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Liu YQ, Wu HL, Zhang ZQ, Wang WL, Han GQ, Zhang CH, Lyu XL, Ma CJ, Li MH. Traditional Use, Phytochemistry, Pharmacology, Toxicology and Clinical Applications of Persicae Semen: A Review. Chin J Integr Med 2024:10.1007/s11655-024-3815-4. [PMID: 39073515 DOI: 10.1007/s11655-024-3815-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 07/30/2024]
Abstract
Persicae Semen (Taoren), the seed of mature peaches consumed as both food and medicine, is native to the temperate regions of China, distributed in the provinces of North and East China, and currently cultivated worldwide. The primary components of Persicae Semen include volatile oil, protein, amino acids, amygdalin, and prunasin, all of which have pharmacological properties, such as anti-inflammatory, antioxidant, and immune regulatory effects, and are clinically used in the treatment of gynecological, cardiovascular, cerebrovascular, orthopedic, and digestive system diseases. This review provides a comprehensive perspective on the resource status, ethnopharmacology, phytochemistry, pharmacology, and toxicology, as well as the trend of Persicae Semen patent, global distribution, and clinical applications. This review will help facilitate the development and utilization of Persicae Semen in clinical settings.
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Affiliation(s)
- Yu-Quan Liu
- School of Traditional Chinese Medicine, Inner Mongolia Medical University, Hohhot, 010000, China
- Department of Rheumatology, Inner Mongolia Autonomous Region Hospital of Traditional Chinese Medicine, Hohhot, 010020, China
| | - Hui-Li Wu
- School of Pharmacy, Baotou Medical College, Baotou, 014040, China
| | - Zhi-Qiang Zhang
- Infectious Disease Department, Hohhot Mongolian Medicine of Traditional Chinese Medicine Hospital, Hohhot, 010000, China
| | - Wen-le Wang
- Department of Rheumatology, Inner Mongolia Autonomous Region Hospital of Traditional Chinese Medicine, Hohhot, 010020, China
| | - Guo-Qing Han
- Department of Rheumatology, Inner Mongolia Autonomous Region Hospital of Traditional Chinese Medicine, Hohhot, 010020, China
| | - Chun-Hong Zhang
- School of Pharmacy, Baotou Medical College, Baotou, 014040, China
| | - Xin-Liang Lyu
- Department of Rheumatology, Inner Mongolia Autonomous Region Hospital of Traditional Chinese Medicine, Hohhot, 010020, China
| | - Chun-Jie Ma
- School of Traditional Chinese Medicine, Inner Mongolia Medical University, Hohhot, 010000, China.
| | - Min-Hui Li
- Department of Rheumatology, Inner Mongolia Autonomous Region Hospital of Traditional Chinese Medicine, Hohhot, 010020, China.
- School of Pharmacy, Baotou Medical College, Baotou, 014040, China.
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Ayele AG, Kawet JS. Evaluations of the in vivo Laxative Effects of Aqueous Leaf and Stem Extracts of Artemisia Abyssinica in Mice. J Exp Pharmacol 2024; 16:135-142. [PMID: 38528962 PMCID: PMC10962457 DOI: 10.2147/jep.s456029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/19/2024] [Indexed: 03/27/2024] Open
Abstract
Background People frequently complain of long-term constipation. The cost associated with using modern medications to treat constipation is significant, and the probability of encountering side effects is notably high. These limitations restrict their effectiveness in therapy, remain unresolved, and underscore the need for research on alternative therapeutic approaches. Plants of the genus Artemisia have been used to treat constipation. Therefore, the aim of this study was to evaluate the laxative effects of aqueous A. abyssinica leaf and stem extracts of Artemisia abyssinica in mice. Methods The laxative activity of A. abyssinica leaf and stem extracts was evaluated using three models: laxative activity, gastrointestinal motility, and gastrointestinal secretion. In this study, bisacodyl was used as a standard laxative and loperamide was used to induce constipation. Results In the laxative test, 200 (P<0.05) and 400 mg/kg (p<0.01) doses of plant extract significantly increased the percentage of fecal water content. Moreover, the highest dose of extract increased the frequency of defecation after 12 h (p<0.05). In the remaining two models, the experimental plans also showed significantly higher gastrointestinal motility and noticeable accumulation of intestinal fluid. Conclusion The results of this study indicate that aqueous leaf and stem extracts of A. abyssinica have laxative effects.
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Affiliation(s)
- Akeberegn Gorems Ayele
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jeylan Sinba Kawet
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Amjadi Suraki S, Bagheri-Nesami M, Nabati M, Moosazadeh M, Habibi E. Flaxseed powder and magnesium hydroxide syrup on the intestinal function of patients with acute myocardial infarction in intensive care units. CASPIAN JOURNAL OF INTERNAL MEDICINE 2024; 15:234-243. [PMID: 38807721 PMCID: PMC11129063 DOI: 10.22088/cjim.15.2.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/17/2023] [Accepted: 10/08/2023] [Indexed: 05/30/2024]
Abstract
Background Flaxseed powder seems to improve bowel movements in these patients. Therefore, this study compares the effects of flaxseed powder and magnesium hydroxide on bowel movements of acute myocardial infarction patients hospitalized in ICU. Methods The population of the present parallel randomized controlled clinical trial included 70 acute myocardial infarction patients hospitalized in ICU who had no history of chronic constipation. The patients in the intervention group were given three sachets of flaxseed powder (each sachet was 3 g) twice a day for four days. The patients in the control group were given 20 cc of magnesium hydroxide syrup each morning. The Bristol scale was used to describe stool consistency. Results The mean and standard deviation of the number of bowel movements within five days after intervention are 1.86 ± 1.08 and 1.6 ± 0.65 in the intervention and the control groups, respectively. The frequency of normal stool consistency of the first bowel movement is 94.3% for the intervention group and 85.7% for the control group, which shows no significant differences between the two groups in terms of stool consistency and bowel movement frequency (P=0.510). The bowel movements started on average after 35.2±97.97 hours in the flaxseed group and 24.771±2.677 hours in the magnesium hydroxide group (P=0.023). Conclusion The results showed that flaxseed powder increases bowel movement frequency and improves the patients' stool consistency, but the differences between the two groups are insignificant. Finally, the time to the first defecation was shorter in the magnesium hydroxide group.
