Abstract

The etiology of diarrhea-predominant irritable bowel syndrome (IBS-D) is complicated and closely related to neurotransmission in the gastrointestinal (GI) tract. Developing new strategies for treating this disease is a major challenge for IBS-D research. Berberine hydrochloride (BBH), the derivative of berberine, is a herbal constituent used to treat IBS. Previous studies have shown that BBH has potential anti-inflammatory, antibacterial, analgesic, and antidiarrheal effects and a wide range of biological activities, especially in regulating the release of some neurotransmitters. A modified IBS-D rat model induced by chronic restraint stress was used in all experiments to study the effects of BBH on the GI tract. This study measured the abdominal withdrawal reflex (AWR) response to graded colorectal distention (CRD; 20, 40, 60, and 80 mmHg) and observed the fecal areas of stress-induced IBS-D model. Experiments were conducted using organ bath techniques, which were performed in vitro using strips of colonic longitudinal smooth muscle. Inhibitory and excitatory neurotransmitter agents were added to each organ bath to observe contractile responses on the strips and the treatment effect exerted by BBH. The IBS-D rat model was successfully induced by chronic restraint stress, which resulted in an increased defecation frequency and visceral hypersensitivity similar to that of humans. BBH could reduce 4-h fecal areas and AWR response to CRD in IBS-D. The stress-induced IBS-D model showed upregulated colonic mRNA expression levels of 5-hydroxytryptamine-3A receptor and downregulated expression levels of neuronal nitric oxide synthase. Meanwhile, BBH could reverse this outcome. The responses of substances that regulate the contraction induced by related neurotransmission in the longitudinal smooth muscle of IBS-D colon (including the agonist of acetylcholine, carbachol; NOS inhibitor, L-NAME; and P2Y1 receptor antagonist, MRS2500) can be inhibited by BBH. In summary, BBH promotes defecation frequency and visceral hypersensitivity in IBS-D and exerts inhibitory effects on contractile responses in colonic longitudinal smooth muscle. Thus, BBH may represent a new therapeutic approach for treating IBS-D.

Highlights

  • Irritable bowel syndrome (IBS) is a prevalent gastrointestinal (GI) disease characterized by abdominal pain and change in bowel habits

  • The change in 4-h fecal areas showed that the defecation frequency of the diarrhea-predominant irritable bowel syndrome (IBS-D) group increased with the passage of time, which is consistent with the change in the bowel habit of clinical patients with IBS-D

  • berberine hydrochloride (BBH) is a derivative of berberine, which is the major constituent of Rhizoma coptidis, a herbal constituent used to treat IBS

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Summary

Introduction

Irritable bowel syndrome (IBS) is a prevalent gastrointestinal (GI) disease characterized by abdominal pain and change in bowel habits. IBS has affected 11.2% of the general population worldwide (Ford, 2020). Many factors, such as heredity, diet, mentality, social culture, and inflammatory substances, influence its onset. IBS incurs a heavy economic and social burden on an individual, as well as the society. The Rome IV standard is the latest diagnostic criteria used to categorize patients with IBS into four types. Drugs targeting neurotransmitter receptors, such as loperamide, iludoline, alosetron and some antidepressants, are used to treat patients with IBS-D (Lacy, 2016). A standard treatment algorithm has not been established yet for IBS-D (Corsetti and Whorwell, 2017)

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