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Frontiers in Pharmacology 2022Constipation is a common syndrome and a worldwide healthy problem. Constipation patients are becoming younger, with a 29.6% overall prevalence in children, which has...
Constipation is a common syndrome and a worldwide healthy problem. Constipation patients are becoming younger, with a 29.6% overall prevalence in children, which has captured significant attention because of its epigenetic rejuvenation and recurrent episodes. Despite the usage of rhubarb extract to relieve constipation, novel targets and genes implicated in target-relevant pathways with remarkable functionalities should still be sought for. We established a reliable constipation model in C57B/6N male mice using intragastric administration diphenoxylate, and the eligible subjects received 600 mg/25 g rhubarb extract to alleviate constipation. Resultant constipation was morphological and genetically compared with the specimen from different groups. Constipation mice exhibited thicker muscle layers, higher levels of cytokines, including IL-17 and IL-23, and lower content of IL-22. Bacterial abundance and diversity varied tremendously. Notably, the alterations were reversed following rhubarb extract treatment. Additionally, Constipation also had a substantial impact on short-chain fatty acids (SCFAs), medium- and long-chain fatty acids (MLCFAs), and the expression of SCFA receptors, GPR41 and GPR43. This thesis has provided insight that rhubarb extract promoted the flexibility of collagen fiber, reduced pro-inflammatory cytokines, enhanced anti-inflammatory cytokines, and maintained gut microflora balance with potential impacts on the fatty acid and polyamine metabolism.
PubMed: 36545319
DOI: 10.3389/fphar.2022.1048134 -
The Oncologist Aug 2019Patients with neuroendocrine tumors (NETs) and carcinoid syndrome experience considerable morbidity and mortality; carcinoid syndrome may be associated with shorter...
BACKGROUND
Patients with neuroendocrine tumors (NETs) and carcinoid syndrome experience considerable morbidity and mortality; carcinoid syndrome may be associated with shorter survival. Carcinoid syndrome is linked to tumoral secretion of serotonin and other bioactive substances. The subsequent debilitating diarrhea and urgency to defecate pose significant health risks. In previous studies, telotristat ethyl, a tryptophan hydroxylase inhibitor, was effective and well tolerated in treating carcinoid syndrome diarrhea. We present pooled safety data from five clinical trials with telotristat ethyl in patients with carcinoid syndrome.
SUBJECTS, MATERIALS, AND METHODS
Adverse events reported during telotristat ethyl treatment were pooled from two phase II and three phase III clinical trials in 239 patients with carcinoid syndrome. Long-term safety of telotristat ethyl and causes of hospitalization and death were reviewed; overall survival was estimated.
RESULTS
Mean (median; range) duration of exposure and follow-up was 1.3 years (1.1 years; 1 week to 5.7 years), with 309 total patient-years of exposure. Leading causes of hospitalization were gastrointestinal disorders or were related to the underlying tumor and related treatment. Survival estimates at 1, 2, and 3 years were 93%, 88%, and 77%. Nearly all deaths were due to progression or complication of the underlying disease; none were attributable to telotristat ethyl. There was one death in year 4.
CONCLUSION
Based on long-term safety data, telotristat ethyl is well tolerated and has a favorable long-term safety profile in patients with carcinoid syndrome.
IMPLICATIONS FOR PRACTICE
Carcinoid syndrome can cause persistent diarrhea, even in patients treated with somatostatin analogs. Across five clinical trials in patients with carcinoid syndrome, telotristat ethyl has been well tolerated and efficacious, providing clinicians with a new approach to help control carcinoid syndrome diarrhea, in addition to somatostatin analog therapy. By reducing the stool frequency in patients with carcinoid syndrome whose diarrhea is refractory to anticholinergics, such as loperamide and atropine/diphenoxylate, and somatostatin analog dose escalation, improvement in quality of life becomes an achievable goal.
Topics: Adult; Aged; Aged, 80 and over; Antineoplastic Agents; Clinical Trials, Phase II as Topic; Clinical Trials, Phase III as Topic; Diarrhea; Female; Humans; Male; Malignant Carcinoid Syndrome; Middle Aged; Patient Safety; Phenylalanine; Pyrimidines; Randomized Controlled Trials as Topic; Retrospective Studies; Treatment Outcome
PubMed: 30651397
DOI: 10.1634/theoncologist.2018-0236 -
Frontiers in Pharmacology 2021Poisoning is a type of accidental injury and it is considered a major public health problem worldwide. Oral drug poisoning in children is an important cause of...
