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Saei Ghare Naz M, Ghasemi V, Amirshekari S, Ramezani Tehrani F. Polycystic Ovary Syndrome and Irritable Bowel Syndrome: Is There a Common Pathway? Endocrinol Diabetes Metab 2024; 7:e00477. [PMID: 38494583 PMCID: PMC10944984 DOI: 10.1002/edm2.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/13/2024] [Accepted: 02/16/2024] [Indexed: 03/19/2024] Open
Abstract
OBJECTIVE Little is known about how polycystic ovary syndrome (PCOS) is linked to irritable bowel syndrome (IBS). This study aimed to review the existing literature regarding the association between PCOS or its symptoms and complications with IBS. METHODS In this review, studies that investigated the proposed cross-link between features of PCOS and IBS were included. This review collectively focused on recent findings on the mechanism and novel insight regarding the association between IBS and PCOS in future clinical practice. An electronic search of PubMed, Scopus, Epistemonikos, Cochrane Library and Google Scholar was performed. We did not restrict the study setting and publication date. RESULTS The existing evidence has not completely answered the question of whether there is an association between PCOS and IBS and vice versa. Six case-control studies (793 women with PCOS and 547 women in the control group) directly assessed the association between PCOS and IBS. The prevalence of IBS among women with PCOS in these studies has ranged from 10% to 52% compared with 5%-50% in control groups. Evidence suggested the common pathways may have contributed to the interaction between IBS and PCOS, including metabolic syndrome, sex hormone fluctuation, dysregulation of neurotransmitters, psychological problems and environmental and lifestyle factors. To date, it is still ambiguous which of the mentioned components largely contributes to the pathogenesis of both. CONCLUSION Although limited evidence has shown a higher prevalence of IBS in women with PCOS, there are several potential, direct and common indirect pathways contributing to the development of both IBS and PCOS.
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Affiliation(s)
- Marzieh Saei Ghare Naz
- Reproductive Endocrinology Research Center, Research Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | | | - Shabahang Amirshekari
- Reproductive Endocrinology Research Center, Research Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
- The Foundation for Research & Education ExcellenceVestavia HillsAlabamaUSA
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Punukollu RS, Chadalawada AK, Siddabattuni K, Gogineni NT. A blend of Withania somnifera (L.) Dunal root and Abelmoschus esculentus (L.) Moench fruit extracts relieves constipation and improves bowel function: A proof-of-concept clinical investigation. JOURNAL OF ETHNOPHARMACOLOGY 2024; 318:116997. [PMID: 37543151 DOI: 10.1016/j.jep.2023.116997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 08/07/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Withania somnifera (L.) Dunal (WS) and Abelmoschus esculentus (L.) Moench (AE) are known as Ashwagandha and Okra, respectively, important herbs in traditional medicine for their diverse therapeutic values. WS root is an adaptogen that relieves stress and anxiety and promotes sleep. AE fruit or Okra is widely consumed as a vegetable and is traditionally used to treat diabetes, gastric irritations, ulcers, and obesity. AIM OF THE STUDY The present randomized, double-blind, placebo-controlled study aimed to establish a proof-of-concept evaluating the efficacy and tolerability of a proprietary blend of standardized extracts of WS root and AE fruit, CL18100F4 in relieving constipation and improving quality of life in adults. MATERIALS AND METHODS Forty-eight male and female participants (age: 25-60 years) with functional constipation (following Rome-III criteria) were randomized into placebo, 300 or 500 mg of CL18100F4 groups, and supplemented for fourteen consecutive days. RESULTS CL18100F4 supplementation significantly (p < 0.0001) reduced the Patient Assessment of Constipation-Symptoms (PAC-SYM), Patient Assessment of Constipation-Quality of Life (PAC-QOL), and Gastrointestinal Symptom Rating Scale (GSRS) scores. CL18100F4 supplementation improved sleep quality and reduced stress (p < 0.0001). At the end of the study, CL18100F4-500 subjects showed significant increases in serum serotonin, gastrin, and interleukin-10 and decrease in interleukin-6 and cortisol levels. Participants' hematology, total blood chemistry, vital signs, and urinalysis parameters were within the normal ranges. No adverse events were reported. CONCLUSIONS This short-duration, single-site clinical investigation demonstrates that CL18100F4 supplementation is tolerable, helps relieve constipation, reduces stress, and improves gastrointestinal function, sleep quality, and general wellness in adults. TRIAL REGISTRATION Clinical Trials Registry- India (CTRI/2020/11/029320); Registered on 24/11/2020. Available at: http://ctri.nic.in/Clinicaltrials/showallp.php?mid1=49391&EncHid=&userName=CL18100F4.