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Affiliation(s)
- Sahar Amjadi Suraki
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoumeh Bagheri-Nesami
- Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
- World Federation of Acupuncture-Moxibustion Societies (WFAS), Beijing, China
| | - Maryam Nabati
- Department of Cardiology, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Emran Habibi
- Medicinal Plants Research center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Pharmacognosy and Biotechnology, School of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
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Sakurai T, Takamatsu S, Shibata S, Minamikawa R, Yamazaki M, Kojima H, Noto K, Makino T, Kawaguchi S, Nohara T, Mizokami A, Gabata T. Factors Affecting Prostate Displacement During Volumetric Modulated Arc Therapy in Prone Position After High-Dose-Rate Brachytherapy for Prostate Cancer. Adv Radiat Oncol 2023; 8:101277. [PMID: 38047223 PMCID: PMC10692303 DOI: 10.1016/j.adro.2023.101277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/17/2023] [Indexed: 12/05/2023] Open
Abstract
Purpose In irradiating the prostate and pelvic lymph node regions, registration based on bony structures matches the pelvic lymph node regions but not necessarily the prostate position, and it is important to identify factors that influence prostate displacement. Therefore, we investigated factors influencing prostate displacement during volumetric modulated arc therapy after single-fraction high-dose-rate brachytherapy (HDR-BT) for prostate cancer and the trends in displacement for each fraction. Methods and Materials Seventy patients who underwent pelvic volumetric modulated arc therapy of 46 Gy in the prone position 15 days after 13 Gy HDR-BT were included. Prostate displacement relative to bony structures was calculated using cone beam computed tomography. Systematic error (SE) and random error (RE) were evaluated in the right-left (RL), craniocaudal (CC), and anteroposterior (AP) directions. The association with clinical and anatomic factors on the planning computed tomography or magnetic resonance imaging was analyzed. Prostate volume change (PVC) was defined as the volume change at 2 days after HDR-BT. Displacement trends were individually examined from the first to 23rd fractions. Results The mean SE in the RL, CC, and AP directions was -0.01 mm, -2.34 mm, and -0.47 mm, respectively. The root mean square of the RE in the RL, CC, and AP directions was 0.44 mm, 1.14 mm, and 1.10 mm, respectively. SE in the CC direction was independently associated with bladder volume (P = .021, t statistic = 2.352) and PVC (P < .001, t statistic = -8.526). SE in the AP direction was independently associated with bladder volume (P = .013, t statistic = -2.553), PVC (P < .001, t statistic = 5.477), and rectal mean area (P = .008, t statistic = 2.743). RE in the CC direction was independently associated with smoking (P = .035). RE in the AP direction was associated with PVC (P = .043). Gradual displacement caudally and posteriorly occurred during the irradiation period. Conclusions Anatomic characteristics of the bladder, rectum, and prostate predict SE. Smoking and PVC predict RE. In particular, whether PVC is ≥140% affects setting internal margins.
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Affiliation(s)
- Takayuki Sakurai
- Department of Radiology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Shigeyuki Takamatsu
- Department of Radiology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Satoshi Shibata
- Department of Radiology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Risako Minamikawa
- Department of Radiology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Masahiro Yamazaki
- Department of Radiology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Hironori Kojima
- Department of Radiology, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan
| | - Kimiya Noto
- Department of Radiology, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan
| | - Tomoyuki Makino
- Department of Integrative Cancer Therapy and Urology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Shohei Kawaguchi
- Department of Integrative Cancer Therapy and Urology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Takahiro Nohara
- Department of Integrative Cancer Therapy and Urology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Atsushi Mizokami
- Department of Integrative Cancer Therapy and Urology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Toshifumi Gabata
- Department of Radiology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
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Suzuki S, Obara T, Ishikawa T, Noda A, Matsuzaki F, Arita R, Ohsawa M, Mano N, Kikuchi A, Takayama S, Ishii T. No association between major congenital malformations and exposure to Kampo medicines containing rhubarb rhizome: A Japanese database study. Front Pharmacol 2023; 14:1107494. [PMID: 37033629 PMCID: PMC10073577 DOI: 10.3389/fphar.2023.1107494] [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: 11/30/2022] [Accepted: 03/14/2023] [Indexed: 04/11/2023] Open
Abstract
Traditional Japanese (Kampo) medicines containing rhubarb rhizome are prescribed for constipation during pregnancy; however, detailed safety information of their use for pregnant women is lacking. The aim of current study was to clarify the association between prescription Kampo-containing rhubarb rhizome (KRR) in the first trimester of pregnancy and congenital malformations in newborns. Using a large Japanese health insurance claims database, we included pregnant women who enrolled the same health insurance society from 3 months before pregnancy to the delivery date, who gave birth between 2010 and 2019, and those with data related to their infants. Pregnant women who were prescribed magnesium oxide (MgO), commonly used for constipation, during the first trimester of pregnancy and their infants were extracted as controls. Associations between KRR prescribed in the first pregnancy trimester and major congenital malformations (MCM) in the infants were examined using multivariate logistic regression analysis. Of 75,398 infants, 4,607 (6.1%) were diagnosed with MCMs within the first year after birth. Furthermore, 9,852 infants were born to women prescribed MgO, among whom 680 (6.9%) had MCMs; 450 infants were born to women prescribed KRR, among whom 28 (6.2%) had MCMs. Multivariate logistic regression analysis identified no difference in MCM risk between the two types of prescriptions [crude odds ratio (OR) 0.895, 95% confidence interval (CI) 0.606-1.322, adjusted OR 0.889, 95% CI 0.599-1.320]. In conclusion, the risk of MCMs did not differ between those prescribed KRR or MgO in the first trimester of pregnancy.
