Treatment Of Radiation Enteritis Research Articles

Network Pharmacology Analysis on the Mechanism of Xihuangwan in Treating Rectal Cancer and Radiation Enteritis.

Recent studies have shown that XihuangWan (XHW) is a kind of Chinese medicine with significant anti-tumor and anti-inflammatory activities. However, its mechanism for preventing and treating radiation proctitis in rectal cancer patients during radiotherapy remains unclear. This study employed the network pharmacology to establish a "drug-active ingredient-target genedisease" network via using TCMSP, SymMap, GeneCard, and OMIM databases. The PPI network was conducted by the String tool. The core targets of XHW in the treatment of rectal cancer and radiation enteritis were identified by topological analysis, and the functional annotation analysis and pathway enrichment analysis were performed. A total of 61 active ingredients of XHW ingredients, 4607 rectal cancer-related genes, 5803 radiation enteritis-related genes, and 68 common targets of XHW in the treatment of rectal cancer and radiation enteritis were obtained. PTGS1 and NR3C2, as identified potential targets, were significantly associated with OS of colorectal cancer patients. GO and KEGG enrichment analysis showed that bioinformatics annotation of these common genes was mainly involved in DNA-binding transcription factor, PI3K/Akt, TNF, HIF-1 signaling pathway, and colorectal cancer pathway. The active ingredients of XHW, mainly including Quercetin, Ellagic acid, and Stigmasterol, might act on common targets of rectal cancer and radiation enteritis, such as PTGS1, NR3C2, IL-6, EGFR, HIF-1A, CASP3, BCL2, ESR1, MYC, and PPARG, and regulate multiple signaling pathways like PI3K-Akt, TNF, and HIF-1 to inhibit tumor proliferation, tumor angiogenesis, inflammatory responses, and oxidative stress, thereby achieving prevention and treatment of radiation enteritis in rectal cancer patients during radiotherapy. It provided an important reference for further elucidating the anti-inflammation and anti-tumor mechanism and clinical application of XHW.

Research progress and treatment of radiation enteritis and gut microbiota.

Radiation enteritis is a kind of intestinal radiation injury in patients with pelvic and retroperitoneal malignancies after radiotherapy, and its occurrence and development process are very complicated. At present, studies have confirmed that intestinal microecological imbalance is an important factor in the formation of this disease. Abdominal radiation causes changes in the composition of the flora and a decrease in its diversity, which is mainly manifested by a decrease in beneficial bacterial species such as Lactobacilli and Bifidobacteria. Intestinal dysbacteriosis aggravates radiation enteritis, weakens the function of the intestinal epithelial barrier, and promotes the expression of inflammatory factors, thereby aggravating the occurrence of enteritis. Given the role of the microbiome in radiation enteritis, we suggest that the gut microbiota may be a potential biomarker for the disease. Treatment methods such as probiotics, antibiotics, and fecal microbiota transplantation are ways to correct the microbiota and may be an effective way to prevent and treat radiation enteritis. Based on a review of the relevant literature, this paper reviews the mechanism and treatment of intestinal microbes in radiation enteritis.

Perturbation of intestinal stem cell homeostasis and radiation enteritis recovery via dietary titanium dioxide nanoparticles.

Small intestinal health and enteritis incidence are tightly coupled to the homeostasis of intestinal stem cells (ISCs), which are sensitive to dietary alterations. However, little is known about the impact of food additives on ISC pool. Here, we demonstrate that chronic exposure to low-dose TiO2 NPs, a commonly used food additive, significantly hampers primary human and mouse ISC-derived organoid formation and growth by specifically attenuating Wnt signal transduction. Mechanistically, TiO2 NPs alter the endocytic trafficking of the Wnt receptor LRP6 and prevent the nuclear entry of β-catenin. Notably, dietary TiO2 NPs elicit modest chronic stress in healthy intestines and considerably impede the recovery of radiation enteritis by perturbing the homeostasis of ISCs in vivo. Our results identify a health concern of TiO2 NP exposure on ISC homeostasis and radiation enteritis recovery. These findings suggest extra precaution during the treatment of radiation enteritis and provide new insights into food additive-ISC interaction.