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Affiliation(s)
- Raghu Sarath Punukollu
- Department of Urology, Aditya Multi Speciality Hospital, Guntur 522001, Andhra Pradesh, India.
| | - Arun Kumar Chadalawada
- Department of Clinical Research, Aditya Multi Speciality Hospital, Guntur 522001, Andhra Pradesh, India.
| | - Kalyani Siddabattuni
- Department of Clinical Research, Aditya Multi Speciality Hospital, Guntur 522001, Andhra Pradesh, India.
| | - Naga Tejaswi Gogineni
- Department of General Medicine, Aditya Multi Speciality Hospital, Guntur 522001, Andhra Pradesh, India.
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Takeshita RS, Edler MK, Meindl RS, Sherwood CC, Hopkins WD, Raghanti MA. Age, adrenal steroids, and cognitive functioning in captive chimpanzees ( Pan troglodytes). PeerJ 2022; 10:e14323. [PMID: 36389417 PMCID: PMC9653054 DOI: 10.7717/peerj.14323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/10/2022] [Indexed: 11/11/2022] Open
Abstract
Background Dehydroepiandrosterone-sulfate is the most abundant circulating androgen in humans and other catarrhines. It is involved in several biological functions, such as testosterone production, glucocorticoid antagonist actions, neurogenesis and neuroplasticty. Although the role of dehydroepiandrosterone-sulfate (DHEAS) in cognition remains elusive, the DHEAS/cortisol ratio has been positively associated with a slower cognitive age-decline and improved mood in humans. Whether this relationship is found in nonhuman primates remains unknown. Methods We measured DHEAS and cortisol levels in serum of 107 adult chimpanzees to investigate the relationship between DHEAS levels and age. A subset of 21 chimpanzees was used to test the potential associations between DHEAS, cortisol, and DHEAS/cortisol ratio in cognitive function, taking into account age, sex, and their interactions. We tested for cognitive function using the primate cognitive test battery (PCTB) and principal component analyses to categorize cognition into three components: spatial relationship tasks, tool use and social communication tasks, and auditory-visual sensory perception tasks. Results DHEAS levels, but not the DHEAS/cortisol ratio, declined with age in chimpanzees. Our analyses for spatial relationships tasks revealed a significant, positive correlation with the DHEAS/cortisol ratio. Tool use and social communication had a negative relationship with age. Our data show that the DHEAS/cortisol ratio, but not DHEAS individually, is a promising predictor of spatial cognition in chimpanzees.