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Affiliation(s)
- Satoko Suzuki
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan
- Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| | - Taku Obara
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Tomofumi Ishikawa
- Laboratory of Clinical Pharmacy, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan
| | - Aoi Noda
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Fumiko Matsuzaki
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Ryutaro Arita
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan
- Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| | - Minoru Ohsawa
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan
- Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
- Department of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Japan
| | - Nariyasu Mano
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
- Laboratory of Clinical Pharmacy, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan
| | - Akiko Kikuchi
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan
- Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| | - Shin Takayama
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan
- Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
- *Correspondence: Shin Takayama,
| | - Tadashi Ishii
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan
- Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
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Evaluations of the in vivo laxative effects of aqueous root extracts of Euclea racemosa L. in mice. Metabol Open 2022; 17:100222. [PMID: 36606022 PMCID: PMC9807816 DOI: 10.1016/j.metop.2022.100222] [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: 11/03/2022] [Revised: 12/08/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Background Management of constipation with currently available modern medicines is costly and chances of side effects are high. This limits their clinical usefulness and remain to be solved, and calls for investigations of new and better compounds. The experimental plant, Euclea racemosa L. (E. racemosa L) is among plants, which are used for management of constipation traditionally but its effect is not yet experimentally validated. Therefore, the aim of the present study is to investigate the laxative effects of this plant. Methods The laxative effects of aqueous root extracts of E. racemosa L. were evaluated using gastrointestinal motility, laxative activity, and gastrointestinal secretion tests. Results In the laxative test, the 200 and 400 mg/kg doses of plant extract showed a significant increase in percent fecal water content. The plant extract also significantly accelerated the charcoal meal in gastrointestinal motility test of loperamide-constipated mice. Moreover, the experimental plant produced significant Gastrointestinal (GI) transit ratio at all doses but failed to produce a significantly higher fluid accumulation except 400 mg/kg doses of extract in gastrointestinal secretion test. The observed effect of the aqueous root extract might be due to the presence of secondary metabolites. The aqueous root extract of E. racemosa L. revealed the presence of terpenes, saponins, flavonoids and phenols when it was subjected to phytochemical screening. Conclusion The investigation obtained from this study suggested that E. racemosa L. has a beneficial effect in producing laxative effect and this substantiate the traditional use of the plant for its claimed indication.
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Ju M, Kim N, Shin CM, Park YS, Yoon H, Choi Y, Lee DH. [A Randomized, Double-blind, Active-controlled Exploratory Clinical Trial for the Evaluation of the Efficacy and Safety of Goodmorning S Granule ® on Constipation]. THE KOREAN JOURNAL OF GASTROENTEROLOGY = TAEHAN SOHWAGI HAKHOE CHI 2022; 80:17-27. [PMID: 35879059 DOI: 10.4166/kjg.2022.025] [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: 02/08/2022] [Revised: 04/06/2022] [Accepted: 04/21/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND/AIMS Constipation is a common gastrointestinal disease that reduces the quality of life and incurs considerable medical expenses. Bisacodyl and sodium docusate are generally used to treat constipation. This study assessed the effectiveness and safety of Goodmorning S Granule® (Hanpoong Pharm. Co., Ltd., Wanju, Korea) in functional constipation by a comparison with bisacodyl. METHODS A 2-week randomized, double-blind, active-controlled exploratory clinical trial was conducted to compare the treatment (Goodmorning S Granule®) with the control (bisacodyl). The efficacy was measured by the changes in transition, Bristol stool type, stomachache, clinical manifestation, defecation time after drug consumption, 36-item short-form survey (SF-36), and the results of improvement evaluation. The safety was evaluated by the incidence of adverse drug events and vital signs. Additional analyses were conducted by dividing the severity according to the proportion of Bristol Stool Scale types 1 and 2. RESULTS Subjects were randomized to the treatment (n=24) or control (n=26) groups. No significant differences were observed in demographics. After 2 weeks from the baseline, the changes in the complete spontaneous bowel movement (CSBM) were higher in the treatment (4.00±2.62) group than in the control group (1.40±2.34) (p<0.05). The treatment group exhibited significant improvement in the score on the SF-36 questionnaire. The clinical side effects, such as stomachache and borborygmus, were reduced in the moderate constipation patients in the treatment group, according to additional analyses. CONCLUSIONS Goodmorning S Granule®, a herbal medicine, was more effective in improving quality of life and CSBM per week and safer in the moderate constipation groups because of the reduced clinical side effects.
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Affiliation(s)
- Munjin Ju
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Nayoung Kim
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Cheol Min Shin
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young Soo Park
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyuk Yoon
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yonghun Choi
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dong Ho Lee
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Imamura T, Hori M, Tanaka S, Kinugawa K. Successful management of refractory constipation using Kampo medicine Mashiningan in a patient with wild-type ATTR cardiac amyloidosis. J Cardiol Cases 2022; 25:34-36. [PMID: 35024066 DOI: 10.1016/j.jccase.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 10/20/2022] Open
Abstract
A wild-type ATTR amyloidosis is a systemic disease with multi-organ dysfunction, involving heart, kidney, skin, and gastrointestinal tract, due to deposition of wild-type transthyretin in each organ. We had a 76-year-old man diagnosed with wild-type ATTR cardiac amyloidosis, whose heart failure symptom improved by anti-heart failure medications but constipation refractory to multiple conventional medications persisted. Following the conversion from lubiprostone to Kampo medicine mashiningan, his average days per one evacuation decreased from around 7.0 days down to 1.6 days. Mashininigan might be an alternative option to improve refractory constipation in patients with cardiac amyloidosis. <Learning objective: Mashininigan might be an alternative option to improve refractory constipation in patients with cardiac amyloidosis.>.