Research progress of intestinal microbiota in the prevention and treatment of radiation enteritis

放射性肠炎是放射治疗引起的肠道并发症。辐射引起肠道微生态改变、肠黏膜屏障破坏，肠道共生微生物及其代谢产物通过影响肠道黏膜屏障免疫功能在辐射损伤和辐射抗性中发挥一定作用。以肠微生态为靶点的微生态制剂和菌群移植可能为预防和治疗放射性肠炎提供新的方向。.

Clinical Evidence and Potential Mechanisms in Treating Radiation Enteritis with Modified Baitouweng Decoction.

To perform a meta-analysis and network analysis identification to evaluate the efficacy, safety, and potential mechanisms of modified Baitouweng decoction (mBTWD) in the treatment of radiation enteritis. We searched PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Databases, SionMed, and Chinese Scientific Journals Database to collect the randomized controlled trials (RCTs) of mBTWD treating radiation enteritis. Rev.Man 5.3 and Stata 14.0 software are employed for meta-analysis. The GRADE online tool is used to evaluate the quality of evidence. Network analysis and molecular docking approach are applied to predict the potential targets and ingredients of representative drugs in mBTWD for the treatment of radiation enteritis. Seventeen studies are eventually included, covering a total of 1611 patients: (1) The clinical efficacy is significantly higher in mBTWD groups than in control groups (RR = 1.24, 95% CI (1.17, 1.32), P < 0.00001). (2) mBTWD has certain advantages in improving TCM syndromes (MD = -3.41, P < 0.00001). (3) mBTWD has a certain positive effect on the improvement of intestinal signs and symptoms (RR = 1.23, P=0.0001; OR = 3.51, P < 0.00001). (4) Indexes including CRP, KPS, and OB, are better in mBTWD groups than in control groups (P < 0.00001, P=0.002, P=0.03), but the credibility is downgraded for a small sample size. Adverse events and recurrence rates require further confirmation with larger sample sizes. (5) Univariate meta-regression for clinical efficacy shows none of the coefficients are significantly associated with the estimated risk ratio. The clinical efficacy overestimates about 4.9% from publication bias. The quality of the included studies is low according to GRADE evidence. (6) Quercetin, isorhamnetin, and beta-sitosterol are the main ingredients from representative drugs in mBTWD and its key targets are MYC, TP53, and MAPK14/MAPK1. mBTWD may be effective in the treatment of radiation enteritis, but its long-term benefits, safety, and molecular mechanisms remain unclear due to the poor quality of the evidence. Larger sample sizes, high-quality studies, and basic research are essential in the future.

Treatment of Radiation Enteritis With Fecal Transplantation.

Radiation enteritis (RE) is a frequent complication in patients who undergo pelvic irradiation, and this condition has been increasingly diagnosed. Fecal microbiota transplantation (FMT) is being developed in recent years, and it has remarkable curative effect for the clostridium and inflammatory bowel disease. Herein, we present a case of recurrent RE in a 59-year-old woman with RE 18years after radiotherapy for cervical carcinoma. Fecal microbiota transplantation therapy with intestinal flora from her 18-year-old son was applied and was successful in relieving the symptoms. To the best of our knowledge, this study is the first case report of FMT in a patient with RE.

External treatment of traditional Chinese medicine for radiation enteritis: A protocol for systematic review and meta-analysis.

Background:Radiation enteritis (RE) is a common complication that often occurs after radiotherapy for abdominal and pelvic malignancies. RE could influence patients’ quality of life seriously and it is difficult to cure by conventional treatments. A lot of studies have revealed that the external treatment of traditional Chinese medicine (TCM) for RE is a safe and economical approach, but there is no relevant systematic review. The present study performed a systematic review and meta-analysis to compare TCM external treatment and conventional treatment for RE to evaluate the effectiveness and safety of external treatment of traditional Chinese medicine in the treatment of RE.Methods:Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure (CNKI), Wan-Fang database, VIP Chinese Science and Technique Journals Database, and the Chinese Biomedical Literature Database (CBM) were searched. The time of publication was limited from inception to April, 2021. Two reviewers independently searched for the selected articles and extract the data. The RevMan V.5.3 statistical software (Cochrane Collaboration) and Stata V.16.0 software were used to conduct the meta-analysis.Results:We will show the results of this study in a peer-reviewed journal.Conclusion:This meta-analysis will provide reliable evidence for external treatment of TCM in the treatment of RE.INPLASY registration number:INPLASY202140120

Ligustilide Prevents Radiation Enteritis by Targeting Gch1/BH4/eNOS to Improve Intestinal Ischemia.