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Affiliation(s)
- Rafaela S.C. Takeshita
- Department of Anthropology, Kent State University, Kent, OH, USA,School of Biomedical Sciences, Kent State University, Kent, OH, USA,Brain Health Research Institute, Kent State University, Kent, OH, USA
| | - Melissa K. Edler
- Department of Anthropology, Kent State University, Kent, OH, USA,School of Biomedical Sciences, Kent State University, Kent, OH, USA,Brain Health Research Institute, Kent State University, Kent, OH, USA
| | - Richard S. Meindl
- Department of Anthropology, Kent State University, Kent, OH, USA,School of Biomedical Sciences, Kent State University, Kent, OH, USA
| | - Chet C. Sherwood
- Department of Anthropology, The George Washington University, Washington, DC, USA
| | - William D. Hopkins
- Department of Comparative Medicine, The University of Texas MD Anderson Cancer Center, Bastrop, TX, USA
| | - Mary Ann Raghanti
- Department of Anthropology, Kent State University, Kent, OH, USA,School of Biomedical Sciences, Kent State University, Kent, OH, USA,Brain Health Research Institute, Kent State University, Kent, OH, USA
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So SY, Savidge TC. Gut feelings: the microbiota-gut-brain axis on steroids. Am J Physiol Gastrointest Liver Physiol 2022; 322:G1-G20. [PMID: 34730020 PMCID: PMC8698538 DOI: 10.1152/ajpgi.00294.2021] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 01/31/2023]
Abstract
The intricate connection between central and enteric nervous systems is well established with emerging evidence linking gut microbiota function as a significant new contributor to gut-brain axis signaling. Several microbial signals contribute to altered gut-brain communications, with steroids representing an important biological class that impacts central and enteric nervous system function. Neuroactive steroids contribute pathologically to neurological disorders, including dementia and depression, by modulating the activity of neuroreceptors. However, limited information is available on the influence of neuroactive steroids on the enteric nervous system and gastrointestinal function. In this review, we outline how steroids can modulate enteric nervous system function by focusing on their influence on different receptors that are present in the intestine in health and disease. We also highlight the potential role of the gut microbiota in modulating neuroactive steroid signaling along the gut-brain axis.
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Affiliation(s)
- Sik Yu So
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas
| | - Tor C Savidge
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas
- Department of Pathology, Texas Children's Microbiome Center, Texas Children's Hospital, Houston, Texas
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5
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Yu S, Chun E, Ji Y, Lee YJ, Jin M. Effects of red ginseng on gut, microbiota, and brain in a mouse model of post-infectious irritable bowel syndrome. J Ginseng Res 2021; 45:706-716. [PMID: 34764725 PMCID: PMC8569328 DOI: 10.1016/j.jgr.2021.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 01/21/2021] [Accepted: 03/26/2021] [Indexed: 02/07/2023] Open
Abstract
Background Irritable bowel syndrome (IBS), the most common functional gastrointestinal disorder, is characterized by chronic abdominal pain and bowel habit changes. Although diverse complicated etiologies are involved in its pathogenesis, a dysregulated gut–brain axis may be an important factor. Red ginseng (RG), a traditional herbal medicine, is proven to have anti-inflammatory effects and improve brain function; however, these effects have not been investigated in IBS. Methods Three-day intracolonic zymosan injections were used to induce post-infectious human IBS-like symptoms in mice. The animals were randomized to receive either phosphate-buffered saline (CG) or RG (30/100/300 mg/kg) for 10 days. Amitriptyline and sulfasalazine were used as positive controls. Macroscopic scoring was performed on day 4. Visceral pain and anxiety-like behaviors were assessed by colorectal distension and elevated plus maze and open field tests, respectively, on day 10. Next-generation sequencing of gut microbiota was performed, and biomarkers involved in gut–brain axis responses were analyzed. Results Compared to CG, RG significantly decreased the macroscopic score, frequency of visceral pain, and anxiety-like behavior in the IBS mice. These effects were comparable to those after sulfasalazine and amitriptyline treatments. Moreover, RG significantly increased the proliferation of beneficial microbes, including Lactobacillus johnsonii, Lactobacillus reuteri, and Parabacteroides goldsteinii. RG significantly suppressed expression of IL-1β and c-fos in the gut and prefrontal cortex, respectively. Further, it restored the plasma levels of corticosterone to within the normal range, accompanied by an increase in adrenocorticotropic hormone. Conclusion RG may be a potential therapeutic option for the management of human IBS.