Poisoning is a type of accidental injury and it is considered a major public health problem worldwide. Oral drug poisoning in children is an important cause of accidental injury and even death. It is a common critical emergency in the field of pediatrics. Once a child unintentionally takes an overdose, regardless of whether it caused poisoning or not, they should be admitted to the hospital for emergency treatment. Acute poisoning in children most frequently occurs through the digestive tract. Drug poisoning can happen in children of all ages. In children younger than 1 year, drug poisoning is mostly caused by the parents during feeding, while in children aged 1-3 years, it predominantly occurs as a result of an accident. A case of diagnosis and treatment of a child with diphenoxylate-atropine poisoning is reported herein. The early manifestation of this child was acute toxic encephalopathy with clinical manifestations of a coma, convulsions, and respiratory depression. A brain MRI showed extensive damage to the bilateral caudate nucleus, lenticular nucleus, parietal lobe, precuneus lobe, and occipital lobe. Accidental administration of a large dose of diphenoxylate results in severe clinical symptoms and can cause obvious diffuse brain damage.
PubMed: 33912057
DOI: 10.3389/fphar.2021.646530 -
Zhen Ci Yan Jiu = Acupuncture Research Feb 2022To observe the effect of electroacupuncture (EA) of "Tianshu"(ST25) and "Dachangshu"(BL25) on the intestinal transit function, expression level of glial cell-derived...
OBJECTIVE
To observe the effect of electroacupuncture (EA) of "Tianshu"(ST25) and "Dachangshu"(BL25) on the intestinal transit function, expression level of glial cell-derived neurotrophic factor (GDNF) and methylation level of GDNF gene promoter region in colon tissue of rats with slow transit constipation (STC), so as to explore its mechanisms underlying improvement of STC.
METHODS
Male Sprague-Dawley (SD) rats were randomized into control, saline, model and EA groups (=16 in each group). The STC model was replicated by gavage of compound diphenoxylate suspension (10 mL· kg· d) for 28 days. Rats of the saline group received the same dose of normal saline via gavage. EA (2 Hz/15 Hz, 0.1-1 mA) was applied to bila-teral ST25 and BL25 for 15 min, once daily for 14 days. The intestinal transmission function (the intestinal propulsion rate) was assessed by recording the first black grain stool discharge time and the number and weight of the discharged stool grains in 30 min after gavage of the activated carbon suspension (1 mL/100 g, 150 g/L). The score of fecal trait and the weight of stool within 24 h were recorded. The ultrastructural changes of Cajal interstitial cells in the colon tissue were observed by transmission electron microscope. The expression levels of GDNF protein and mRNA in the colon tissue were detected by using Western blot and real-time fluorescent quantitative PCR, separately, and changes of methylation level in the promoter region of GDNF gene detected by using Bisulfite sequencing method.
RESULTS
Compared with the control group, the time of the 1 black stool grain discharging was obviously prolonged, and the number and weight of the discharged black stool grains were significantly decreased in the mo-del group (<0.05), suggesting a success of STC. The weight and trait score of stool in 24 h, intestinal propulsive rate, and the expression levels of GDNF protein and mRNA were significantly lower in the model group than in the control group (<0.01, <0.05). After EA, the weight and trait score of stool within 24 h, intestinal propulsive rate,and the expression levels of GDNF protein and mRNA were significantly increased in the EA group in contrast to the model group (<0.01,<0.05). The total CpGs methylation level of GDNF gene in colon tissue was considerably higher in the model group than in the control group (<0.05), and markedly lower in the EA group than in the model group (<0.05). No significant differences were found between the control and saline groups in all the above-mentioned indexes (>0.05).
CONCLUSION
EA of back-shu and front-mu acupoints can effectively improve symptoms of constipation and intestinal transport function in STC rats, which may be related to its function in up-regulating the expression of GDNF and down-regulating the methylation level in the promoter region of GDNF gene in colon tissue.
Topics: Acupuncture Points; Animals; Constipation; Electroacupuncture; Gastrointestinal Motility; Glial Cell Line-Derived Neurotrophic Factor; Male; Methylation; Rats; Rats, Sprague-Dawley
PubMed: 35218624
DOI: 10.13702/j.1000-0607.20210253 -
Zhen Ci Yan Jiu = Acupuncture Research Jul 2023To observe the effect of acupuncture of "Tianshu"(ST25) at different depths on colonic transportation function, expressions of colonic substance P (SP) and interstitial...
