Role of laxative and antioxidant properties of Malva sylvestris leaves in constipation treatment

How do probiotics alleviate constipation? A narrative review of mechanisms

Constipation is a common gastrointestinal condition, which may occur at any age and affects countless people. The search for new treatments for constipation is ongoing as current drug treatments fail to provide fully satisfactory results. In recent years, probiotics have attracted much attention because of their demonstrated therapeutic efficacy and fewer side effects than pharmaceutical products. Many studies attempted to answer the question of how probiotics can alleviate constipation. It has been shown that different probiotic strains can alleviate constipation by different mechanisms. The mechanisms on probiotics in relieving constipation were associated with various aspects, including regulation of the gut microbiota composition, the level of short-chain fatty acids, aquaporin expression levels, neurotransmitters and hormone levels, inflammation, the intestinal environmental metabolic status, neurotrophic factor levels and the body's antioxidant levels. This paper summarizes the perception of the mechanisms on probiotics in relieving constipation and provides some suggestions on new research directions.

Effects of natural products on functional constipation: analysis of active ingredient and mechanism

Constipation is a prevalent clinical ailment of the gastrointestinal system, yet its pathogenesis remains ambiguous. Despite the availability of numerous treatment modalities, they are insufficient in resolving the issue for patients. This work conducted a comprehensive review of the existing literature pertaining to the utilization of natural products for the treatment of constipation, with a focus on the efficacy of natural products in treating constipation, and to provide a comprehensive summary of their underlying mechanisms of action. Upon conducting a thorough review of the extant literature, we found that natural products can effectively treat constipation as modern synthetic drugs and compounded drugs with acetylcholinesterase (AChE) effects, rich in fiber and mucus, and the effects of increasing the tension of the ileum and gastrointestinal tract muscle, mediating signaling pathways, cytokine, excitability of the smooth muscle of the gastrointestinal tract, and regulating the homeostasis of intestinal flora. However, there is a wide variety of natural products, and there are still relatively few studies; the composition of natural products is complex, and the mechanism of action of natural products cannot be clarified. In the future, we need to further improve the detailed mechanism of natural products for the treatment of constipation.

Structure characterization of polysaccharides from Cistanche deserticola and their neuroprotective effects against oxidative stress in slow transit constipation mice

Oxidative stress-induced enteric neuropathy is an important factor in slow transit constipation (STC). Cistanche deserticola crude polysaccharides (CDCP) are natural antioxidants with various biological activities. We prepared CDCP through water-extract and alcohol-precipitation methods. The structural characteristics of CDCP were analyzed by infrared spectroscopy and methylation analysis. The results showed that CDCP was primarily composed of (1 → 4)-linked glucans with minor amounts of pectic polysaccharides. Different doses of CDCP (100, 200, and 400 mg/kg) were administered to loperamide-induced STC mice to explore the therapeutic effects of CDCP. Compared with the untreated group, CDCP treatment significantly improved constipation symptoms, relevant gut-regulating peptides levels, colonic pathological damage, and colonic myenteric nerons injury. CDCP enhanced the antioxidant capacity by decreasing Malondialdehyde (MDA) content, increasing Superoxide Dismutase (SOD) activity and Reduced Glutathione (GSH) content. CDCP significantly reduced oxidative stress-induced injury by preserving mitochondrial function in the colonic myenteric plexus. Furthermore, the neuroprotective effects of CDCP might be associated with the Nrf2/Keap1 pathway. Thus, our findings first revealed the potential of CDCP to protect the colonic myenteric plexus against oxidative stress-induced damage in STC, establishing CDCP as promising candidates for natural medicine in the clinical management of STC.

Moringa oleifera Lam. Leaf improves constipation of rats induced by low-fiber-diet: A proteomics study

ETHNOPHARMACOLOGICAL RELEVANCE

The leaf of Moringa oleifera Lam., a medicinal and edible herb for thousands of years in Ayurveda, is used as Pancha (na) karma (purgative) during and after the body cleansing process, to treat constipation, reduce cholesterol and body weight.

AIM OF STUDY

The aim was to investigate the diarrhea effects and possible mechanism of M. oleifera leaves in constipation rats.

MATERIALS AND METHODS

The hot water extract of M. oleifera leaves (WEMOL) was prepared and analyzed using LC-20AT HPLC system. The constipated rat model was induced by feeding with low fiber diet for 21 days. After oral administration of WEMOL for 7 days, the excretion parameter analysis, gastro-intestinal propulsion, histological analysis by HE and Alcian blue staining, and gastrointestinal hormone in rat's digestive tract through ELISA were used to evaluate the laxative effect of WEMOL. Label-free quantitation (LFQ) with LC-MS/MS, bioinformatics and Western blot were used to discover and verify the signal pathways and key proteins of WEMOL related to diarrhea.

RESULTS

The contents of isoquercitrin and astragalin were 2.7 mg/g and 1.7 mg/g, respectively in WEMOL. The stool number, weight, and water content of constipation rats were significantly reduced, indicating model had been established successfully. WEMOL (1.25 and 2.5 g/kg) increased water content of feces and the levels of Gas, MTL, NPY in gastric antrum and VIP, SP in colon of constipation rats, improved the muscle layer thickness and mucin secretion of colon. The proteomics revealed a total of 1731 differential proteins and 9 signaling pathways, WEMOL increased the expression of Vamp2, Gnai3, and Prkacb.