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Affiliation(s)
- Seonhye Yu
- Department of Microbiology, College of Medicine, Gachon University, Incheon, Republic of Korea
| | - Eunho Chun
- Department of Health Sciences and Technology, GAIHST, Gachon University, Incheon, Republic of Korea
| | - Yeounjung Ji
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon, Republic of Korea
| | - Young Joo Lee
- Department of Bioscience and Biotechnology, Sejong University, Seoul, Republic of Korea
| | - Mirim Jin
- Department of Microbiology, College of Medicine, Gachon University, Incheon, Republic of Korea.,Department of Health Sciences and Technology, GAIHST, Gachon University, Incheon, Republic of Korea.,Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon, Republic of Korea
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Rolle T, Vue Z, Murray SA, Shareef SA, Shuler HD, Beasley HK, Marshall AG, Hinton A. Toxic stress and burnout: John Henryism and social dominance in the laboratory and STEM workforce. Pathog Dis 2021; 79:ftab041. [PMID: 34410372 PMCID: PMC8435059 DOI: 10.1093/femspd/ftab041] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/16/2021] [Indexed: 12/24/2022] Open
Abstract
Persons Excluded from science because of Ethnicity and Race (PEERs) face chronic exposure to interpersonal stressors, such as social discrimination, throughout their scientific careers, leading to a long-term decline in physical and mental health. Many PEERs exhibit John Henryism, a coping mechanism to prolonged stress where an individual expends higher levels of effort and energy at the cost of their physical and mental health. In this article, we discuss how social dominance may increase John Henryism within the STEM community; the causes, effects and costs of John Henryism; and highlight solutions to combat these social adversity stressors within the academic institution.
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Affiliation(s)
- Tiffany Rolle
- American Society of Human Genetics, Rockville, MD 20852, USA
- National Human Genome Research Institute, Bethesda, MD 20894, USA
| | - Zer Vue
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37232, USA
| | - Sandra A Murray
- Department of Cell Biology, University of Pittsburgh, Pittsburgh, PA 15206, USA
| | - Salma Ash Shareef
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Haysetta D Shuler
- Department of Biological Sciences, Winston-Salem State University, Winston-Salem, NC 27110, USA
| | - Heather K Beasley
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37232, USA
- Department of Biochemistry and Cancer Biology, School of Graduate Studies and Research, Meharry Medical College, Nashville, TN 37208, USA
| | - Andrea G Marshall
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37232, USA
| | - Antentor Hinton
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37232, USA
- Hinton and Garza Lopez Family Consulting Company, Iowa City, IA 52246, USA
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Lee JH, Kim JI, Baeg MK, Sunwoo YY, Do K, Lee JH, Kim HJ, Choi JS, Kim J, Seo CS, Shin HK, Ha H, Park TY. Effect of Samryungbaekchul-san Combined with Otilonium Bromide on Diarrhea-Predominant Irritable Bowel Syndrome: A Pilot Randomized Controlled Trial. J Clin Med 2019; 8:jcm8101558. [PMID: 31569833 PMCID: PMC6832362 DOI: 10.3390/jcm8101558] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/21/2019] [Accepted: 09/23/2019] [Indexed: 12/12/2022] Open
Abstract
Conventional and herbal drugs are frequently used together to treat many disorders. Samryungbaekchul-san (SRS, a herbal formula) and otilonium bromide (OB, an antispasmodic agent) are widely used to treat diarrhea-predominant irritable bowel syndrome (D-IBS) in Eastern Asian countries. However, there have been no studies on the co-administration of SRS and OB. Therefore, we aimed to preliminarily assess the feasibility of SRS combined with OB for D-IBS treatment in a pilot double-blind, four-arm, parallel-group, randomized controlled trial (RCT), including 80 patients diagnosed with D-IBS according to the Rome III criteria. The patients were randomly assigned to four treatment groups and were administered drugs for eight weeks after a two-week preparatory period. Follow-up was conducted four weeks after the administration period. The primary outcome was evaluated by using a global D-IBS symptom improvement score; no statistically significant difference was observed between the groups. However, multiple logistic regression analysis of primary outcome scores shows that SRS significantly improved D-IBS symptoms (p < 0.05). For secondary outcomes, better results were observed in the SRS + OB group, in terms of symptoms, including abdominal pain, discomfort, frequency of abdominal pain, and stool form than in OB alone or placebo groups (p < 0.05). In conclusion, the co-administration of SRS and OB might be an effective and safe strategy for the treatment of D-IBS. Large-scale RCTs are warranted to further confirm and clarify these findings.