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Affiliation(s)
- Teruhiko Imamura
- The Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan
| | - Masakazu Hori
- The Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan
| | - Shuhei Tanaka
- The Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan
| | - Koichiro Kinugawa
- The Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan
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Yamamoto S, Kawamura Y, Yamamoto K, Yamaguchi Y, Tamura Y, Izawa S, Nakagawa H, Wakita Y, Hijikata Y, Ebi M, Funaki Y, Ohashi W, Ogasawara N, Sasaki M, Maekawa M, Kasugai K. Internet Survey of Japanese Patients With Chronic Constipation: Focus on Correlations Between Sleep Quality, Symptom Severity, and Quality of Life. J Neurogastroenterol Motil 2021; 27:602-611. [PMID: 34642281 PMCID: PMC8521473 DOI: 10.5056/jnm20135] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/14/2020] [Accepted: 02/18/2021] [Indexed: 12/13/2022] Open
Abstract
Background/Aims Chronic constipation and lifestyle factors can affect sleep quality. We evaluated the relationship between chronic constipation and sleep in the Japanese population. Methods This cross-sectional internet-based survey included 3000 subjects with constipation, classified according to sleep status (good/poor). Primary endpoints were Bristol stool form scale (BSFS) score and correlations between sleep disorder criteria of the Pittsburgh Sleep Quality Index (PSQI) and sleep status (good/poor sleep). Secondary endpoints included correlations between quality of life (QOL) and mood, medical, lifestyle, and sleep factors. Results The proportion of participants with BSFS category 4 (normal stool) was significantly higher in the good sleep group (P < 0.001). Sleep disturbance (P < 0.05), sleep quality, and duration, use of hypnotic medication, and daytime dysfunction of PSQI (all P < 0.001) significantly correlated with poor sleep. In the poor sleep group, QOL was significantly worse and anxiety and depression levels were significantly higher (all P < 0.001) compared with the good sleep group. Anemia and smoking (both P < 0.05), recent body weight increases, and poor eating habits (all P < 0.001) were significantly higher in the poor sleep group. Male sex, onset associated with change in frequency of stools, sensation of incomplete evacuation for at least 25% of defecations, and manual maneuvers to facilitate at least 25% of defecations correlated with poor sleep. Conclusions Subjects with constipation and poor sleep experienced severe symptoms and had poor QOL. These data support the need for a multifocal treatment approach, including lifestyle advice and pharmacotherapy.
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Affiliation(s)
- Sayuri Yamamoto
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Yurika Kawamura
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Kazuhiro Yamamoto
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Yoshiharu Yamaguchi
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Yasuhiro Tamura
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Shinya Izawa
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Hiroaki Nakagawa
- Division of General Medicine, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Yoshinori Wakita
- Division of General Medicine, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Yasutaka Hijikata
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Masahide Ebi
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Yasushi Funaki
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Wataru Ohashi
- Division of Biostatistics, Clinical Research Center, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Naotaka Ogasawara
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Makoto Sasaki
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Masato Maekawa
- Division of General Medicine, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Kunio Kasugai
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
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Katsumata R, Manabe N, Fujita M, Ayaki M, Sunago A, Kamada T, Monobe Y, Kawamoto H, Haruma K. Colorectal neoplasms in melanosis coli: a survey in Japan and a worldwide meta-analysis. Int J Colorectal Dis 2021; 36:2177-2188. [PMID: 34156546 DOI: 10.1007/s00384-021-03970-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/30/2021] [Indexed: 02/04/2023]
Abstract
PURPOSE The association between melanosis coli (MC) and colorectal neoplasms remains unclear. Thus, we primarily aimed to clarify the epidemiology of MC in the Japanese population, identify the relationship between the use of anthranoids and MC, and determine the prevalence of detected intestinal lesions in patients with MC. We subsequently conducted a meta-analysis of published data, including our results, to summarize the influence of MC on the prevalence of colonic neoplasms. METHODS We conducted a retrospective survey in Japan to investigate the effects of MC on intestinal disorders. The prevalence of colorectal neoplasms and ileal ulcers was evaluated by colonoscopy, and the clinical characteristics of the participants were investigated using an electronic database. Odds ratios for colorectal neoplasms were calculated. We also performed a meta-analysis using Review Manager to reveal the comprehensive relationship between MC and colorectal neoplasms. RESULTS We enrolled 690 Japanese participants in the primary study. The prevalence of regular anthranoid use was significantly higher in the MC group than in the control group (50.9% vs. 6.5%, p < 0.01). Hyperplastic/inflammatory polyps and adenomas were more frequently detected in the MC group than in the control group. In a meta-analysis of five studies, a significantly higher prevalence of hyperplastic/inflammatory polyps and adenomas was reported in the MC group than in the control group, while the incidence of adenocarcinoma was not significantly different between the two groups. CONCLUSION Although hyperplastic polyps and adenomas were more frequently detected in MC patients, MC was not associated with an elevated risk of colorectal cancer.
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Affiliation(s)
- Ryo Katsumata
- Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange Kita-ku, Okayama City, Okayama, 7008505, Japan
| | - Noriaki Manabe
- Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange Kita-ku, Okayama City, Okayama, 7008505, Japan.
| | - Minoru Fujita
- Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange Kita-ku, Okayama City, Okayama, 7008505, Japan
| | - Maki Ayaki
- Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange Kita-ku, Okayama City, Okayama, 7008505, Japan
| | - Aya Sunago
- Department of Health Care Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Tomoari Kamada
- Department of Health Care Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Yasumasa Monobe
- Department of Pathology, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Hirofumi Kawamoto
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Ken Haruma
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan
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Abstract
OBJECTIVES Although the endogenous cannabinoid system modulates bowel function, our understanding of the impact of recreational marijuana (MJ) use on bowel motility is limited. This study examines the effect of MJ on self-reported bowel function among a large cohort of US adults. METHODS We identified adults (age: 20-59 years) who completed both the drug use and bowel health questionnaires in the National Health and Nutrition Examination Survey over a 6-year period from 2005 to 2010 (n = 9,645). Constipation and diarrhea were defined according to stool form (Bristol Stool Form Scale) and/or frequency criteria. Adjusted odds ratios (AORs) for likelihood of constipation or diarrhea were estimated in a multinomial logistic model according to MJ use status. RESULTS Overall, constipation prevalence was lower among those with recent MJ use compared with those with past/never use (7.5% vs 10.2%, P = 0.03). Recent MJ use was associated with a 30% decreased odds of constipation (crude odds ratio: 0.71 [0.56-0.98], P = 0.005), which persisted after stepwise adjustment for age and other demographic factors including sex, ethnicity, education, body mass index, and socioeconomic status (AOR: 0.64 [0.49-0.83], P = 0.001); comorbidities, substance use (alcohol, tobacco, heroin, and cocaine), constipating medications, general health condition, rigorous physical activity, and emotional disturbances (AOR: 0.68 [0.48-0.93], P = 0.016); and diet (AOR: 0.68 [0.52-0.89], P = 0.006). There was no association between recent MJ use and diarrhea. DISCUSSION In a nationally representative sample of community-dwelling US adults, recent MJ use was associated with decreased odds of constipation, counter to the known physiologic effects of cannabinoids on colonic motility.