CONCLUSIONS

The laxative mechanism of WEMOL maybe modulate the signaling pathways mediated by 5-HT and Ach receptors, related to gastrointestinal motility and intestinal fluid secretion. It can be considered as the scientific connotation of Pancha (na) karma of M. oleifera leaves in ayurveda.

Alleviation of loperamide-induced constipation with sticky rice fermented huangjiu by the regulation of serum neurotransmitters and gut microbiota

BACKGROUND

Huangjiu is an important component of traditional fermented food. It is produced by cereal fermentation. Sticky rice fermented huangjiu is an abundant source of polysaccharides, oligosaccharides, proteins, amino acids, and flavor compounds (POPAF), and it has been used as a dietary supplement and pharmaceutical ingredient. The purpose of this study is to explore the alleviation of constipation using sticky rice fermented huangjiu, with the aim of providing a basis for the nutritional treatment of constipation.

RESULTS

Sticky rice fermented huangjiu was more effective in the alleviation of constipation than same concentration of ethanol treatment on serum neurotransmitters, gut microbiota, and intestinal metabolites in this 17 days constipation mouse model. Compared with ethanol treatment, the administration of sticky rice fermented huangjiu to constipated mice increased gastrointestinal motility. It alleviated the decrease in motilin (27.94%), substance P (13.85%), gastrin (63.46%), 5-hydroxytryptamine (4.55%), and short-chain fatty acid (19.80%) levels, and alleviated the increase in somatostatin levels (9.54%). Furthermore, the administration of sticky rice fermented huangjiu regulated the microbiota-mediated gut ecology through alterations in the characteristic taxa.

CONCLUSION

The results reveal that sticky rice fermented huangjiu may alleviate loperamide-induced constipation by the regulation of serum neurotransmitters and gut microbiota. These findings reveal that huangjiu is endowed with many functional components by cereal fermentation, and the bioactive substances in huangjiu can be separated and applied for medical treatment or diet therapy in the future. © 2022 Society of Chemical Industry.

Chinese patent medicine shouhui tongbian capsule attenuated loperamide-induced constipation through modulating the gut microbiota in rat

ETHNOPHARMACOLOGICAL RELEVANCE

Shouhui tongbian capsule (SHTC) is a commercial Chinese patent medicine used in the treatment of constipation. However, its mechanism of action remains unclear.

AIM OF THE STUDY

The present study was undertaken to assess SHTC relieved effects on the clinical symptoms of loperamide (LOP) induced constipation in Sprague Dawley (SD) rat model and to clarify the relationship between the protective effect of SHTC on constipation and the gut microbiota.

MATERIALS AND METHODS

Constipation male SD rats models were induced with solution of LOP (1.5 mg/kg bw), and rats were treated with an oral dose of SHTC (35, 70 mg/kg bw) three times a day after successful modeling. All rats were assessed weekly by change in body weight, gastric emptying rate, fecal moisture content and wet/dry weight. Hematoxylin and eosin (H&E) were used to observe parts of the rats small intestine. The gut microbiota in colonic contents was analyzed using 16SrRNA gene sequencing. Contents of short-chain fatty acids (SCFAs) were analyzed by gas chromatography-mass spectrometer (GCMS).

RESULTS

The results confirmed the therapeutic effects of SHTC on constipation. Specifically, SHTC could alleviate the decrease in body weight, gastric emptying rate and fecal moisture content caused by LOP-induced constipation. The pathological damage of small intestine was significantly improved by H&E staining. Notably, SHTC increased the relative abundances of Lactobacillus and the ratio of Firmicutes to Bacteroides (F/B). In addition, the content of acetic acid and propionic acid was significantly increased in constipated rats fed with SHTC.

CONCLUSION

SHTC could ameliorate the development of LOP-induced constipation in rats by remodeling the structure of gut microbial community and regulating production of intestinal metabolites.

Extraction and Fractionation of Prokinetic Phytochemicals from Chrozophora tinctoria and Their Bioactivities

Chrozophora tinctoria is an annual plant of the family Euphorbiaceae, traditionally used as a laxative, a cathartic and an emetic. A methanolic extract of Chrozophora tinctoria (MEC) whole plant and an n-butanol fraction of Chrozophora tinctoria (NBFC) were analyzed by gas chromatography–mass spectrometry (GC-MS) to detect the phytochemicals. MEC and NBFC were tested for in vitro anti acetylcholinesterase (AChE) potential. The effect of both samples on intestinal propulsive movement and spasmolytic activity in the gastrointestinal tract (GIT) was also studied. About twelve compounds in MEC and three compounds in NBFC were tentatively identified through GC-MS. Some of them are compounds with known therapeutic activity, such as toluene; imipramine; undecane; 14-methyl-pentadecanoic acid methyl ester; and hexadecanoic acid. Both NBFC and MEC samples were checked for acute toxicity and were found to be highly toxic in a dose-dependent manner, causing diarrhea and emesis at 1 g/kg concentration in pigeons, with the highest lethargy and mortality above 3 g/kg. Both the samples of Chrozophora tinctoria revealed significant (p ≤ 0.01) laxative activity against metronidazole (7 mg/kg) and loperamide hydrochloride (4 mg/kg)-induced constipation. NBFC (81.18 ± 2.5%) and MEC (68.28 ± 2.4%) significantly increased charcoal meal intestinal transit compared to distal water (41.15 ± 4.3%). NBFC exhibited a significant relaxant effect (EC₅₀ = 3.40 ± 0.20 mg/mL) in spontaneous rabbit jejunum as compared to MEC (EC₅₀ = 4.34 ± 0.68 mg/kg). Similarly, the impact of NBFC on KCl-induced contraction was more significant than that of MEC (EC₅₀ values of 7.22 ± 0.06 mg/mL and 7.47 ± 0.57 mg/mL, respectively). The present study scientifically validates the folk use of Chrozophora tinctoria in the management of gastrointestinal diseases such as constipation. Further work is needed to isolate the phytochemicals that act as diarrheal agents in Chrozophora tinctoria.