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Affiliation(s)
- Jin-Hyun Lee
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary's Hospital, Incheon 22711, Korea.
| | - Joong Il Kim
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
| | - Myong Ki Baeg
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary's Hospital, Incheon 22711, Korea.
| | | | - Kwangsun Do
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary's Hospital, Incheon 22711, Korea.
| | - Jung-Han Lee
- Department of Korean Rehabilitation Medicine, Wonkwang University College of Korean Medicine, Iksan 54383, Korea.
| | - Hye-Jung Kim
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary's Hospital, Incheon 22711, Korea.
| | - Ja Sung Choi
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary's Hospital, Incheon 22711, Korea.
| | - Jayoung Kim
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary's Hospital, Incheon 22711, Korea.
| | - Chang-Seob Seo
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
| | - Hyeun-Kyoo Shin
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
| | - Hyekyung Ha
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
| | - Tae-Yong Park
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary's Hospital, Incheon 22711, Korea.
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Impact of occupational stress on irritable bowel syndrome pathophysiology and potential management in active duty noncombat Greek military personnel: a multicenter prospective survey. Eur J Gastroenterol Hepatol 2019; 31:954-963. [PMID: 31107738 DOI: 10.1097/meg.0000000000001439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Irritable bowel syndrome (IBS) is one of the gut-brain axis interaction disorders. It has global distribution with varying prevalence and particular financial and psychological consequences. IBS has been associated with stress and anxiety, conditions that are usually prevalent in the army. There are scarce data investigating the impact of IBS on noncombat active duty military without reports of Greek military or stress in the occupational environment. MATERIALS AND METHODS The main exclusion criteria in our noncombat military multicenter prospective survey were gastrointestinal pathologies, malignancies, hematochezia, recent infections and antibiotics prescription, and pregnancy. Questionnaires included a synthesis of baseline information, lifestyle, and diet, psychological and stress-investigating scales and the IBS diagnosis checklist. Hospital Anxiety and Depression Scale and Rome IV criteria were utilized. RESULTS Among 1605 participants included finally, the prevalence of IBS was 8% and 131 cases were identified. Women were more vulnerable to IBS, although male sex was prevalent at a ratio of 3.5 : 1 (male:female) in the entire sample. The mean age of all participants was 23.85 years; most of the IBS patients were older than thirty. Abnormal anxiety scores and high levels of occupational stress were related to an IBS diagnosis. DISCUSSION This prospective multicenter survey showed, for the first time, the potential impact of occupational stress on IBS in active duty noncombat Greek Military personnel. The diagnosis of IBS by questionnaire is a quick, affordable way that can upgrade, by its management, the quality of life and relieve from the military burden. Our results are comparable with previous studies, although large-scale epidemiological studies are required for the confirmation of a possible causative relationship.