OBJECTIVE
To observe the effect of acupuncture of "Tianshu"(ST25) at different depths on colonic transportation function, expressions of colonic substance P (SP) and interstitial cells of Cajal (ICC) in rats with slow transit constipation (STC), so as to explore its mechanisms underlying improvement of STC..
METHODS
Fifty male Wistar rats were selected and randomly divided into control,STC model,conventional acupuncture,deep needling group 1 and deep needling group 2 groups,with 10 rats in each group.The STC model was established by gavage of 1 mg/mL compound diphenoxylate suspension (10 mg/kg), once every other day for 21 days, and rats of the control group were given the same dose of distilled water by gavage.EA (2 Hz, 2 mA) was applied to "Tianshu"(ST25), with the acupuncture needle inserted to a depth of 3 mm for rats of the conventional acupuncture group, 4.5 mm for those of deep needling group 1, and 10 mm for those of the deep needling group 2. The acupuncture needle was twirled for 1 min, then retained for 15 min each time, once a day for 15 consecutive days.Following modeling, rats of the 4 groups and the control group received gavage of active carbon 2 mL (100 g/L) for observing the excretion time of the first black stool grain to assess the intestinal transit function. The colonic myoelectric activities (frequency and amplitude) were recorded by using BIOPAC multichannel physiograph. The immunoactivity of SP and c-kit (a transmembrane protein kinase for identification of ICC) of colonic musculature was detected by immunohistochemistry.
RESULTS
Compared with the control group,the time of excretion of the first black stool grain, and the amplitude of colonic electromyogram (EMG) were significantly increased (<0.01), while the frequency of EMG, expressions of SP and c-kit (ICC) were significantly decreased in the model group (<0.01). In contrast to the model group, both deep needling group 1 and 2 had a decrease in the time of excretion of the first black stool grain, and amplitude of intestinal EMG, and an increase of frequency of intestinal EMG, and immunoactivity of SP and c-kit (<0.01). The effect of deep needling 2 is superior to that of deep needling 1 in reducing the time of excretion of the first black stool grain (<0.05), lowering the amplitude of EMG of the gut smooth muscle (<0.05) and in increasing the frequency of EMG (<0.05) and the expressions of SP and c-kit (<0.05). No significant changes were found in the levels of frequency and amplitude of EMG, and expressions of SP and c-kit after routine needling in comparison with the model group (>0.05), except the excretion time of the first black stool grain (<0.05).
CONCLUSION
Deep needling at ST25 at depth of 4.5 mm and 10 mm,especially at depth of 10 mm,has a significant effect in promoting gut motility to ameliorate constipation in rats with STC, which may be related to its function in up-regulating the expressions of SP and ICC activity.
Topics: Animals; Male; Rats; Acupuncture Points; Colon; Constipation; Defecation; Proto-Oncogene Proteins c-kit; Rats, Wistar; Substance P
PubMed: 37518957
DOI: 10.13702/j.1000-0607.20220588 -
Journal of Biosciences 2021Slow transit constipation (STC) is a gastrointestinal disorder characterized by abnormal prolonged colonic transit time, which affects the life quality of many people....
Slow transit constipation (STC) is a gastrointestinal disorder characterized by abnormal prolonged colonic transit time, which affects the life quality of many people. The decrease number of interstitial cells of Cajal (ICCs) is involved in the pathogenesis of STC. However, the molecular mechanism of loss of ICCs in STC remains unclear, making it difficult to develop new agents for the disease. In this study, we investigated the mechanism of decreasing ICCs in the pathogenesis of STC. We constructed the STC model rats by using atropine and diphenoxylate. A series of methods were used including immunofluorescence and immunochemistry staining, western blot, qRT-PCR, exosomes extraction and exosomes labeling. The results indicate that ICCs decreased in the STC rats accompanied with the macrophages activation. Further studies suggested that macrophages decreased the cell viability of ICCs by secretion exosomes containing miR-34c-5p. miR-34c5p targeted the 3Ꞌ -UTR of stem cell factor(SCF) mRNA and regulated the expression of SCF negatively. In conclusion, we demonstrated a novel regulatory mechanism of ICCs cell viability in STC. We found that exosome miR-34c-5p mediate macrophage-ICCs cross-talk. M1 macrophages derived exosomes miR-34c-5p decreased ICCs cell viability by directly targeting SCF.