Dose-dependent Action of Zingiber officinale on Colonic Dysmotility and Ex Vivo Spontaneous Intestinal Contraction Modulation

Ginger (Zingiber officinale) rhizomes are commonly used in foods and employed for many ailments including gastrointestinal disorders. Our main objective was to evaluate the effect of Zingiber officinale aqueous extract (ZOAE) on gastrointestinal (GI) physiological motility and colonic dysmotility. Thereby, Wistar rats were given loperamide (LP, 3 mg/kg, b.w.) and ZOAE (75, 150, and 300 mg/kg, b.w.) or yohimbine (YOH, 2 mg/kg, b.w.). ZOAE-action on intestinal secretion was assessed using Ussing chamber technique and intestinal motility with isometric transducer. GI-transit (GIT) and gastric emptying (GE) were evaluated with the charcoal meal test and the red phenol methods. ZOAE-bioactive components were analyzed by liquid chromatography-high resolution electrospray ionization mass spectrometry (LC-HRESIMS). Constipation was induced with LP and the different indicators such as stool composition, GIT, oxidative stress biological parameters, and colonic mucosa histological alteration were performed. Anti-constipation effect of ZOAE was confirmed on stool composition, GIT (53.42% to 85.57%), GE (55.47% to 98.88%), and re-established oxidative balance. ZOAE induces an amplitude increase of spontaneous intestinal contraction with EC50 of 10.52 μg/mL. No effect of ZOAE was observed on electrogenic transport of intestinal fluid. These findings suggest that ZOAE-bioactive candidates might exert an anti-constipation action and spontaneous intestinal contraction modulation.

Evaluation of the effect of prebiotic sesame candies on loperamide-induced constipation in mice

Constipation is one of the most common gastrointestinal tract symptoms. In this study, prebiotic sesame sugar (PSC) was prepared from isomalto-oligosaccharide, konjac glucomannan and sesame, and the relieving effect of PSC on constipation induced by loperamide was explored. The results showed that PSC treatment profoundly improved the defecation function and boosted intestinal motility. Moreover, PSC repaired gastrointestinal tissue injury and inflammation induced by constipation, which confirmed the effectiveness of PSC intervention in the treatment of constipation. The mechanism of PSC improving constipation might be that PSC improved the imbalance of gastrointestinal neurotransmitters and increased the content of short-chain fatty acids in feces. In conclusion, PSC dietotherapy could effectively alleviate the symptoms and lay a theoretical foundation for the development of an anti-constipation diet.

Prokinetic and Laxative Effects of Chrozophora tinctoria Whole Plant Extract

Chrozophora tinctoria (Euphorbiaceae) has been used as an emetic, anthelminthic, and cathartic agent in traditional medicine. We used gas chromatography-mass spectrometry (GC-MS) to characterize the composition of ethyl acetate (EAC) and dichloromethane (DCMC) fractions from the whole Chrozophora tinctoria plant. EAC and DCMC fractions were evaluated for acetylcholinesterase (AChE) inhibitory activity and acute toxicity. Their effects on intestinal propulsive movement and spasmogenic activity of the gastrointestinal tract (GIT) muscle were also assessed. The compounds detected in both fractions were mostly fatty acids, with about seven compounds in EAC and 10 in DCMC. These included pharmacologically active compounds such as imipramine, used to treat depression, or hexadecanoic acid methyl ester, an antioxidant. Both EAC and DCMC fractions inhibited acetylcholinesterase (AChE) activity with IC₅₀ values of 10 µg and 130 µg, respectively. Both the fractions were found to be toxic in a dose-dependent manner, inducing emesis at 0.5 g or higher and lethargy and mortality from 3–5 g upwards. Similarly, both of the fractions showed laxative activity in metronidazole- and loperamide-induced constipation models. EAC relaxed the intestinal muscle at a lower dose (1 mg/mL) than DCMC. Similarly, the EAC extract showed a significant relaxation effect (EC₅₀ = 0.67 ± 0.15 mg/mL) on KCL-induced contraction in rabbit jejunum as compared to DCMC (EC₅₀ = 5.04 ± 0.05 mg/kg). The present study strongly supports the folklore that this valuable plant is a cathartic agent. Further work is required to isolate and validate the bioactive compounds that act as diarrheal agents in Chrozophora tinctoria.