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Pozos-Radillo E, Preciado-Serrano L, Plascencia-Campos A, Morales-Fernández A, Valdez-López R. Predictive study of academic stress with the irritable bowel syndrome in medicine students at a public university in Mexico. Libyan J Med 2018; 13:1479599. [PMID: 29865994 PMCID: PMC5990944 DOI: 10.1080/19932820.2018.1479599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder associated with stress, which may appear by an educational context, given that students are exposed to demands in the academic environment during their education process that may lead to developing diseases. This study reports on the relationship between the IBS and academic stress and compares results of men and women. METHODS A random survey was made of 561 medicine students at a public university in Mexico. The ROMA III criteria were used for the IBS and the Academic Stress Inventory for academic stress. A multiple regression analysis was made. RESULTS The results showed that students with academic overload and lack of time are at risk for developing the IBS. CONCLUSIONS Therefore, the recommendation is to implement educational programs aiming at self-care as well as gaining knowledge about academic stress-related factors and the physical responses that may result in repercussions with serious consequences for student life such as pain, disease and dropping out of school.
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Affiliation(s)
- Elizabeth Pozos-Radillo
- Public Health Department, University Center for Health Sciences, University of Guadalajara, México,CONTACT Elizabeth Pozos-Radillo Public Health Department, University Center for Health Sciences, University of Guadalajara, Paseo de los Virreyes 706 A-19, Virreyes Residencial, , JaliscoC. P. 45110, México
| | - Lourdes Preciado-Serrano
- Public Health Department, University Center for Health Sciences, University of Guadalajara, México
| | - Ana Plascencia-Campos
- Public Health Department, University Center for Health Sciences, University of Guadalajara, México
| | | | - Rosa Valdez-López
- Public Health Department, University Center for Health Sciences, University of Guadalajara, México
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Kim JI, Kim P, Lee JH, Kim YJ, Yang NR, Baeg MK, Choi JS, Kim HJ, Kim J, Sunwoo YY, Lee JH, Ha H, Park TY. Effect of herbal extract granules combined with otilonium bromide on irritable bowel syndrome with diarrhoea: a study protocol for a randomised controlled trial. BMJ Open 2017; 7:e018362. [PMID: 29196484 PMCID: PMC5719308 DOI: 10.1136/bmjopen-2017-018362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Irritable bowel syndrome (IBS), known as a functional and organic gastrointestinal disorder, is a collection of symptoms that occur together and generally include pain or discomfort in the abdomen and changes in bowel movement patterns. Due to the limitations of conventional treatments, alternative IBS treatments are used by many patients worldwide. Samryungbaekchulsan (SRS), a herbal formula, has long been used for alleviating diarrhoea-predominant IBS (D-IBS) in traditional Korean medicine. Otilonium bromide (OB) is an antimuscarinic compound used to relieve spasmodic pain in the gut, especially in IBS. Although herbal formulae and Western drugs are commonly coadministered for various diseases in Korea, few clinical studies have been conducted regarding the synergic effects of these treatments for any disease, including D-IBS. METHODS AND ANALYSIS This trial is a randomised, double-blinded, placebo-controlled, double-dummy, four-arm, parallel study. After a 2-week preparation period, 80 patients with D-IBS will be randomly assigned to one of four treatment groups consisting of SRS (water extract granules, 5 g/pack, three times a day) with OB (tablet form, one capsule three times a day) or their placebos, with treatment lasting for 8 weeks. Post-treatment follow-up will be conducted 4 weeks after the end of treatment. The primary outcome is the finding obtained using the Subject's Global Assessment of Relief method. The secondary outcomes are the severity of symptoms related to D-IBS, determined using a 10-point scale, and the change in symptoms. ETHICS AND DISSEMINATION This trial has full ethical approval of the Ethics Committee of Catholic Kwandong University International St. Mary's Hospital (IS15MISV0033) and the Korean Ministry of Food and Drug Safety (30769). The results of the study will be disseminated through a peer-reviewed journal and/or conference presentations. TRIAL PROTOCOL VERSION IS15MISV0033 version 4.0 (25 July 2016). TRIAL REGISTRATION NUMBER KCT0001621 (approval date: 10 August 2015).