There is a high incidence of radiation enteritis (RE) after abdominal radiotherapy. The occurrence of RE seriously affects the treatment and quality of life of patients; however, its pathogenesis is complex and there are no effective drugs for its prevention or treatment. Intestinal ischemia plays an important role in the occurrence of enteritis. Previous studies have shown that targeting GTP-cyclohydrolase 1 (Gch1) to improve intestinal ischemia could be a new strategy to prevent and treat RE. A high content of the naturally occurring phthalide derivative ligustilide (LIG) has been found in the plant drug Rhizoma Ligustici Chuanxiong for the treatment of cardiovascular diseases. The purpose of this study was to evaluate the protective effects of LIG on RE. Ionizing radiation (IR) rat and endothelial cell models were used to observe and record rat body weights and stool morphologies, measure intestinal blood perfusion by laser Doppler blood flow imaging, determine the diastolic functions of mesenteric arteries, detect the levels of Gch1/BH4/eNOS pathway-related proteins and regulatory molecules in the mesenteric arteries and endothelial cells, and predict affinity by molecular docking technology. The results showed that LIG significantly improved the body weights, loose stools, intestinal villi lengths, intestinal perfusion and vasodilatory functions of IR rats. LIG also significantly improved Gch1 protein and BH4 levels in the mesenteric arteries and endothelial cells after IR, increased the NO content, reduced superoxide accumulation, and improved p-eNOS (Ser1177) levels in endothelial cells. LIG has good affinity for Gch1, which significantly improves its activity. These results indicate that LIG is the preferred compound for the prevention and treatment of RE by improving intestinal ischemia through the Gch1/BH4/eNOS pathway. This study provides a theoretical basis and new research ideas for the development of new drugs for RE.

Ionizing radiation induces BH4 deficiency by downregulating GTP-cyclohydrolase 1, a novel target for preventing and treating radiation enteritis

Radiation enteritis (RE) is a common side effect after radiotherapy for abdominal cancer. RE pathogenesis is complicated, with no drugs available for prevention or treatments. Intestinal ischemia is a key factor in the occurrence and development of enteritis. The effect of ionizing radiation (IR) on intestinal ischemia is unknown. Deficiency of tetrahydrobiopterin (BH4) produced by GTP-cyclohydrolase 1 (Gch1) is important in ischemic diseases. This study focused on the relationship of Gch1/BH4 between intestinal ischemia in radiation enteritis. BH4 levels were analyzed by high-performance liquid chromatography in humans and rats after radiotherapy. Intestinal blood perfusion was measured by laser doppler flow imaging. Vascular ring tests determined the diastolic functions of rat mesenteric arteries. Gene, protein, and immunohistochemical staining experiments and inhibitor interventions were used to investigate Gch1 and endothelial NOS (eNOS) in rat mesenteric arteries and endothelial cells. The results showed that IR decreased BH4 levels in patients and rats after radiotherapy and decreased intestinal blood perfusion in rats. The degree of change in intestinal ischemia was consistent with intestinal villus injury. Gch1 mRNA and protein levels and nitric oxide (NO) production significantly decreased, while eNOS uncoupling in arterial and vascular endothelial cells strongly increased. BH4 supplementation improved eNOS uncoupling and NO levels in vascular endothelia after IR. The results of this study showed that downregulation of Gch1 in intestinal blood vessels after IR is an important target in RE. BH4 supplementation may prevent intestinal ischemia and improve vascular endothelial function after IR. These findings have clinical significance for the prevention and treatment of RE.

Therapeutic role of glutamine in management of radiation enteritis: a meta-analysis of 13 randomized controlled trials.