Extraction of Pectin from Orange Peel and Study of Its Protective Effect Against Loperamide-Induced Impaired Gastrointestinal Motor Functions and Oxidative Stress in Rats

Pectin is a polysaccharide attached to carbohydrates. These are substances exclusively of plant origin. The aim of the present study is to evaluate the laxative effects of orange peel pectin extract (OPPE) against constipation induced by loperamide (LOP) in rats. Rats were equally divided into six groups and treated daily 1 week as follows: Control, LOP (3 mg/kg, body weight [b.w.], Per Os [p.o.]), LOP+yohimbine (2 mg/kg, b.w., i.p.), and LOP+OPPE (6.25, 12.5, and 25 mg/kg, b.w., p.o.). At the end of the experiment, the effects of OPPE were assessed by fecal parameters (numbers, weight, and water content), gastrointestinal transit, gastric emptying, serum metabolic parameter changes, intestinal and colon mucosa oxidative stress, and the histological examination. The defecation test showed that administration of LOP (3 mg/kg, b.w., p.o.) leads to the production of remarkable constipation. Indeed, the number and water content of stools decreased (25.50 [n/24 h] and 29.86%) significantly (P < .05). Acute pretreatment with OPPE significantly and dose dependently accelerated the stool moistening and allowed an increase of stool weight (2.85, 3.61, 3.93 [g/24 h/rat]) as well as the frequency of defecation (47.36, 54.54, and 56.26 [n/24 h]). OPPE also significantly (P < .05) and dose dependently increased the intestinal motility (70.78%, 73.33%, and 75.01%) and gastric emptying. LOP-induced reduction (P < .05) of intestinal secretion was accompanied by a colonic and small bowel oxidative stress status and histological changes, which was attenuated by OPPE treatment. The findings of this study indicate that OPPE possesses an important role in the gastrointestinal motility regulation, and thus lend pharmacological credence to the suggested use of the natural pectin for the treatment, management, and/or control of constipation.

Phenolic Content and Antioxidant and Antimicrobial Activities of Malva sylvestris L., Malva oxyloba Boiss., Malva parviflora L., and Malva aegyptia L. Leaves Extract

Background. The plants brought by Arabs were of real therapeutic values. Ibn Al-Baitar, an Islamic scholar (pharmacist, botanist, and physician), in his encyclopedia wrote the detailed characterization of more than one thousand herbs describing their medicinal value, methods of preparation, and their route of administration. Objectives. The current investigation points towards the quantitative characterization of the phenolic contents among the four edible Malva plants species (Malva sylvestris L., Malva oxyloba Boiss., Malva parviflora L., and Malva aegyptia L.) and also towards assessing their antibacterial activity against one Gram-positive isolate (Staphylococcus aureus) and four Gram-negative strains Escherichia coli, Pseudomonas aeruginosa, Shigella sonnei, and Proteus vulgaris. It also aimed to evaluate the free radical scavenging activity of hexane, methanolic, aqueous, and acetone extracts of four Malva species. Methods. By utilizing the Folin–Ciocalteu procedure and gallic acid as a reference molecule, the phenolic contents were estimated. In addition, the broth microdilution method was used to evaluate four plants’ 16 extracts, and the DPPH (2,2-diphenyl-1-picrylhydrazyl) method was utilized to assess the abovementioned extracts against oxidative stress. Results. The results showed that the methanolic extract of M. oxyloba has the highest contents of phenols (191.54 ± 2.84 mg of GAE/g) and has the best antioxidant capacity with an IC50 value of 1.94 ± 1.84 µg/ml, which is very close to Trolox. Regarding the ferrous ion chelating activity of the extract, the methanolic extract of M. sylvestris exhibits appreciable activity with IC50 values of 52.7 ± 1.8 µg/ml. In addition, the plant extract and acetone extract of M. sylvestris showed a strong antibacterial activity with an MIC value of 0.0078 mg/ml. Conclusion. The methanolic extract of M. oxyloba has a pharmacological potential as a valuable natural product that can be utilized as a main ingredient in the design and development of new therapeutic formulations. It exerts multiple inhibitory properties against oxidative stress and bacterial growth. As such, it is emerging as a promising therapeutic agent for the treatment of various neurodegenerative diseases and many types of human infectious diseases.

A multiple-strain probiotic product provides a better enzymatic antioxidant response in individuals with constipation in a double-blind randomized controlled trial

OBJECTIVES

Probiotics may have beneficial effects on intestinal dysbiosis. However, the effects of probiotics on redox and inflammatory responses in intestinal constipation remain unknown. The aim of this study was to investigate the effect of a multiple-strain probiotic on the redox and inflammatory responses in individuals with intestinal constipation.

METHODS

A randomized, double-blind, placebo controlled clinical trial was conducted with individuals diagnosed with constipation (defined according to the Rome IV criteria). The participants were randomized into two groups to receive either a probiotic capsule (PC; n = 25) containing probiotic strains or to receive a control capsule (CC; n = 20) containing a matching placebo for 30 d. In the baseline and at the end of the study, biomarkers of the redox (malondialdehyde, carbonylated protein, antioxidant enzymes, and ferric-reducing antioxidant power) and inflammatory responses, and Rome IV criteria for constipation were analyzed.

RESULTS

The consumption of a multiple-strain probiotic attenuated the reduction of glutathione peroxidase (PC = -9.41 and CC = -19.60; P = 0.041) and glutathione-s-transferase activity (PC = -3.28 and CC = -12.08, P < 0.0001) in erythrocytes and marginally improved the symptom of feeling incomplete defecation in ≥25% of bowel movements, compared with the placebo group. No changes were observed in total antioxidant capacity, oxidative damage, and levels of inflammatory markers in the serum.

CONCLUSIONS

Our data suggested that a multiple-strain probiotic may provide a better enzymatic antioxidant response and partially alleviate the feeling of incomplete defecation in ≥25% of bowel movements in individuals with intestinal constipation.