Topics: Analgesics, Opioid; Animals; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Atropine; Cell Survival; Constipation; Diphenoxylate; Exosomes; Gastrointestinal Motility; Gene Expression Regulation; Interstitial Cells of Cajal; Macrophages; MicroRNAs; Muscarinic Antagonists; Proto-Oncogene Proteins c-kit; RNA, Messenger; Rats; Rats, Sprague-Dawley; Stem Cell Factor
PubMed: 34544909
DOI: No ID Found -
Antimicrobial Agents and Chemotherapy May 2024Cell culture-based screening of a chemical library identified diphenoxylate as an antiviral agent against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)....
Cell culture-based screening of a chemical library identified diphenoxylate as an antiviral agent against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The observed 50% effective concentrations ranged between 1.4 and 4.9 µM against the original wild-type strain and its variants. Time-of-addition experiments indicated that diphenoxylate is an entry blocker targeting a host factor involved in viral infection. Fluorescence microscopic analysis visualized that diphenoxylate prevented SARS-CoV-2 particles from penetrating the cell membrane and also impaired endo-lysosomal acidification. Diphenoxylate exhibited a synergistic inhibitory effect on SARS-CoV-2 infection in human lung epithelial Calu-3 cells when combined with a transmembrane serine protease 2 (TMPRSS2) inhibitor, nafamostat. This synergy suggested that efficient antiviral activity is achieved by blocking both TMPRSS2-mediated early and endosome-mediated late SARS-CoV-2 entry pathways. The antiviral efficacy of diphenoxylate against SARS-CoV-2 was reproducible in a human tonsil organoids system. In a transgenic mouse model expressing the obligate SARS-CoV-2 receptor, human angiotensin-converting enzyme 2, intranasal administration of diphenoxylate (10 mg/kg/day) significantly reduced the viral RNA copy number in the lungs by 70% on day 3. This study underscores that diphenoxylate represents a promising core scaffold, warranting further exploration for chemical modifications aimed at developing a new class of clinically effective antiviral drugs against SARS-CoV-2.
PubMed: 38742905
DOI: 10.1128/aac.00341-24 -
Drug Design, Development and Therapy 2021The naturally fermented yak yogurt of pastoralists in the Tibetan Plateau, China, because of its unique geographical environment and the unique lifestyle of Tibetan...
AIM
The naturally fermented yak yogurt of pastoralists in the Tibetan Plateau, China, because of its unique geographical environment and the unique lifestyle of Tibetan pastoralists, is very different from other kinds of sour milk, and the microorganisms it contains are special. subsp. HFY14 (LLSL-HFY14) is a new lactic acid bacterium isolated from naturally fermented yak yogurt. The purpose of this study was to study the inhibitory effect of the bacterium on constipation.
METHODS
Constipation was induced in ICR mice with diphenoxylate, and the constipated mice were treated with LLSL-HFY14. The weight and feces of the mice were visually detected. Colonic tissues were observed on hematoxylin and eosin-stained sections. Serum indices were detected with kits. mRNA expression in the colon was determined by quantitative polymerase chain reaction assay.
RESULTS
Constipation caused weight loss, the number of defecation granules, defecation weight, fecal water content decreased, and the first black stool excretion time increased. LLSL-HFY14 alleviated these symptoms, and the effects were similar to those of lactulose (drug). The pathological examination revealed that constipation caused pathological changes in the colon, and LLSL-HFY14 effectively alleviated the disease. LLSL-HFY14 increased serum levels of motilin, gastrin, endothelin, substance P, acetylcholinesterase, and vasoactive intestinal peptide (VIP) and decreased serum levels of somatostatin in constipated mice. In addition, LLSL-HFY14 upregulated VIP, cAMP, protein kinase A, and aquaporin 3 expression in colonic tissues of constipated mice in a dose-dependent manner.
CONCLUSION
LLSL-HFY14 inhibited constipation, similar to lactulose, and has the potential to become a biological agent.
Topics: Animals; Aquaporin 3; Cattle; Constipation; Cyclic AMP; Cyclic AMP-Dependent Protein Kinases; Diphenoxylate; Disease Models, Animal; Female; Lactococcus lactis; Mice; Mice, Inbred ICR; Probiotics; Signal Transduction; Somatostatin; Vasoactive Intestinal Peptide; Yogurt
PubMed: 34007157
DOI: 10.2147/DDDT.S309675 -
Zhen Ci Yan Jiu = Acupuncture Research Aug 2022To observe the effect of electroacupuncture (EA) of bilateral "Tianshu"(ST25) at different frequencies on the first black stool discharge time, colonic electromyography...