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Affiliation(s)
- Joong Il Kim
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Pumsoo Kim
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Jin-Hyun Lee
- Department of Rehabilitation Medicine of Korean Medicine, College of Korean Medicine, Wonkwang University, Iksan, Jeonbuk, Republic of Korea
| | - Yoo-Jin Kim
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Na-rae Yang
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Myong Ki Baeg
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Ja Sung Choi
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Hye-Jung Kim
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Jayoung Kim
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Yun-Young Sunwoo
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Jung-Han Lee
- Department of Rehabilitation Medicine of Korean Medicine, College of Korean Medicine, Wonkwang University, Iksan, Jeonbuk, Republic of Korea
| | - Hyekyung Ha
- K-herb Research Center, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Tae-Yong Park
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
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Jo KB, Lee YJ, Lee IG, Lee SC, Park JY, Ahn RS. Association of pain intensity, pain-related disability, and depression with hypothalamus-pituitary-adrenal axis function in female patients with chronic temporomandibular disorders. Psychoneuroendocrinology 2016; 69:106-15. [PMID: 27082645 DOI: 10.1016/j.psyneuen.2016.03.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 03/30/2016] [Accepted: 03/30/2016] [Indexed: 10/22/2022]
Abstract
Patients with temporomandibular disorders (TMD) commonly experience myofascial and joint pain, pain-related disability, and other pain conditions including depression. The present study was carried out to explore the function of the hypothalamus-pituitary-adrenal (HPA) axis in relation to variables of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis II and comorbid depression in female patients with TMD. Cortisol and dehydroepiandrosterone (DHEA) levels were determined in saliva samples that had been collected at various periods after waking (0, 30, and 60min) and at nighttime (2100-2200h) from 52 female patients with chronic TMD pain and age- and gender-matched controls (n=54, 20-40 years old). There were no significant differences in the levels and diurnal patterns of cortisol and DHEA secretion between groups of patients with TMD and controls. In patients, the cortisol awakening response (CAR) or diurnal cortisol rhythm were not associated with any variables of the RDC/TMD Axis II or the Beck Depression Inventory (BDI)-II total scores. However, the ratio of overall cortisol secretion within the first hour after waking (CARauc) to overall DHEA secretion during the post-waking period (Daucawk), defined as CARauc/Daucawk, was significantly associated with pain-related RDC/TMD variables (pain intensity and pain-related disability) and BDI-II total scores. Pain intensity and pain-related disability scores were also significantly associated with BDI-II total scores. These results indicated that an increase in molar cortisol/DHEA ratio due to the dissociation between cortisol and DHEA secretion was associated with pain intensity, pain-related disability, and depression in female patients with TMD.
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Affiliation(s)
- Kyung B Jo
- Graduate School of Integrative Medicine, CHA University, Seoul, Republic of Korea
| | - Young J Lee
- Graduate School of Integrative Medicine, CHA University, Seoul, Republic of Korea
| | - Il G Lee
- Department of Dental Surgery, The Armed Forces Dental Hospital, Seoul, Republic of Korea
| | - Sang C Lee
- Research Center for Chronic Pain and Integrative Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Jai Y Park
- Department of Anesthesiology and Pain Medicine, The Armed Forces Capital Hospital, Seoul, Republic of Korea
| | - Ryun S Ahn
- Research Center for Chronic Pain and Integrative Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
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12
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Souza-Teodoro LH, de Oliveira C, Walters K, Carvalho LA. Higher serum dehydroepiandrosterone sulfate protects against the onset of depression in the elderly: Findings from the English Longitudinal Study of Aging (ELSA). Psychoneuroendocrinology 2016; 64:40-6. [PMID: 26600009 PMCID: PMC4712651 DOI: 10.1016/j.psyneuen.2015.11.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 11/05/2015] [Accepted: 11/07/2015] [Indexed: 01/23/2023]
Abstract
Depression is one of the major causes of disability worldwide, but the complete etiology of depression is not fully understood. Dehydroepiandrosterone (DHEA) and its sulphated form DHEA(S) have been associated with mood and healthy aging. Associations with mental illness over the middle to late years of life have not yet been extensively investigated in large, western community-dwelling samples. The aim of this study was to investigate whether low DHEA(S) levels are associated with the development of depressive symptoms in a large longitudinal cohort study of older men and women. We assessed data from English Longitudinal Study of Aging (ELSA) to evaluate the association of DHEA(S) levels and depressive symptoms measured by Center for Epidemiologic Studies Scale (CES-D) at baseline (n=3083) and at 4-year follow-up (n=3009). At baseline, there was an inverse association between DHEA(S) and depressive symptoms (B=-0.252, p=0.014). Adjustments for physical illnesses, impairments in cognitive function and health behaviors abolished this association (p=0.109) at baseline. Decreased DHEA(S) levels at baseline also predicted incident depression at 4-year follow-up (B=-0.332, p<0.001). In conclusion, higher DHEA(S) levels were associated with reduced risk of developing depressive symptoms in both men and women.