Antioxidant activity and laxative effects of tannin-enriched extract of Ecklonia cava in loperamide-induced constipation of SD rats

To investigate the role of tannin-enriched extracts of Ecklonia cava (TEE) on the regulation of oxidative balance and laxative activity in chronic constipation, we investigated alterations after exposure to TEE, on constipation phenotypes, muscarinic cholinergic regulation, and oxidative stress responses in the transverse colons of SD rats with loperamide (Lop)-induced constipation. This extract contains high levels of total condensed tannin content (326.5 mg/g), and exhibited high inhibitory activity against 2,2-diphenyl-1-picrylhydrazyl (DPPH) radicals. TEE treatment induced significant improvements in reactive oxygen species (ROS) production, superoxide dismutase (SOD) expression and nuclear factor erythroid 2-related factor 2 (Nrf2) phosphorylation in primary smooth muscles of rat intestine cells (pRISMCs) and transverse colon of constipation model. Also, Lop+TEE treated groups showed alleviated outcomes for the following: most stool parameters, gastrointestinal transit, and intestine length were remarkably recovered; a similar recovery pattern was observed in the histopathological structure, mucin secretion, water channel expression and gastrointestinal hormones secretion in the transverse colon; expressions of muscarinic acetylcholine receptors M2/M3 (mAChR M2/M3) and their mediators on muscarinic cholinergic regulation were significantly recovered. Taken together, these results provide the first evidence that TEE stimulates oxidative stress modulation and muscarinic cholinergic regulation when exerting its laxative effects in chronic constipation models.

Aster tataricus alleviates constipation by antagonizing the binding of acetylcholine to muscarinic receptor and inhibiting Ca2+ influx

BACKGROUND

The dried root and rhizome of Aster tataricus (RA), is a traditional Chinese medicine has been used for more than 2000 years with the function of antitussive, expectorant and antiasthmatic. Ancient books and modern pharmacological researches demonstrated that RA may have the function of moistening intestines and relieving constipation, but there was a lack of systematic evidence. The aim of this study was to comprehensively evaluate the efficacy and possible mechanisms of ethanol extract of Aster tataricus (ATE) in treating constipation from in vivo to in vitro.

METHODS

In vivo, the ATE was studied in loperamide-induced constipation of mice. In vitro, different concentrations of ATE was tested separately or cumulatively on spontaneous and agonists-induced contractions of isolated rat duodenum strips.

RESULTS

In vivo, at doses of 0.16, 0.8 g/mL, ATE showed significantly promotion of the small intestinal charcoal transit, decrease of the amount of remnant fecal, and increase of the content of fecal water in colon. In addition, ATE could effectively relieve colonic pathological damage caused by loperamide as well. In vitro, with the cumulative concentration increase of ATE from 0.8 to 6.4 mg/mL, it could significantly decrease the contraction caused by KCl or Ach, and gradually restore to near base tension value.Meanwhile, it could also partially but significantly inhibit the contractions induced by Ach and CaCl2 on rat duodenum in a concentration related manner.

CONCLUSIONS

Taking all these findings together, it could be speculated that ATE may attenuate constipation mainly through antagonizing the binding of acetylcholine to muscarinic receptor, inhibiting Ca2+ influx and anti-inflammation.

Prevention of loperamide induced constipation in mice by KGM and the mechanisms of different gastrointestinal tract microbiota regulation

Constipation is one of the most prevalent gastrointestinal tract diseases. Konjac glucomannan (KGM) dietotherapy can effectively relieve the clinical symptoms of patients with constipation. However, the causal relationship among KGM, constipation and different gastrointestinal microbiome (i.e., the stomach {St}, small intestine {S}, and large intestine {L}) remains poorly understood. In this study, constipated mice were treated with KGM (75, 150, 300 mg/kg bw). Results showed that KGM treatment improved the general physiological state, fecal character, small intestinal propulsive rate, gastric emptying rate, MTL and AchE activities, ET-1, 5-HT, and NO levels, and SCFA concentrations. KGM in the diets of constipated mice reduced the diversity of St and S microbiota, while increased those in the L. The KGM intervention regulated the microbiota profile, which afterwards was closer to the normal mouse group: confirmation was provided by different changes of bacteria like Lactobacillus, Bifidobacterium and Allobaculum spp et al.

Circular RNA Involved in the Protective Effect of Malva sylvestris L. on Myocardial Ischemic/Re-Perfused Injury

Ischemic heart disease has become a major health challenge worldwide. Malva sylvestris L. (MS) is a traditional herbal medicine with anti-inflammatory properties and have been used as antioxidant and anti- inflammatory agent in infectious diseases and inflammatory diseases.In this study, we aimed at elucidating the mechanism of MS against ischemia-reperfusion (I/R)–induced injury in vivo and in vitro. The I/R animal model in rats and oxygen glucose deprivation/re-oxygenation (OGD/Re) model in H9c2 cells were used in this study. MS was used to pre-treat the rats and cells. Electrocardiogram, histology staining, qPCR, ELISA, CCK-8, and circRNA microarray were performed. We found that pre-treatment with MS extract attenuate OGD/Re-induced cell apoptosis and cell viability inhibition in H9c2 cells. In addition, pre-treatment with MS protected against I/R injury in vivo. The protective effects of MS pre-treatment were associated with inflammatory genes expression and cytokines release. Further mechanistic investigation revealed that MS protected cardiomyocytes through regulating circular RNA (circRNA). We identified a novel circRNA circ003593 that mediated the protective role of MS in vitro through NLRP3 complex, which was associated with reperfusion injury salvage kinase (RISK) signaling pathway. Conclusion: this study is the first time to demonstrate the protective role of MS on I/R injury. Our findings reveal a novel circRNA circ003593-mediated the protective role of MS through NLRP3 inflammasome. Circ003593 may serve as a potential therapeutic target for ischemic heart diseases.

