Pharmacological mechanism responsible for the Atractylodes japonica-induced distal colonic contraction in rats

Bioinformatics and LC-QTOF-MS based discovery of pharmacodynamic and Q-markers of Pitongshu against functional dyspepsia

ETHNOPHARMACOLOGICAL RELEVANCE

Pitongshu (PTS) is a clinically effective empirical formula for the treatment of FD. The efficacy and safety of PTS have been demonstrated in randomized, controlled, double-blind trials, but there is a lack of understanding of the systematic evaluation of the efficacy of PTS and its material basis.

OBJECTIVE

To investigate the efficacy of PTS in Functional dyspepsia (FD) mice and possible Q-markers.

METHOD

In this study, we used "irregular feeding + chronic unpredictable chronic stimulation" to establish a mice model of FD with hepatogastric disharmony. The efficacy of PTS was assessed from hair condition, behavioral, pain, gastrointestinal function, and serum 5-HT, GAS, MTL levels in mice by instillation of different doses of PTS. In addition, the composition of drugs in blood was analyzed by LC-QTOF-MS and potential Q-markers were selected by combining network pharmacology, molecular docking and actual content.

RESULT

Our study showed that different doses of PTS increased pain threshold and writhing latency, decreased the number of writhings, increased gastric emptying rate and small intestinal propulsion rate, decreased total acidity of gastric contents and gastric acid secretion, and increased serum levels of 5-HT, GAS, and MTL in mice to different degrees. Enrichment analysis showed that PTS may be anti-FD through multiple pathways such as Serotonergic synapse, thyroid hormone signaling pathway, cholinergic synapse, and dopaminergic synapse. In addition, potential active ingredient substances were explored by LC-QTOF-MS combined with bioinformatics. Combined with the actual contentselected six constituents, hesperidin, neohesperidin, naringin, paeoniflorin, magnolol and honokiol, possible as Q-markers.

CONCLUSION

PTS may exert its anti-FD effects through multi-component, multi-target and multi-pathway". Constituents, hesperidin, neohesperidin, naringin, paeoniflorin, magnolol and honokiol may be the Q-markers of its anti-FD effects.

Two new sesterterpenoids from Atractylodes japonica Koidz. ex Kitam

Two new sesterterpenoids, atractylodes japonica terpenoid acid I (1) and atractylodes japonica terpenoid aldehyde I (2), were isolated from the rhizomes of Atractylodes japonica Koidz. ex Kitam together with ten known compounds (3-12). Their structures were elucidated on the basis of comprehensive spectroscopic analysis (1D/2D NMR, HRESIMS and IR). In addition, all of these isolated compounds were evaluated for their cytotoxic activities against human gastric cancer cell MGC-803 and human hepatocellular cancer cell HepG-2. Most of them exhibited moderate to weak inhibitory effects with IC50 values in the range of 25.15-88.85 μM except for 9-12.

Zhizhu Kuanzhong, a traditional Chinese medicine, alleviates gastric hypersensitivity and motor dysfunction on a rat model of functional dyspepsia