[Effect of electroacupuncture of "Tianshu"(ST25) at different frequencies on electromyography and immunoactivity of SP and VIP of colon in rats with slow transit constipation].
OBJECTIVE
To observe the effect of electroacupuncture (EA) of bilateral "Tianshu"(ST25) at different frequencies on the first black stool discharge time, colonic electromyography (EMG) and immunoactivity of vasoactive intestinal peptide (VIP) and substance P (SP) in the colon tissue in rats with slow transit constipation (STC), so as to choose a better stimulating frequency in the treatment of STC.
METHODS
A total of 50 male Wistar rats were randomized into control, model, 2 Hz-EA, 100 Hz- EA, and 2 Hz/100 Hz-EA groups, with 10 rats in each group. The STC model was established by intraperitoneal injection of compound diphenoxylate suspension fluid (10 mg/kg). EA was applied to bilateral ST25 for 30 min, once a day for 14 consecutive days. The discharge time for the first black stool was recorded after gavage of mixed suspension fluid of active carbon (2 mL) for assessing the gastrointestinal motility. The colonic EMG was recorded by using a pair of silver electrodes and bioelectric amplifier. The expression of SP and VIP in the colonic tissue was detected by immunohistochemistry.
RESULTS
Following mode-ling, the colonic EMG amplitude, the discharge time for the first black stool and VIP immunoactivity were significantly increased (<0.01), and the EMG frequency and SP immunoactivity were significantly decreased (<0.01) in the model group compared with the control group. Compared with the model group, the increase of the discharge time for the first black stool, EMG amplitude and VIP immunoactivity, the decrease of EMG frequency and SP immunoactivity were reversed in the 3 EA groups (<0.01, <0.05). The therapeutic effect of 100 Hz-EA was notably weaker than that of both 2 Hz-EA and 2 Hz/100 Hz-EA in up-regulating EMG frequency and SP immunoactivity and in down-regulating the discharge time for the first black stool, EMG amplitude and VIP immunoactivity (<0.05, <0.01). There was no significant difference between the 2 Hz/100 Hz-EA and 2 Hz-EA groups (>0.05).
CONCLUSION
EA can accelerate colonic EMG activities, which may be associated with its functions in down-regulating VIP immunoactivity and up-regulating SP immunoactivity in the colonic tissues. The therapeutic effects of 2 Hz/100 Hz-EA and 2 Hz-EA are better than that of 100 Hz-EA.
Topics: Acupuncture Points; Animals; Colon; Constipation; Electroacupuncture; Electromyography; Male; Rats; Rats, Wistar; Substance P; Vasoactive Intestinal Peptide
PubMed: 36036105
DOI: 10.13702/j.1000-0607.20210638 -
Journal of Agricultural and Food... Jul 2020Three new flavonoids, quercetin-3--6-[methyl-()-3-hydroxy-3-methylglutaroyl(1→6]-β-d-glucopyranoside (),...
Three new flavonoids, quercetin-3--6-[methyl-()-3-hydroxy-3-methylglutaroyl(1→6]-β-d-glucopyranoside (), kaempferol-3--[methyl-()-3-hydroxy-3-methylglutaroyl(1→6)]-β-d-glucopyranoside (), and quercetin-3--6-[()-4-methoxy-5-methylhexa-2,4-dienoatyl(1→6)]-β-d-glucopyranoside (), and two new alkaloids, 5-dehydroxymethyl-pyrrolemarumine 4″--α-l-rhamnopyranoside () and -methyl--((4--α-l-rhamnopyranoside)benzyl) oxalamide (), together with 45 known compounds (-) were isolated from the leaves of Lam. Among those compounds, 1-octacosanol (), a straight-chain 28-carbon alcohol, exhibited good activity against diphenoxylate-induced constipation in mice, which is obtained as a laxative constituent from the plant for the first time. In order to have an accurate understanding of the content of compound , a quantification with gas chromatography-tandem mass spectrometry (GC-MS/MS) was carried out. The anti-inflammatory and α-glucosidase inhibitory activity of some compounds also was assessed.
Topics: Flavonoids; Gas Chromatography-Mass Spectrometry; Laxatives; Moringa oleifera; Plant Extracts; Plant Leaves
PubMed: 32631058
DOI: 10.1021/acs.jafc.0c01564