High-Fat Diet Causes Constipation in Mice via Decreasing Colonic Mucus

BACKGROUND

Constipation is one of the most common gastrointestinal complaints. Although the causes of constipation are varied, dietary habits have a significant influence. Excessive fat intake is suggested as one of the main causes of constipation; however, the exact mechanism is unknown.

AIMS

To investigate whether a high-fat diet (HFD) causes constipation in mice and to clarify the underlying mechanism, focusing on the amount of colonic mucus.

METHODS

Six-week-old male C57BL/6 mice were randomly divided into two groups: mice fed with HFD and those with normal chow diet (NCD). Fecal weight, water content, total gastrointestinal transit time, and colon transit time were measured to determine whether the mice were constipated. The colonic mucus was evaluated by immunostaining and quantified by spectrometry. Malondialdehyde (MDA) was measured using the thiobarbituric acid (TBA) test as a marker for oxidative stress.

RESULTS

Compared to the NCD group, the weight of feces was less in the HFD group. In the functional experiment, the total gastrointestinal transit time and colon transit time were longer in the HFD group. Furthermore, HFD significantly reduced the amount of colonic mucus. In addition, the reduction in colonic mucus caused by surfactant resulted in constipation in the NCD group.

CONCLUSIONS

HFD causes constipation with delayed colon transit time possibly via the reduction in colonic mucus in mice.

Purgative/laxative actions of Globularia alypum aqueous extract on gastrointestinal-physiological function and against loperamide-induced constipation coupled to oxidative stress and inflammation in rats

BACKGROUND

Chronic constipation is a gastrointestinal functional disorder which affects patient quality of life. Therefore, many studies were oriented to search herbal laxative agents. In this study, we investigated the effect of Globularia alypum L. leaves aqueous extract (GAAE) against loperamide (LOP)-produced constipation.

METHODS

Animals were given LOP (3 mg/kg, b.w., i.p.) and GAAE (100, 200, and 400 mg/kg, b.w., p.o.) or yohimbine (2 mg/kg, b.w., i.p.), simultaneously, for 1 week. Gastric-emptying test and intestinal transit were determined. Colon histology was examined, and oxidative status was evaluated using biochemical-colorimetric methods.

KEY RESULTS

GAAE ameliorates significantly gastric emptying (64% to 76.5%) and intestinal transit (66.65% to 84.73%). LOP negatively influenced defecation parameters and generated a stress situation. GAAE administration in contrast ameliorated those parameters and re-established oxidative balance.

CONCLUSION

GAAE showed a modest action against oxidative stress and decreased LOP effect and thereby can be considered a pharmacological agent in constipation.

Laxative and antioxidant effects of ramie (Boehmeria nivea L.) leaf extract in experimental constipated rats

Ramie leaf (Boehmeria nivea L.) is rich in cellulose, polyphenol compounds, vitamin C, and minerals. The leaves of this plant, which are used for medicinal purposes, have long been reported to have anti-inflammatory, antioxidant, anticolitis, and antidiabetic effects. We investigated the protective effects of ramie leaf ethanol extract (RLE) against loperamide-induced constipation and oxidative stress in rats. Male Sprague-Dawley rats were administered 200 or 400 mg/kg body weight of RLE (RLEL and RLEH groups) by gavage, while normal (NOR) and control (CON) rats received saline. Loperamide (4.0 mg/kg, twice per day) was injected subcutaneously to induce constipation in RLEL, RLEH, and CON groups. Total fecal number, wet weight, and water content decreased, while the total number of loperamide-induced fecal pellets in the distal colon increased with administration of RLE in a dose-dependent manner. Gastrointestinal transit time was more greatly reduced in RLE-treated groups than in the CON group. Serum total cholesterol (TC) level, as well as alanine aminotransferase (ALT) and alkaline phosphatase (ALP) activity, was significantly lower in both RLEL and RLEH groups compared with the CON group. Intestinal mucosa malondialdehyde (MDA) and hydrogen peroxide (H2O2) production decreased significantly in a dose-dependent manner in the RLE-treated groups. Loperamide decreased the antioxidant enzyme activity, including that of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), while RLE administration increased the antioxidant activity. These results suggest that RLE exerts potent laxative and antioxidant effects in model rats with loperamide-induced constipation.

Antioxidant and laxative effects of taurine-xylose, a synthetic taurine-carbohydrate derivative, in loperamide-induced constipation in Sprague-Dawley rats

PURPOSE

In this study, we examined the in vitro antioxidant activities and laxative effects of taurine-xylose (T-X), a synthetic taurine-carbohydrate derivative, in a rat model of constipation induced by loperamide.

METHODS

The animals were divided into four treatment groups: normal untreated rats (NOR group), loperamide-treated control rats (CON group), loperamide and taurine-xylose (15 mg/kg)-treated rats (T-X group), and loperamide and commercial Dulcolax S (5.5 mg/kg)-treated rats (DS group).