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Ishiyama Y, Hoshide S, Mizuno H, Kario K. Constipation-induced pressor effects as triggers for cardiovascular events. J Clin Hypertens (Greenwich) 2019; 21:421-425. [PMID: 30761728 DOI: 10.1111/jch.13489] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 12/02/2018] [Accepted: 12/24/2018] [Indexed: 12/16/2022]
Abstract
Constipation is associated with cardiovascular events. Changes to the intestinal microbiota by constipation can induce atherosclerosis, blood pressure rise, and cardiovascular events. Constipation increases with age and often coexists with cardiovascular risk factors. In addition, strain at stool causes blood pressure rise, which can trigger cardiovascular events such as congestive heart failure, arrhythmia, acute coronary disease, and aortic dissection. However, because cardiovascular medical research often focuses on more dramatic interventions, the risk from constipation can be overlooked. Physicians caring for patients with cardiovascular disease should acknowledge constipation and straining with it as important cardiovascular risk, and prematurely intervene to prevent it. The authors review and discuss the relationship between constipation and cardiovascular disease.
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Affiliation(s)
- Yusuke Ishiyama
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Hiroyuki Mizuno
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan
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Efficacy and Safety of Daikenchuto for Constipation and Dose-Dependent Differences in Clinical Effects. Int J Chronic Dis 2018; 2018:1296717. [PMID: 29693001 PMCID: PMC5859840 DOI: 10.1155/2018/1296717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 01/23/2018] [Accepted: 01/31/2018] [Indexed: 12/20/2022] Open
Abstract
Background Daikenchuto (DKT) is a Kampo medicine used for the treatment of constipation. In this study, we evaluated the effectiveness of DKT against constipation. Patients and Methods Thirty-three patients administered DKT for constipation were selected and divided into low-dose (7.5 g DKT; n = 22) and high-dose (15 g DKT; n = 11) groups. We retrospectively evaluated weekly defaecation frequency, side effects, and clinical laboratory data. Results Median defaecation frequencies after DKT administration (5, 5.5, 5, and 8 for the first, second, third, and fourth weeks, resp.) were significantly higher than that before DKT administration (2) in all 33 cases (P < 0.01). One case (3%) of watery stool, one case of loose stools (3%), and no cases of abdominal pain (0%) were observed. Median defaecation frequencies in the high-dose group (7 and 9) were significantly higher than those in the low-dose group (4 and 3) in the first (P = 0.0133) and second (P = 0.0101) weeks, respectively. There was no significant change in clinical laboratory values. Conclusion We suggest that DKT increases defaecation frequency and is safe for treating constipation.
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Numata T, Sato-Numata K, Okada Y, Inoue R. Cellular mechanism for herbal medicine Junchoto to facilitate intestinal Cl -/water secretion that involves cAMP-dependent activation of CFTR. J Nat Med 2018; 72:694-705. [PMID: 29569221 PMCID: PMC5960480 DOI: 10.1007/s11418-018-1207-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 03/16/2018] [Indexed: 12/17/2022]
Abstract
Constipation is a common symptom frequently compromising the quality of daily life. Several mechanistically different drugs have been used to mitigate constipation, including Japanese herbal (Kampo) medicines. However, the mechanisms of their actions are often not well understood. Here we aimed to investigate the molecular mechanisms underlying the effects of Junchoto (JCT), a Kampo medicine empirically prescribed for chronic constipation. Cl− channel activity was measured by the patch-clamp method in human cystic fibrosis transmembrane conductance regulator (CFTR)-expressing HEK293T cells and human intestinal Caco-2 cells. cAMP was measured by a luciferase-based assay. Cell volume change was measured by a particle-sizing and particle-counting analyzer and video-microscopic measurement. In both CFTR-expressing HEK293T and Caco-2 cells, JCT dose-dependently induced whole-cell currents showing typical biophysical and pharmacological features of CFTR. Robust expression of CFTR was confirmed by RT-PCR and Western blotting in Caco-2 cells. Luciferase-based measurement revealed that JCT increases intracellular cAMP levels. Administration of the adenylate cyclase inhibitor SQ22536 or CFTR inhibitor-172, or treatment with small interfering RNAs (siRNA) targeting CFTR, abolished JCT-induced whole-cell currents, suggesting that elevated intracellular cAMP by JCT causes activation of CFTR in Caco-2 cells. Finally, blockade of CFTR activity by CFTR inhibitor-172 or siRNA-knockdown of CFTR or application of SQ22536 markedly reduced the degree of cell volume decrease induced by JCT. JCT can induce a Cl− efflux through the CFTR channel to promote water secretion, and this effect is likely mediated by increased cAMP production.
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Affiliation(s)
- Tomohiro Numata
- Department of Physiology, Graduate School of Medical Sciences, Fukuoka University, 7-45-1 Nanakuma, Johnan-ku, Fukuoka, 814-0180, Japan.
| | - Kaori Sato-Numata
- Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
| | - Yasunobu Okada
- Department of Molecular Cell Physiology Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Ryuji Inoue
- Department of Physiology, Graduate School of Medical Sciences, Fukuoka University, 7-45-1 Nanakuma, Johnan-ku, Fukuoka, 814-0180, Japan.