Ethnopharmacological relevance: Zhizhu Kuanzhong (ZZKZ) is a traditional Chinese medicine modified from classic formula Zhizhu decoction in "Synopsis of Golden Chamber" (Han Dynasty in the 3rd century) and the Zhizhu pill in "Differentiation on Endogenous" in Jin Dynasty (1,115-1,234). ZZKZ contains four botanical drugs, including Citrus × Aurantium L [Rutaceae; Aurantii Fructus Immaturus], Atractylodes Macrocephala Koidz. [Compositae; Rhizoma Atractylodis Macrocephalae], Bupleurum Chinense DC [Apiaceae; Radix Bupleuri Chinensis], and Crataegus Pinnatifida Bunge [Rosaceae; Fructus Crataegi Pinnatifidae], which have been widely used in clinical therapy for functional dyspepsia (FD). Aim of the study: This study aimed to evaluate the pharmacological effects and mechanisms of action of ZZKZ on gastric hypersensitivity and motor dysfunction in a rat model of FD. Materials and methods: FD was induced in Sprague-Dawley rats by neonatal gastric irritation with 0.1% iodoacetamide. The FD rats were treated with ZZKZ (0.5 g/kg, 1.0 g/kg, or 1.5 g/kg respectively) by gavage for 7 days, while domperidone (3 mg/kg) acted as treatment control. Body weight gain, food intake, gastric emptying, and intestinal propulsion were also measured. Ex vivo gastric smooth muscle activity recordings and greater splanchnic afferent (GSN) firing recordings were employed to evaluate gastric motility and sensation. Particularly, the role of 5-HT in the action of ZZKZ in improving gastric dysmotility and hypersensitivity was explored. Results: ZZKZ promoted weight gain, food intake, gastric emptying, and intestinal propulsion in FD rats. ZZKZ promoted spontaneous and ACh-induced contractions of gastric smooth muscle strips in FD rats, alleviated spontaneous activity, and chemical (acid perfusion) and mechanical (intragastric distension) stimulated GSN firing in FD rats. ZZKZ ameliorated gastric smooth muscle contraction and GSN firing induced by 5-HT in FD rats. ZZKZ stimulated the release of serum 5-HT, with reduced 5-HT3 receptor and increased 5-HT4 receptor mRNA expression in the guts of FD rats. Conclusion: This study demonstrated that ZZKZ improves FD-related gastric hypersensitivity and motor dysfunction and should be an effective compound for relieving FD symptoms. The gastric 5-HT system with lower 5-HT3 activity and increased 5-HT4 distribution is involved in the mechanisms of ZZKZ underlying the treatment of FD.

Traditional, complementary and alternative medicine in children constipation: a systematic review

OBJECTIVES

This review aims to evaluate the efficacy and safety of complementary and alternative medicine methods for constipation in the pediatric population.

EVIDENCE ACQUISITION

Medical literature search was performed in several databases for a variety of Traditional, Complementary and Alternative Medicine in childhood constipation. Databases included Web of Science, Scopus, Embase, Cochrane Library, PubMed, ScienceDirect, Google scholar and a number of Persian databases including IranDoc, Magiran and SID. No time limitation was determined. Clinical trials or case series that had evaluated the effectiveness of CAM therapies in functional constipation of 1-18 year old children were included. Papers not in English or Persian language were excluded. Related articles were screened independently by two reviewers according to their titles and abstracts. A data extraction form was filled in for each eligible paper. Quality assessment of eligible documents was also performed.

RESULTS

30 studies were included, comprising 27 clinical trials and 3 case series. Ten documents were on herbal medicine, nine on traditional medicine, ten on manual therapies and one on homeopathy. Except for two herbal and one reflexology interventions, all studies reported positive effects on childhood constipation, with the majority being statistically significant. As the number of studies in each method was limited, we could not perform a meta-analysis.

CONCLUSION

The scarcity of research on the efficacy and safety of different types of complementary and alternative medicine methods in children with constipation necessitates conducting more studies in each field. Graphical abstract.

Quantitative Interrelation between Atractylenolide I, II, and III in Atractylodes japonica Koidzumi Rhizomes, and Evaluation of Their Oxidative Transformation Using a Biomimetic Kinetic Model

Analytical methods based on ultraperformance liquid chromatography/ion-trap mass spectrometry (UPLC/ion-trap MS) were developed for quantification of atractylenolide I, II, and III in the methanol extract of Atractylodes japonica rhizomes with a C₁₈ column in an acidified water/acetonitrile gradient eluent in an LC system, and ion-trap MS coupled with electrospray ionization was employed under positive-ion mode. The three atractylenolides were quantified in all A. japonica samples, and the content of atractylenolide I, II, and III showed a significant correlation to each other. Such high correlation was explained by the mechanistic insights into the biosynthetic pathway of atractylenoide III and I from atractylenoide II by using the biomimetic cytochrome P450 model, [Fe(tmp)](CF₃SO₃) (tmp = meso-tetramesitylporphyrin). Atractylenolides could be transformed by oxidation via the oxidative enzyme in the A. japonica plant. The present study first reports the first oxidative transformation of atractylenolides using the heme iron model complex.