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Affiliation(s)
- Luis H Souza-Teodoro
- Department of Epidemiology and Public Health, University College London, London, UK,Chronopharmacology Laboratory, Institute of Biosciences, University of São Paulo, São Paulo, Brazil
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Kate Walters
- Research Department of Primary Care and Population Health, UCL and Medical Research Council General Practice Research Framework, London, UK
| | - Livia A Carvalho
- Department of Epidemiology and Public Health, University College London, London, UK.
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13
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Rondelli MCH, Munhoz TD, Catandi PB, Freschi CR, Palacios Junior RJG, Machado RZ, Tinucci-Costa M. Serum DHEA-S increases in dogs naturally infected with Ehrlichia canis. Res Vet Sci 2015; 100:18-20. [PMID: 25956636 DOI: 10.1016/j.rvsc.2015.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 03/15/2015] [Accepted: 04/13/2015] [Indexed: 10/23/2022]
Abstract
Adrenocortical disturbances are expected in canine ehrlichiosis due to the immunological challenges caused by infection and consequent inflammation. Thus, this study aimed to evaluate the occurrence of adrenocortical hormonal alterations in dogs naturally infected with Ehrlichia canis (n = 21) as positively confirmed by the presence of anti-E. canis antibodies (Dot-ELISA) and nested PCR (nPCR). Serum dehydroepiandrosterone sulfate (DHEA-S) concentrations were assessed via ELISA before and one hour after ACTH stimulation. Another 10 healthy dogs were subjected to the same stimulation protocol and used as controls. The results revealed that baseline and post-ACTH DHEA-S concentrations were significantly greater in sick dogs, regardless of gender, and this finding illustrates the stress induced by naturally acquired ehrlichiosis in dogs.
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Affiliation(s)
- M C H Rondelli
- Department of Veterinary Clinic and Surgery, Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista, Via de Acesso Prof. Paulo Donato Castellane, Jaboticabal, SP 14884-900, Brazil.
| | - T D Munhoz
- Centro Universitário Barão de Mauá, Ramos de Azevedo Street 423, Jardim Paulista, Ribeirão Preto, SP 14031-580, Brazil
| | - P B Catandi
- Autonomous Veterinarian, Joá Street, 45, Catanduva, SP 15800-190, Brazil
| | - C R Freschi
- Department of Veterinary Pathology, Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista, Via de Acesso Prof. Paulo Donato Castellane, Jaboticabal, SP 14884-900, Brazil
| | | | - R Z Machado
- Department of Veterinary Pathology, Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista, Via de Acesso Prof. Paulo Donato Castellane, Jaboticabal, SP 14884-900, Brazil
| | - M Tinucci-Costa
- Department of Veterinary Clinic and Surgery, Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista, Via de Acesso Prof. Paulo Donato Castellane, Jaboticabal, SP 14884-900, Brazil
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