Effects of N-Trans Caffeoyltyramine and N-Trans Feruloyltyramine supplementation in individuals with diarrhea predominant-irritable bowel syndrome: Randomized, double-blind, placebo-controlled trial

Abstract

Objective: This clinical trial investigated the effects of 3-week ingestion of a proprietary gut health supplement containing the bioactives N-trans caffeoyltyramine (NCT) and N-trans feruloyltyramine (NFT), on intestinal barrier function and on severity of GI symptoms in individuals with diarrhea-predominant irritable bowel syndrome (IBS-D). 

Methods: Participants included 29 males and females who met the ROME IV criteria for IBS-D, having lipopolysaccharide (LPS) levels >0.21 ng/ml, and experiencing symptoms related to IBS-D. A randomized, double-blind, placebo-controlled, parallel design was used with a 3-week supplementation period with a dietary supplement providing 120mg of NCT and NFT. The primary outcome measure was Lactulose/Mannitol (L/M) ratio, a measure of intestinal permeability. Secondary endpoints included changes in other biomarkers of intestinal permeability (serum LPS, LBP, sCD14, Zonulin, LCN2) and subjective changes in stool frequency and consistency using the Bristol Stool Chart and bloating and abdominal pain using the IBS Symptom Severity Scale (IBS-SSS). 

Results: The NCT/NFT supplementation group showed significant improvements in L/M ratio (p=0.048), lipopolysaccharide-binding protein (LBP) levels (p=0.018), and the IBS-SSS abdominal distention scores (p=0.044) compared to the placebo group, demonstrating improvement in gut barrier integrity and GI comfort. No between-group differences were found for other endpoints. No adverse events were reported, and study compliance was high. 

Conclusions: NCT/NFT intake for 3 weeks led to a significant improvement in L/M ratio, LBP, and IBS-SSS abdominal distention scores, and a trend for a decrease in abdominal pain scores, thereby demonstrating marked improvement in both objective and subjective outcomes supporting gut barrier function. This proprietary gut health supplement shows promise for restoring a healthy gut barrier.

Novelty of the Study: This study is among the first randomized, double-blind, placebo-controlled clinical trials to evaluate the effects of N-trans caffeoyltyramine (NCT) and N-trans feruloyltyramine (NFT) supplementation on gut barrier function in individuals with gut barrier compromise, as in the case of IBS-D. While prior research has focused on symptom management in cases of high gut permeability, this study uniquely integrates both objective (e.g., L/M ratio, LBP) and subjective (e.g., IBS-SSS scores) endpoints, providing a comprehensive assessment of gut integrity restoration through novel bioactive compounds. The findings introduce a new direction for bioactive supplementation targeting gut barrier dysfunction.

Keywords: irritable bowel syndrome, dietary supplements, N-trans caffeoyltyramine, N-trans feruloyltyramine, gut barrier function, intestinal permeability