A Randomized Controlled Trial of Chinese Patent Medicine Xiao'er Biantong Granules in the Treatment of Functional Constipation in Children

Objective

To confirm the effect and safety of Xiao'er Biantong (XEBT) granules for treating chronic constipation in children.

Methods

This randomized, double-blind, multicenter study enrolled 480 children with age of 1–14 years who had FC. All of them were randomly assigned to receive either XEBT granules or its placebo in the ratio of 3 : 1. The primary efficacy outcome was the frequency of spontaneous bowel movements (SBM) for 14 days, and secondary outcomes were effectual time, score of main symptoms, effect of constipation, disappearance rate of accompanying symptoms, and recurrence rate. We also observed the adverse event (AE) and adverse drug reaction (ADR) to evaluate safety.

Results

The sociodemographic characteristics and efficiency data were comparable in the two groups at baseline. The mean values of SBM for 14 days were 8.89 and 5.63 in the XEBT group and the placebo group, respectively, and there were 86.87% and 30.91% subjects in two groups up to SBM ≥ 3/week, respectively. There were significant differences between the two groups. The effects in the XEBT group on median effectual time of defecation, main symptom score, disappearance rate of symptoms, and the differences were significant. The conclusions based on full analysis set (FAS) and per protocol set (PPS) were consistent. Nine AEs were reported, of which 7 were in the XEBT group (2.02%) while 2 were in the placebo group (1.77%). There were no significant differences in the occurrence rate of AE and ADR between the two groups.

Conclusions

Xiao'er Biantong granules have superior efficacy compared to the placebo for the treatment of functional constipation in children and are well tolerated.

Assessment of chemical equivalence in herbal materials using chromatographic fingerprints by combination of three similarity indices and three-dimensional kernel density estimation

An intuitive and practical way to control chemical equivalence of secondary metabolites in herbal materials based on chromatographic fingerprints deserves a thorough discussion, yet it is relatively unexplored. For the first time, we propose a mixture of three similarity indices, the congruence coefficient, the average of the peak area ratios, and the larger value between the maximum peak area ratio and the reciprocal of the minimum peak area ratio, to make up for the weak points of some widely used similarity indices and to evaluate the chemical equivalence of two fingerprints from various perspectives. The three similarity values are fed into a three-dimensional kernel density estimation to determine the quality of herbal materials. This estimation enables precise detection of anomalies in the absence of prior quality determination experience. Forty Atractylodes samples similar in appearance and indiscriminately used for medical purposes were used to demonstrate the effectiveness of the developed approach. After a reference sample was postulated, a quality assessment of the 40 samples was performed using the three similarity values and the estimated kernel density. The samples that were judged by the developed approach to be of good quality were compared with those chosen by the most popular approach using decision criterion of a single similarity index. The benefits of the proposed approach were evident in that the qualified samples had the composition ratio and individual concentrations of multi-components closer to those of the reference in general, and their inter-sample deviation was significantly smaller.

Using UPLC-MS/MS for Characterization of Active Components in Extracts of Yupingfeng and Application to a Comparative Pharmacokinetic Study in Rat Plasma after Oral Administration

Yupingfeng (YPF), a famous traditional Chinese medicine, which contains a large array of compounds, has been effectually used in health protection. A two-dimensional liquid chromatography (²D-LC) combined with quadrupole time-of-flight mass spectrometry (QTOF-MS) method was firstly established to separate and identify chemical components in YPF. A total of 33 compounds were identified, including 15 constituents (flavonoids and saponins) in Astragali radix; seven constituents (sesquiterpenoids and polysaccharide) in Atractylodis rhizoma; and 11 constituents (chromone and coumarins) in Saposhnikoviae radix. The corresponding fragmentation pathway of typical substances was investigated. Then, seven active constituents (astragaloside, calycosin, formononetin, cimicifugoside, 4-O-beta-d-glucosyl-5-O-methylvisamminol, sec-O-glucosylhamaudol, and atractylenolide II) derived from three medicinal plants were chosen to further investigate the pharmacokinetic behavior of YPF formula using ultrahigh-performance liquid chromatography with triple quadrupole mass spectrometry system. The method was sensitive, accurate and reliable. We also used the area under the plasma concentration-time curve from zero to infinity (AUC_0-∞) as weighting factor to make an integrated pharmacokinetic curve. Results show that the constituents of Saposhnikoviae radix have the best absorption and pharmacokinetic behavior and may play important role in leading to the changes of overall therapeutic effects of YPF. Further study is needed to confirm the association between them.

