Abstract
Irritable bowel syndrome (IBS) is a functional gastrointestinal disease characterized by visceral hypersensitivity-related abdominal pain, in which diarrhea-predominant IBS (IBS-D) is the main subtype and has a high clinical incidence. Tongxie Anchang Decoction (TXACD) has been proved to significantly improve abdominal pain in patients with IBS-D, but its underlying therapeutic mechanism still remains unclear. In the present study, IBS-D model rats were induced by neonatal maternal separation (NMS) combined with restraint stress (RS). The therapeutic effect of TXACD was evaluated by fecal characteristics and abdominal withdrawal reflex (AWR) scores. After 14 days of intragastric administration, the colonic tissues of rats were collected to detect the protein and gene level of the NGF, TrkA, and TRPV1 using Western blotting and real-time polymerase chain reaction, respectively, and detect mast cells infiltration using toluidine blue staining. The abdominal aorta blood centrifuged was collected for detecting serum levels of SP, 5-HT, and CGRP with ELISA. The results revealed that TXACD could significantly improve visceral hypersensitivity in IBS-D rats, reflected in the decrease of AWR score and the serum levels of SP, 5-HT, and CGRP. In addition, TXACD treatment could alleviate mast cells infiltration. Moreover, the expression levels of the NGF, TrkA, and TRPV1 were repressed by TXACD. The findings of the present study indicated that the therapeutic effect of TXACD on visceral hypersensitivity might be closely related to the downregulation of the NGF/TrkA signaling pathway, the reversal of TRPV1 expression and mast cells infiltration, and the decreased release of neuroendocrine factors SP, 5-HT, and CGRP.
Highlights
Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disease characterized by visceral hypersensitivity-related abdominal pain accompanied by changes in defecation habits and characteristics [1, 2]
The wet feces weight and fecal water content in the Tongxie Anchang Decoction (TXACD) group and Pinaverium bromide (PB) group were significantly decreased than those in the NR group (P < 0.01). ese results suggested that the symptoms of the IBS with diarrhea (IBS-D) model improved effectively by TXACD
Effect of TXACD on Visceral Hypersensitivity. e visceral hypersensitivity was measured with the abdominal withdrawal reflex (AWR) score system based on the behavioral response of rats to Colorectal distension (CRD)
Summary
Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disease characterized by visceral hypersensitivity-related abdominal pain accompanied by changes in defecation habits and characteristics [1, 2]. According to Roman IV, IBS can be divided into four subtypes: IBS with diarrhea (IBS-D), IBS with constipation (IBS-C), IBS with mixed bowel habit (IBS-M), and IBS unclassified (IBS-U), of which IBS-D is the most common in clinic [3]. IBS seriously affects the work and life of patients, causing a huge economic burden [8]. The direct economic loss caused by IBS amounts to US $1 billion [9]. A variety of pathological factors are involved in the occurrence and development of IBS-D, among which visceral hypersensitivity is considered to be very important [10].
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