Pharma Limited, Hino, Tokyo, Japan

Uremic toxins (UTs) such as indoxyl sulfate (IS) accumulate in the blood of patients with impaired renal function. Since several observation studies have demonstrated a link between serum UT levels and clinical outcomes, UTs have much attention as key factors in the progression of chronic kidney diseases (CKDs) and cardiovascular diseases. Spherical activated carbon (AST-120) adsorbs UTs and those precursors such as indole in the intestinal tract and excretes them out of the body with feces, leading to reduce serum UT levels. Therefore AST-120 is effective in improving symptoms of uremia and delaying the introduction to dialysis in CKD patients. However, the oral adsorbents comprising AST-120 have insufficient adsorption performance and need to be taken at high daily doses. To improve their compliance and efficacy, we focused on activated carbon fiber (ACF) and have identified a novel and potent oral UT adsorbent, ACF-TEI. In this study, we analyzed in vitro adsorption profiles of ACF-TEI and compared in vivo efficacy of ACF-TEI and AST-120 on serum IS levels. We also evaluated the effects of ACF-TEI on renal fibrosis in rat model of kidney injury.


As for the in vitro adsorption profiles, we examined the adsorption of precursors including indole and p-cresol, and digestive enzymes. In in vivo studies, we compared the effects of ACF-TEI and AST-120 on serum IS concentrations in rat model of CKD and dog model treated with tryptophan, a precursor of indole. To evaluate the effects on renal fibrosis, cisplatin-induced nephrotoxicity (CDDP) model were used.


Compared with AST-120, ACF-TEI showed more potent capacity and speed in adsorbing the UT precursors. ACF-TEI had a low capacity to adsorb digestive enzymes and the capacity was comparable to that of AST-120. In rats and dogs, ACF-TEI reduced serum IS levels more potent than AST-120. ACF-TEI decreased serum and renal IS levels, urinary excretion of KIM-1, and a-SMA expression in CDDP model.


The adsorption capacity and efficiency of ACF-TEI were superior to AST-120. In addition, ACF-TEI reduced the serum IS levels more potent than AST-120 in in vivo models. Thus, ACF-TEI is expected to show more beneficial effects than AST-120 in clinical.