Spatiotemporal Mapping Techniques Show Clozapine Impairs Neurogenic and Myogenic Patterns of Activity in the Colon of the Rabbit in a Dose-Dependent Manner

Background: Clozapine, an antipsychotic used in treatment-resistant schizophrenia, has adverse gastrointestinal effects with significant associated morbidity and mortality. However, its effects on defined patterns of colonic contractile activity have not been assessed.

Method: We used novel radial and longitudinal spatiotemporal mapping techniques, combined with and monitoring of ambient lumen pressure, in ex vivo preparations of triply and of singly haustrated portions of rabbit colon. We identified the contractile patterns of mass peristalses, fast phasic, and ripple contractions and directly qualified the effects of clozapine, at concentrations of 10 μmol/L, 20 μmol/L, and 30 μmol/L, and of norclozapine, the main metabolite of clozapine, on contractile patterns. The effects of carbachol, serotonin and naloxone on clozapine-exposed preparations were also determined. Tetradotoxin was used to distinguish neurogenic from myogenic contractions.

Results: At 10 μmol/L, clozapine temporarily abolished the longitudinal contractile components of mass peristalsis, which on return were significantly reduced in number and amplitude, as was maximal mass peristaltic pressure. These effects were reversed by carbachol (1 μmol/L) and to some extent by serotonin (15 μmol/L). At 10 μmol/L, myogenic ripple contractions were not affected. At 20 μmol/L, clozapine had a similar but more marked effect on mass peristalses with both longitudinal and radial components and corresponding maximal pressure greatly reduced. At 30 μmol/L, clozapine suppressed the radial and longitudinal components of mass peristalses for over 30 min, as well as ripple contractions. Similar dose-related effects were observed on addition of clozapine to the mid colon. At 20 μmol/L, norclozapine had opposite effects to those of clozapine, causing an increase in the frequency of mass peristalsis with slight increases in basal tone. These slightly augmented contractions were abolished on addition of clozapine. Concentrations of norclozapine below 20 μmol/L had no discernible effects.

Conclusion: Clozapine, but not norclozapine, has potent effects on the motility of the rabbit colon, inhibiting neurogenic contractions at lower concentrations and myogenic contractions at higher concentrations. This is the likely mechanism for the serious and life-threatening gastrointestinal complications seen in human clozapine-users. These effects appear to be mediated by cholinergic and serotonergic mechanisms. Spatiotemporal mapping is useful in directly assessing the effects of pharmaceuticals on particular patterns of gastrointestinal motility.

Effect of Atractylodes macrocephala Koidz and Rehmannia dride rhizome on gastrointestinal motility in rats with cathartic colon

AIM: To observe the influence of Atractylodes macrocephala Koidz and Rehmannia dride rhizome on gastrointestinal motility in a rat model which was given rhein suspension to induce cathartic colon.

METHODS: Seventy healthy male Wistar rats were randomly divided into seven groups: a control group, a model group, a conventional dose Atractylodes macrocephala Koidz group, a high-dose Atractylodes macrocephala Koidz group, a Rehmannia dride rhizome group, a conventional dose Atractylodes macrocephala Koidz+Rehmannia dride rhizome group, and a high-dose Atractylodes macrocephala Koidz+Rehmannia dride rhizome group, with ten rats in each group. Rhein suspension was administered to induce cathartic colon. After successful modelling, the control and model groups were given normal saline by gavage, and the rest groups were given corresponding drug(s), respectively. All rats were killed after 14 d. The gastric motility and intestinal transit function were examined.