RESULTS

In the present study, T-X exhibited potent reducing power and free radical scavenging activities for DPPH (1,1-diphenyl-2-picrylhydrazyl) and ABTS+ (2,2'-azino-bis (3-ethylbenzothiazoline 6-sulfonic acid ammonium salt) radicals. The laxative effects of T-X were dependent on food, body weight, fecal properties, gastrointestinal transit (GIT) ratio, and serum metabolic parameters. In the T-X group, the number, wet weight, and water content of fecal pellets were noticeably increased compared to those in the loperamide-induced group. T-X treatment significantly increased the activities of hepatic antioxidant enzymes, including those of glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), and catalase (CAT), relative to those in loperamide-induced constipated rats. Furthermore, the GIT ratio and loperamide-induced metabolic parameters in serum, including gastrin (GAS), motilin (MTL), and somatostatin (SS) levels, were significantly improved by T-X treatment.

CONCLUSION

These results suggest that taurine-xylose exerts antioxidant activities and laxative effects on loperamide-induced constipation by promoting gastrointestinal motility.

From plant selection by elephants to human and veterinary pharmacopeia of mahouts in Laos

ETHNOPHARMACOLOGICAL RELEVANCE

To what extent has animal observation contributed to the development of human pharmacopeias? We approach this question here through the study of mahouts' knowledge regarding the responses by elephants to their health problems, and the human medicinal uses of plants and the care of domestic animals that result from their observations.

MATERIALS AND METHODS

32 mahouts were interviewed in Thongmyxay district and 28 at the Elephant Conservation Center in the province of Xayabury. Interviews focused on the elephants' diet, health problems, plant items they consume in particular physiological or pathological contexts and the treatments that mahouts provide them. For each plant mentioned, the part of the plant consumed and mode of preparation and administration if used by mahouts were recorded. Species samples were then collected and later identified by specialists.

RESULTS

114 species were recorded as being consumed by elephants during interviews with mahouts and forest outings with them to collect samples. Twenty species were identified as used by elephants in particular pathological conditions or physiological states. According to interviewed mahouts, the consumption of certain plants improves the health of the elephant. We observed clear convergences between the observations interpreted by the mahouts as self-medication behaviour from elephants and their own medicinal practices (for human and veterinary purposes).

CONCLUSION

Beyond a mere reproduction of elephant self-medication behaviours observed, the human or veterinary medicinal cares derived from these observations are the result of complex arrangements integrating all available medicinal and conceptual resources into elaborate preparations. We recommend that mahouts' knowledge about traditional medicinal care given to elephants be further compiled, as it could have a beneficial impact on veterinary health care provided in elephant resorts and elephants' well-being.

Physicochemical properties and laxative effects of polysaccharides from Anemarrhena asphodeloides Bge. in loperamide-induced rats

ETHNOPHARMACOLOGICAL RELEVANCE

As a traditional Chinese herbal medicine, Anemarrhena asphodeloides Bge. possesses the effects of nourishing yin, moistening dryness, clearing lungs and relieving fire. Simultaneously, it has been used to treat constipation for more than one thousand years in China. However, modern medical studies are limited and lacking on its therapeutic mechanism.

AIM OF THE STUDY

This current study was aimed to investigate the laxative activities and explore the potential mechanism of Anemarrhena asphodeloides Bge. polysaccharides (AABP) in loperamide-induced constipation rats.

MATERIALS AND METHODS

The structure of AABP was determined by using infrared spectrum, high performance gel permeation chromatography (HPGPC), and high performance liquid chromatography (HPLC). Real-time quantitative polymerase chain reaction (PCR), multitudinous methods were adopted to explore the underlining therapeutic mechanism of AABP in treating constipation, including enzyme-linked immunosorbent assay (ELISA), histopathological, immunohistochemistry and western blotting.

RESULTS

In the present study, the average molecular weight of AABP was determined as 1.11 × 10³ kDa. The primary monosaccharide compositions were analyzed including D-mannose, L-rhamnose, D-galacturonic acid, D-glucose, D-galactose and L-arabinose (1, 0.04, 0.53, 0.11, 0.33, 0.25, respectively) by high-performance liquid chromatography (HPLC). AABP significantly increased the levels of gastrin (Gas), motilin (MTL), substance P (SP), 5-hydroxytryptamine (5-HT) and vasoactive intestinal peptide (VIP), and decreased the NO content of loperamide-induced rats to ameliorate constipation in the rats. Whilst, AABP repaired the damaged colons by regulating PCNA and ICAM-1 protein expressions. Additionally, AABP up-regulated the levels of SCF, c-Kit, AQP3 and VIP as well as down-regulated the expressions of AQP8, AQP4 and PGE2.

CONCLUSION

The present findings suggested that AABP were the laxative active ingredients isolated from Anemarrhena asphodeloides Bge., which could treat constipation through regulating the gastrointestinal hormones and neurotransmitters to improve the intestinal motility and water metabolism.

Effects of Lactobacillus plantarum CQPC01-fermented soybean milk on activated carbon-induced constipation through its antioxidant activity in mice

A newly found strain, Lactobacillus plantarum CQPC01 (LP-CQPC01), was used for soybean milk fermentation, and its effects against constipation were determined. LP-CQPC01-FSM (LP-CQPC01-fermented soybean milk) was found to have six kinds of soybean isoflavones; the isoflavones of LP-CQPC01-FSM were more than those of Lactobacillus bulgaricus-fermented soybean milk (LB-FSM) and unfermented soybean milk (U-FSM). Animal experiment showed that the MTL, Gas, ET, AchE, SP, VIP, and GSH levels in the constipated mice were increased; however, the SS, MPO, NO, and MDA levels in the constipated mice were reduced by soybean milk treatment. Further, LP-CQPC01-FSM increased the mRNA and protein expression of Cu/Zn-SOD, Mn-SOD, CAT, c-Kit, SCF, and GDNF and reduced the expression of TRPV1 and NOS relative to those of the mice with untreated constipation. LP-CQPC01 could be used as a new starter to produce high-quality soybean milk, which might be used as a functional drink.