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Kuchnia AJ, Conlon B, Greenberg N. Natural Bioactive Food Components for Improving Enteral Tube Feeding Tolerance in Adult Patient Populations. Nutr Clin Pract 2018; 33:107-120. [PMID: 28820648 DOI: 10.1177/0884533617722164] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2023] Open
Abstract
Tube feeding (TF) is the most common form of nutrition support. In recent years, TF administration has increased among patient populations within and outside hospital settings, in part due to greater insurance coverage, reduced use of parenteral nutrition, and improved formularies suitable for sole source nutrition. With increasing life expectancy and improved access to TFs, the number of adults dependent on enteral nutrition is expected to grow. However, enteral TF intolerance (ETFI) is the most common complication of TFs, typically presenting with at least 1 adverse gastrointestinal event, including nausea, diarrhea, and constipation. ETFI often leads to reductions in TF volume with associated energy and protein deficits. Potentially ensuing malnutrition is a major public health concern due its effects on increased risk of morbidity and mortality, infections, prolonged hospital length of stay, and higher healthcare costs. As such, there is a need for intervention strategies to prevent and reduce ETFI. Incorporating whole foods with bioactive properties is a promising strategy. Emerging research has elucidated bioactive properties of whole foods with specific benefits for the prevention and management of adverse gastrointestinal events commonly associated with TFs. However, lack of evidence-based recommendations and technological challenges have limited the use of such foods in commercial TF formulas. This review addresses research gaps by discussing 5 whole foods (rhubarb, banana, curcumin, peppermint oil, and ginger) with bioactive attributes identified through literature searches and clinical experience as having substantial scientific rationale to consider their application for ETFI in adult populations.
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Affiliation(s)
- Adam J Kuchnia
- Department of Food Science and Nutrition, University of Minnesota-Twin Cities, Saint Paul, Minnesota, USA
| | - Beth Conlon
- Nestlé Nutrition R&D Centers Inc, Bridgewater, New Jersey, USA
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Harada Y, Iizuka S, Saegusa Y, Mogami S, Fujitsuka N, Hattori T. Mashiningan Improves Opioid-Induced Constipation in Rats by Activating Cystic Fibrosis Transmembrane Conductance Regulator Chloride Channel. J Pharmacol Exp Ther 2017; 362:78-84. [PMID: 28465373 DOI: 10.1124/jpet.117.240630] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 04/21/2017] [Indexed: 12/18/2022] Open
Abstract
Opioid receptor stimulants are analgesics used in patients with and without cancer; however, they often cause constipation, resulting in poor adherence and deterioration of the quality of life. Hence, suitable treatments for constipation are required. In this study, we investigated the pharmacological mechanisms of action of mashiningan (MNG), a Kampo medicine used to treat constipation, and evaluated the effect of MNG on opioid-induced constipation in rats. MNG (100 or 300 mg/kg) was orally administered to normal or codeine phosphate (CPH)-induced constipation in rats, and its effect was evaluated on the basis of fecal counts, characteristics, and weight. Small intestinal fluid secretion was measured after treatment with MNG alone or coadministration with a cystic fibrosis transmembrane conductance regulator (CFTR)-specific inhibitor (CFTRinh-172). The effects of MNG on the CFTR and type-2 chloride channel were determined using patch-clamp or short-circuit current experiments, respectively. MNG increased the fecal weight and proportion of soft feces in normal rats. CPH-induced constipation in rats decreased fecal counts and weight, whereas MNG prevented these effects and increased the proportion of soft feces. MNG increased the electronic chloride current, and this effect was inhibited by the CFTRinh-172 in the CFTR assay. Furthermore, MNG increased small intestinal fluid secretion, and this effect was abolished by coadministration with the CFTRinh-172. MNG improved opioid-induced constipation in rats, and this improvement may have been mediated by increasing intestinal fluid secretion via CFTR chloride channel activation. Therefore, MNG is expected as a medicine of the treatment of constipation in patients taking opioids.
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Affiliation(s)
- Yumi Harada
- Tsumura Kampo Research Laboratories, Tsumura & Co., Ibaraki, Japan (Y.H., S.I., Y.S., S.M., N.F., T.H.)
| | - Seiichi Iizuka
- Tsumura Kampo Research Laboratories, Tsumura & Co., Ibaraki, Japan (Y.H., S.I., Y.S., S.M., N.F., T.H.)
| | - Yayoi Saegusa
- Tsumura Kampo Research Laboratories, Tsumura & Co., Ibaraki, Japan (Y.H., S.I., Y.S., S.M., N.F., T.H.)
| | - Sachiko Mogami
- Tsumura Kampo Research Laboratories, Tsumura & Co., Ibaraki, Japan (Y.H., S.I., Y.S., S.M., N.F., T.H.)
| | - Naoki Fujitsuka
- Tsumura Kampo Research Laboratories, Tsumura & Co., Ibaraki, Japan (Y.H., S.I., Y.S., S.M., N.F., T.H.)
| | - Tomohisa Hattori
- Tsumura Kampo Research Laboratories, Tsumura & Co., Ibaraki, Japan (Y.H., S.I., Y.S., S.M., N.F., T.H.)