RESULTS: Carbon black transit rate (%) in the model group was significantly lower compared with the blank control group (39.24 ± 4.28 vs 61.84 ± 3.05, P < 0.05), while gastric residual rate (%) increased significantly (72.74 ± 8.94 vs 36.30 ± 9.57, P < 0.05). Compared with the model group, each treatment significantly reduced the gastric residual rate (%) (57.90 ± 8.57, 45.65 ± 9.31, 41.75 ± 9.16, 45.05 ± 8.52, 38.10 ± 9.79 vs 72.74 ± 8.94, P < 0.05) and increased the carbon black transit rate (%) (49.10 ± 3.06, 56.76 ± 5.16, 52.13 ± 4.37, 53.72 ± 4.29, 60.96 ± 2.51 vs 39.24 ± 4.28, P < 0.05). The gastric residual rate (%) was lower and carbon black transit rate (%) was higher in the high-dose Atractylodes macrocephala Koidz group, conventional dose Atractylodes macrocephala Koidz group, conventional dose Atractylodes macrocephala Koidz+Rehmannia dride rhizome group, and high-dose Atractylodes macrocephala Koidz+Rehmannia dride rhizome group than in the Rehmannia dride rhizome group (45.65 ± 9.31, 41.75 ± 9.16, 45.05 ± 8.52, 38.10 ± 9.79 vs 57.90 ± 8.57, P < 0.05; 56.76 ± 5.16, 52.13 ± 4.37, 53.72 ± 4.29 vs 49.10 ± 3.06, P < 0.05), with the difference in carbon black transit rate (%) was most significant in the high-dose Atractylodes macrocephala Koidz+Rehmannia dride rhizome group (60.96 ± 2.51 vs 49.10 ± 3.06, 56.76 ± 5.16, 52.13 ± 4.37, 53.72 ± 4.29, P < 0.05).

CONCLUSION: Atractylodes macrocephala Koidz and Rehmannia dride rhizome can promote the gastrointestinal motility, with high-dose Atractylodes macrocephala having a better effect. High-dose Atractylodes macrocephala Koidz+Rehmannia dride rhizome has the most significant effect on gastrointestinal motility.

Effects of traditional Chinese herbal medicine San-Huang-Xie-Xin-Tang on gastrointestinal motility in mice

AIM: To investigate the effects of San-Huang-Xie-Xin-Tang (SHXXT), a herbal product used in traditional Chinese medicine, on gastrointestinal (GI) motility in mice.

METHODS: The in vivo effects of SHXXT on GI motility were investigated by measuring the intestinal transit rates (ITRs) using Evans blue in normal mice and in mice with experimentally induced GI motility dysfunction (GMD).

RESULTS: In normal ICR mice, ITRs were significantly and dose-dependently increased by SHXXT (0.1-1 g/kg). GMD was induced by injecting acetic acid or streptozotocin intraperitoneally. The ITRs of GMD mice were significantly reduced compared to normal mice, and these reductions were significantly and dose-dependently inhibited by SHXXT (0.1-1 g/kg).

CONCLUSION: These results suggest that SHXXT is a novel candidate for the development of a prokinetic agent that may prevent or alleviate GMD.

Effect of Sijunzi decoction and its active substances on gastrointestinal motility

Sijunzi decoction (SJZD), earliest recorded in Taiping Huimin Heji Ju Fang, is a classic recipe for the therapy of spleen deficiency. The recipe consists of merely four kinds of traditional Chinese herbs (ginseng, rhizoma atractylodis macrocephalae, poria cocos and licorice), but it has wide clinical applications and good efficacy, especially in the treatment of gastrointestinal function. It is reported that each component of the SJZD has different effects on gastrointestinal movement. Experimental studies have shown that SJZD has bidirectional modulatory effects on gastrointestinal motility and can therefore treat gastrointestinal movement dysfunction.