Probiotics decrease depressive behaviors induced by constipation via activating the AKT signaling pathway

Chronic constipation is often accompanied by emotional disorders such as depression and anxiety. The aim of this study was to determine whether administration of a multispecies probiotic can decrease depressive behaviors through the gut-brain axis and identify any underlying mechanisms. A mouse model of constipation induced by loperamide (5 mg·kg^-1,i.p.) was used. For that purpose, 36 ICR male mice were divided into three groups: control, constipation and probiotic groups. The probiotic group received treatment with a probiotic once per day for 14 days via a gavage. All other groups were given an equal volume of normal saline. The fecal parameters and intestinal transit ratio were recorded. The forced swimming test and tail suspension test were used to detect changes in depressive behaviors. Total superoxide dismutase (T-SOD) activity and malondialdehyde (MDA) levels were measured by assay kits. We also detected neuronal survival, as well as phosphorylated Ser/Thr protein kinase (p-AKT), Bcl-2, Bcl-2 associated X protein (Bax) and cleaved caspase-3 levels in the hippocampus. The results showed that administration of a probiotic could ameliorate depressive behaviors and relieve neuronal cell injury in the hippocampal CA3 regions. Moreover, probiotic treatment decreased MDA levels and increased SOD activity. Furthermore, probiotic administration increased p-AKT and Bcl-2 levels in the hippocampus of the constipated mice, while decreasing the concentrations of Bax and cleaved caspase-3, so as to inhibit the neural apoptosis. In the present study, we confirm that probiotics can alleviate depression induced by constipation through protecting neuronal health via activation of the AKT signaling pathway.

The combination of Cassia obtusifolia L. and Foeniculum vulgare M. exhibits a laxative effect on loperamide-induced constipation of rats

Chronic constipation is a functional gastrointestinal disease that is detrimental to the quality of patient life. Cassia obtusifolia L. (CO) and Foeniculum vulgare M. (FV) are commonly used as medicinal foods in many countries. We aimed to examine the laxative effect and their underlying mechanism of CO and FV mixture on loperamide (lop)-induced constipated rats. To determine the laxative effects of these compounds, Sprague-Dawley rats were divided into six groups: the control, lop-induced constipated (2mg/kg), and three doses (100, 300, and 500mg/kg) of CO and FV mixture-, and Bisacodyl (bis, 3.3mg/kg)-treated groups. The mixture of CO and FV and bis were orally administered once a day for 4 weeks. For induction of constipation, the lop were treated with a dose of 2 mg/kg twice a day on the 3^rd week after treatments of CO and FV extracts and bis. The results were revealed that the CO and FV mixture has the laxative effects more than those in CO and FV-alone treatments on constipated rats by determining the stool parameters, including stool number and weight. Indeed, stool parameters, such as, stool number, weight, and water contents and colonic peristalsis from the intestinal transit length and ratio were dramatically improved by CO and FV mixture treatment. Histological study also revealed that CO and FV mixture enhanced the thicknesses of mucosa and muscular layers of the colon in constipated rats. For their underlying mechanism, the mRNAs and proteins expression of muscarinic acetylcholine receptors (mAchR) M2 and M3 and their downstream signaling were preserved by CO and FV mixture treatment in constipated rats. Therefore, this study suggests that treatment with CO and FV mixture has beneficial effects against constipation. We further suggest that CO and FV mixture may be utilized as an alternative therapeutic strategy for constipation.

Enteromorpha and polysaccharides from enteromorpha ameliorate loperamide-induced constipation in mice

Slow-transit constipation(STC)is a disease characterized by functional gastrointestinal disorder. Common laxatives used in clinical practice against constipation such as Senna have side effects. Enteromorpha(EP)is a common marine alga, and the polysaccharide extracted from EP has been reported possessing anti-cancer and anti-inflammation effects. The aim of this study is to investigate the effects of EP and Polysaccharides from Enteromorpha (PEP) on loperamide induced constipated mice model and illustrating mechanism of action. We investigated the effect of EP and PEP on fecal water content, defecation frequency and gastrointestinal transit (GI) time of loperamide-induced STC mice. In addition, serum Nitric Oxide (NO) content and vasoactive intestinal peptide receptor1 (VIPR1) as well as serotonin receptor (5-HT₄) expression in the distal colon were analyzed. Furthermore, we determined the role of EP and PEP on microbiota distribution using stool genomic 16S rRNA sequencing. EP and PEP significantly enhanced intestinal motility function, and alleviated constipation associated intestinal inflammation. Moreover, EP and PEP significantly decreased serum NO concentration, down-regulated VIPR1 expression and up-regulated 5-HT₄ expression in distal colon. Genomic stool DNA MiSeq Sequencing Analysis of microbiota community structures and distribution revealed that intestinal microecological changes caused by constipation recovered after both EP and PEP treatment. Our results indicate that EP and PEP are potent natural products which could be suggested in constipation therapy strategies.