Abstract
Dai-kenchu-to (TJ-100) is an herbal medicine used to shorten the duration of intestinal transit by accelerating intestinal movement. However, intestinal movement in itself has not been evaluated in healthy volunteers using radiography, fluoroscopy, and radioisotopes because of exposure to ionizing radiation. The purpose of this study was to evaluate the effect of TJ-100 on intestinal motility using cinematic magnetic resonance imaging (cine MRI) with a steady-state free precession sequence. Ten healthy male volunteers received 5 g of either TJ-100 or lactose without disclosure of the identity of the substance. Each volunteer underwent two MRI examinations after taking the substances (TJ-100 and lactose) on separate days. They drank 1200 mL of tap water and underwent cine MRI after 10 min. A steady-state free precession sequence was used for imaging, which was performed thrice at 0, 10, 20, 30, 40, and 50 min. The bowel contraction frequency and distention score were assessed. Wilcoxon signed-rank test was used, and differences were considered significant at a P-value <0.05. The bowel contraction frequency tended to be greater in the TJ-100 group and was significantly different in the ileum at 20 (TJ-100, 8.95 ± 2.88; lactose, 4.80 ± 2.92; P < 0.05) and 50 min (TJ-100, 9.45 ± 4.49; lactose, 4.45 ± 2.65; P < 0.05) between the groups. No significant differences were observed in the bowel distention scores. Cine MRI demonstrated that TJ-100 activated intestinal motility without dependence on ileum distention.
Highlights
Dai-kenchu-to (TJ-100) is an herbal medicine used to shorten the duration of intestinal transit by accelerating intestinal movement
TJ-100 acts on transient receptor potential V1 (TRPV1), which is distributed in the sensory nerve and is a channel opened by a nociceptive stimulus, and results in the release of substance P that influences bowel contraction [6]
The acceleration of gastrointestinal and colonic transit by TJ-100 was demonstrated in humans [10]
Summary
Dai-kenchu-to (TJ-100) is an herbal medicine used to shorten the duration of intestinal transit by accelerating intestinal movement. Acceleration of small bowel motility after oral administration of TJ-100 assessed by cine MRI has been performed to elucidate the mechanism and establish the clinical roles of herbal medicine. Previous studies have shown that three major mechanisms enhanced intestinal motility, and it has been shown that TJ-100 has an acetylcholine-releasing action in the smooth muscle tissues of the ileum and that 5-HT3 and 5-HT4 receptors were involved in this action [3, 4]. TJ-100 is an agonist for transit receptor potential A1 (TRPA1) and TRPV1, and stimulation of these receptors induces release of adrenomedullin (ADM) from the intestinal epithelium and calcitonin gene-related peptide (CGRP) from the nerve terminal in vascular smooth muscles, which is referred to as a vasodilator peptide hormone [7, 8]. TJ-100 has an anti-inflammatory effect through the release of ADM and suppression of cycloxygenase-2 (COX-2) [9]
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