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Kim H, Kim HJ, Yang D, Jung MH, Kim BJ. Depolarizing Effects of Daikenchuto on Interstitial Cells of Cajal from Mouse Small Intestine. Pharmacogn Mag 2017; 13:141-147. [PMID: 28216898 PMCID: PMC5307899 DOI: 10.4103/0973-1296.196312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Daikenchuto (DKT; TJ-100, TU-100), a traditional herbal medicineis used in modern medicine to treat gastrointestinal (GI) functional disorders. Interstitial cells of Cajal (ICCs) are the pacemaker cells of the GI tract and play important roles in the regulation of GI motility. Objective: The objective of this study was to investigate the effects of DKT on the pacemaker potentials (PPs) of cultured ICCs from murine small intestine. Materials and Methods: Enzymatic digestions were used to dissociate ICCs from mouse small intestine tissues. All experiments on ICCs were performed after 12 h of culture. The whole-cell patch-clamp configuration was used to record ICC PPs (current clamp mode). All experiments were performed at 30-32°C. Results: In current-clamp modeDKT depolarized and concentration-dependently decreased the amplitudes of PPs. Y25130 (a 5-HT3 receptor antagonist) or SB269970 (a 5-HT7 receptor antagonist) did not block DKT-induced PP depolarization, but RS39604 (a 5-HT4 receptor antagonist) did. Methoctramine (a muscarinic M2 receptor antagonist) failed to block DKT-induced PP depolarization, but pretreating 4-diphenylacetoxy-N-methylpiperidine methiodide (a muscarinic M3 receptor antagonist) facilitated blockade of DKT-induced PP depolarization. Pretreatment with an external Ca2+-free solution or thapsigargin abolished PPsand under these conditions, DKT did not induce PP depolarization. Furthermore Ginseng radix and Zingiberis rhizomes depolarized PPs, whereas Zanthoxyli fructus fruit (the third component of DKT) hyperpolarized PPs. Conclusion: These results suggest that DKT depolarizes ICC PPs in an internal or external Ca2+-dependent manner by stimulating 5-HT4 and M3 receptors. Furthermore, the authors suspect that the component in DKT largely responsible for depolarization is probably also a component of Ginseng radix and Zingiberis rhizomes. SUMMARY Daikenchuto (DKT) depolarized and concentration-dependently decreased the amplitudes of pacemaker potentials (PPs) Y25130 (a 5-HT3 receptor antagonist) or SB269970 (a 5-HT7 receptor antagonist) did not block DKT-induced PP depolarization, but RS39604 (a 5-HT4 receptor antagonist) did Methoctramine (a muscarinic M2 receptor antagonist) failed to block DKT-induced PP depolarization, but pretreating 4-DAMP (a muscarinic M3 receptor antagonist) facilitated blockade of DKT-induced PP depolarization Ginseng radix and Zingiberis rhizomes depolarized PPswhereas Zanthoxyli fructus fruit (the third component of DKT) hyperpolarized PPs.
Abbreviation used: DKT: Daikenchuto, GI: Gastrointestinal, ICCs: Interstitial cells of Cajal, PPs: Pacemaker Potentials.
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Affiliation(s)
- Hyungwoo Kim
- Division of Pharmacology, School of Korean Medicine, Pusan National University, Yangsan, Gyeongsangnam-do 50612, Republic of Korea
| | - Hyun Jung Kim
- Division of Longevity and Biofunctional Medicine and Healthy Aging Korean Medical Research Center, School of Korean Medicine, Pusan National University, Yangsan, Gyeongsangnam-do 50612, Republic of Korea
| | - Dongki Yang
- Department of Physiology, College of Medicine, Gachon University, Incheon, Republic of Korea
| | - Myeong Ho Jung
- Division of Longevity and Biofunctional Medicine and Healthy Aging Korean Medical Research Center, School of Korean Medicine, Pusan National University, Yangsan, Gyeongsangnam-do 50612, Republic of Korea
| | - Byung Joo Kim
- Division of Longevity and Biofunctional Medicine and Healthy Aging Korean Medical Research Center, School of Korean Medicine, Pusan National University, Yangsan, Gyeongsangnam-do 50612, Republic of Korea
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Web-Based Evaluation System to Measure Learning Effectiveness in Kampo Medicine. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:2043535. [PMID: 27738440 PMCID: PMC5055925 DOI: 10.1155/2016/2043535] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 08/29/2016] [Indexed: 11/17/2022]
Abstract
Measuring the learning effectiveness of Kampo Medicine (KM) education is challenging. The aim of this study was to develop a web-based test to measure the learning effectiveness of KM education among medical students (MSs). We used an open-source Moodle platform to test 30 multiple-choice questions classified into 8-type fields (eight basic concepts of KM) including "qi-blood-fluid" and "five-element" theories, on 117 fourth-year MSs. The mean (±standard deviation [SD]) score on the web-based test was 30.2 ± 11.9 (/100). The correct answer rate ranged from 17% to 36%. A pattern-based portfolio enabled these rates to be individualized in terms of KM proficiency. MSs with scores higher (n = 19) or lower (n = 14) than mean ± 1SD were defined as high or low achievers, respectively. Cluster analysis using the correct answer rates for the 8-type field questions revealed clear divisions between high and low achievers. Interestingly, each high achiever had a different proficiency pattern. In contrast, three major clusters were evident among low achievers, all of whom responded with a low percentage of or no correct answers. In addition, a combination of three questions accurately classified high and low achievers. These findings suggest that our web-based test allows individual quantitative assessment of the learning effectiveness of KM education among MSs.
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Lee SI, Bae JA, Ko YS, Lee KI, Kim H, Kim KK. Geijigajakyak decoction inhibits the motility and tumorigenesis of colorectal cancer cells. Altern Ther Health Med 2016; 16:288. [PMID: 27527352 PMCID: PMC4986256 DOI: 10.1186/s12906-016-1281-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 08/11/2016] [Indexed: 12/29/2022]
Abstract
Background Recent studies report that inflammatory diseases of the large intestine are associated with colorectal cancer. Geijigajakyak Decoction (GJD) has antispasmodic and anti-inflammatory effects on the gastrointestinal tract. Thus, in light of the connection between chronic bowel inflammation and colorectal cancer (CRC), we asked whether GJD inhibits colorectal tumorigenesis. Methods The effects of GJD on the viability and proliferation of CRC cells were evaluated using MTT and BrdU assays, respectively. The motility of CRC cells was examined by a Transwell migration/invasion assay and immunoblot analysis was used to examine the signaling pathways associated with migration. A syngeneic Balb/c mice allograft model, in which CT26 cells were injected into the dorsum, was used to evaluate the anti-tumor effects of GJD in vivo. Results GJD had no cytotoxic effects against HCT116 CRC cells, although it did inhibit their proliferation. GJD inhibited the migration of HCT116 cells, and suppressed the invasion of HCT116, Caco2, and CSC221 CRC cells. In addition, GJD downregulated the expression of p-JNK and p-p38 MAPK, which are downstream signaling molecules associated with invasiveness. Furthermore, oral administration of GJD (333 mg/kg, twice a day) inhibited tumor growth in a mouse xenograft model. Conclusions GJD inhibited the motility of human CRC cells and suppressed tumorigenesis in a mouse model. These results suggest that GJD warrants further study as a potential adjuvant anti-cancer therapy. Electronic supplementary material The online version of this article (doi:10.1186/s12906-016-1281-z) contains supplementary material, which is available to authorized users.
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Yu CP, Lin HJ, Lin SP, Shia CS, Chang PH, Hou YC, Hsieh YW. Rhubarb decreased the systemic exposure of cyclosporine, a probe substrate of P-glycoprotein and CYP 3A. Xenobiotica 2015; 46:677-82. [PMID: 26634287 DOI: 10.3109/00498254.2015.1117159] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
1. Rhubarb, rhizome of Rheum palmatum L. (RP), is an important herb in clinical Chinese medicine. 2. Cyclosporine (CSP) is an immunosuppressant with narrow therapeutic window. The oral bioavailability of CSP was associated with P-glycoprotein (P-gp) and CYP 3A4. CSP was used as a probe substrate to investigate the in vivo modulation effects of RP on P-gp and CYP 3A. 3. Rats were orally administered 2.5 mg/kg of CSP with and without 0.25 and 1.0 g/kg of RP. The blood CSP concentration was determined by a specific monoclonal fluorescence polarization immunoassay. 4. Both dosages of RP significantly decreased the Cmax and AUC0-t of CSP in rats. Mechanism studies indicated that RP activated the functions of P-gp and CYP 3A. 5. RP ingestion reduced the systemic exposure of CSP through activating P-gp and CYP 3A.
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Affiliation(s)
- Chung-Ping Yu
- a School of Chinese Medicine, China Medical University , Taichung , Taiwan, R.O.C.
| | - Hui-Ju Lin
- a School of Chinese Medicine, China Medical University , Taichung , Taiwan, R.O.C. .,b Department of Ophthalmology , China Medical University Hospital , Taichung , Taiwan, R.O.C.
| | - Shiuan-Pey Lin
- c School of Pharmacy, China Medical University , Taichung , Taiwan, R.O.C.
| | - Chi-Sheng Shia
- c School of Pharmacy, China Medical University , Taichung , Taiwan, R.O.C.
| | - Pei-Hua Chang
- d Graduate Institute of Pharmaceutical Chemistry, China Medical University , Taichung , Taiwan, R.O.C. , and
| | - Yu-Chi Hou
- c School of Pharmacy, China Medical University , Taichung , Taiwan, R.O.C. .,e Department of Pharmacy , China Medical University Hospital , Taichung , Taiwan, R.O.C
| | - Yo-Wen Hsieh
- c School of Pharmacy, China Medical University , Taichung , Taiwan, R.O.C. .,e Department of Pharmacy , China Medical University Hospital , Taichung , Taiwan, R.O.C
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Kono T, Shimada M, Yamamoto M, Kaneko A, Oomiya Y, Kubota K, Kase Y, Lee K, Uezono Y. Complementary and synergistic therapeutic effects of compounds found in Kampo medicine: analysis of daikenchuto. Front Pharmacol 2015; 6:159. [PMID: 26300774 PMCID: PMC4523940 DOI: 10.3389/fphar.2015.00159] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 07/17/2015] [Indexed: 01/17/2023] Open
Abstract
Herbal medicines have been used in Japan for more than 1500 years and traditional Japanese medicines (Kampo medicines) are now fully integrated into the modern healthcare system. In total, 148 Kampo formulae are officially approved as prescription drugs and covered by the national health insurance system in Japan. However, despite their long track record of clinical use, the multi-targeted, multi-component properties of Kampo medicines, which are fundamentally different from Western medicines, have made it difficult to create a suitable framework for conducting well-designed, large-scale clinical trials. In turn, this has led to misconceptions among western trained physicians concerning the paucity of scientific evidence for the beneficial effects of Kampo medicines. Fortunately, there has been a recent surge in scientifically robust data from basic and clinical studies for some of the Kampo medicines, e.g., daikenchuto (TU-100). Numerous basic and clinical studies on TU-100, including placebo-controlled double-blind studies for various gastrointestinal disorders, and absorption, distribution, metabolism and excretion (ADME) studies, have been conducted or are in the process of being conducted in both Japan and the USA. Clinical studies suggest that TU-100 is beneficial for postoperative complications, especially ileus and abdominal bloating. ADME and basic studies indicate that the effect of TU-100 is a composite of numerous actions mediated by multiple compounds supplied via multiple routes. In addition to known mechanisms of action via enteric/sensory nerve stimulation, novel mechanisms via the TRPA1 channel and two pore domain potassium channels have recently been elucidated. TU-100 compounds target these channels with and without absorption, both before and after metabolic activation by enteric flora, with different timings and possibly with synergism.
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Affiliation(s)
- Toru Kono
- Center for Clinical and Biomedical Research, Sapporo Higashi Tokushukai Hospital Sapporo, Hokkaido, Japan ; Pathophysiology and Therapeutics, Faculty of Pharmaceutical Sciences, Hokkaido University Sapporo, Japan ; Department of Surgery, Institute of Health Biosciences, Graduate School of Medicine, Tokushima University Tokushima, Japan
| | - Mitsuo Shimada
- Department of Surgery, Institute of Health Biosciences, Graduate School of Medicine, Tokushima University Tokushima, Japan
| | - Masahiro Yamamoto
- Kampo Scientific Strategies Division, Tsumura Research Laboratories, Tsumura & CO. Ami, Japan
| | - Atushi Kaneko
- Kampo Scientific Strategies Division, Tsumura Research Laboratories, Tsumura & CO. Ami, Japan
| | - Yuji Oomiya
- Kampo Scientific Strategies Division, Tsumura Research Laboratories, Tsumura & CO. Ami, Japan
| | - Kunitsugu Kubota
- Kampo Scientific Strategies Division, Tsumura Research Laboratories, Tsumura & CO. Ami, Japan
| | - Yoshio Kase
- Kampo Scientific Strategies Division, Tsumura Research Laboratories, Tsumura & CO. Ami, Japan
| | - Keiko Lee
- Kampo Scientific Strategies Division, International Pharmaceutical Development Department, Tsumura & CO. Tokyo, Japan
| | - Yasuhito Uezono
- Division of Cancer Pathophysiology, National Cancer Center Research Institute Tokyo, Japan
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