ObjectiveTo systematically evaluate the clinical efficacy of glutamine in treating radiation enteritis in cancer patients treated with radiotherapy.MethodsElectronic databases including Pubmed, Embase, the Cochrane library, and CNKI were systematically searched, until April 2016. Randomized controlled trials (RCT) of glutamine in the treatment of radiation enteritis in cancer patients were searched, and RevMan 5.3 software was used for Meta-analysis.ResultsA total of 13 RCTs were included, involving 979 patients. The results of meta-analysis showed that the total efficacy of glutamine was higher for patients with radiation enteritis compared with that in control group, however, there was no statistically significant difference(OR = 3.07, 95%CI: 0.79-11.96; P > 0.05). The combined ORs for all 5 grades(from grade 0 to grade 4) of radiation enteritis in patients receiving glutamine were 2.06, 1.35, 0.55, 0.62 and 0.59, respectively(P > 0.05 for all). Glutamine also failed to significantly improve the symptoms of radiation enteritis in terms of tenesmus, abdominal cramping and blood in bowel movement(P > 0.05).ConclusionsImplementation of glutamine fails to improve the severity and symptoms in patients with radiation enteritis.

NUTRIENTS AND RADIOTHERAPY; REVIEW OF THE LITERATURE

nutrition is an important influence on treatments and quality of life of cancer patients. The relationship between different nutritional components and radiotherapy is today a topic of growing interest. to evaluate the influence of macro and micronutrients on tolerance and effectiveness of radiotherapy and their role in modulating chronic toxicity. we performed a research of the published literature by consulting the MEDLINE database and Cochrane Library online between 1995 and 2015, relevant publications based on impact factor were selected. Data from the analyzed studies were exposed in sections by type of nutrient. most of the studies showed common features: small sample sizes, high heterogeneity, underpowered results and few prospective randomized studies. In the section of fiber, its use in prophylaxis and treatment of radiation enteritis has been successfully evaluated in some studies, although evidence of its recommendation is still weak. Omega 3 and omega 6 fatty acids have a high metabolic potential, however the evidence regarding this benefit is limited to observational studies in certain tumors. Among the amino acids, glutamine is the most studied, and controversial results of its effect on mucositis, esophagitis and radiation enteritis were found. Vitamins and minerals are a heterogeneous group of substances that showed potential benefit due to their antioxidant activity and their supposed protector effect against toxicity secondary to radiotherapy. Ketogenic diets are beginning to be clinically studied after promising preclinical results. the analyzed studies show controversial or inconclusive results regarding the influence of nutrients in the radiotherapy. It has been not found Sorong evidence about their role in patients receiving ionizing radiation. Well-designed, prospective and randomized studies are needed to establish recommendations.

Clinical efficacy of TCM retention enema combined with moxibustion and massage therapy in the treatment of radiation enteritis

Objective To analyze clinical efficacy of TCM retention enema combined with moxibustion and massage therapy in the treatment of radiation enteritis.Methods 124 patients with radiation enteritis were randomly divided into control group and observation group,each group of 62 cases.Control group was treated with metronidazole combined with dexamethasone,while treatment group was treated with TCM retention enema combined with moxibustion and massage.Observed efficacy and quality of life.Results 15 cases were cured,31 cases were markedly effective,13 cases were effective,the effective rate was 95.2％ in observation group.8 cases were cured,26 cases were markedly effective,16 cases were effective,the effective rate was 80.6％ in control group,with statistical difference between two groups (x 2 =4.854,P =0.028).SF36 scores were (84.1 ± 13.0) and (89.1 ± 13.8) 1 month and 6 months after treatment in observation group,and those in control group were (76.4 ± 12.5) and (80.5 ± 12.7),P ＜ 0.05.Conclusions TCM retention enema combined with moxibustion and massage in the treatment of radiation enteritis is effective and safe,which can effectively improve patients' gastrointestinal mucosa function and quality of life. Key words: TCM retention enema; Moxibustion; Massage; Radiation enteritis; Efficacy; Quality of life

137 Treatment of radiation enteritis with pravastatin : Role of the rho pathway on CTGF expression

137 Treatment of radiation enteritis with pravastatin : Role of the rho pathway on CTGF expression

Effect of Qingre Buyi Decoction on nitric oxide and histomorphology of intestinal mucosa in rats with radiation enteritis

Objective: To explore the mechanism of Qingre Buyi Decoction (QBD) in prevention and treatment of radiation enteritis in rats.Methods: Forty-eight Wistar rats were randomly divided into four groups, the TCM group, the WM group, the model group and the control group, 12 in each group. Rats in the former three groups were given orally with QBD, norfloxacin and normal saline once a day for 7 successive days, after being irradiated with X-ray at single dose of 10 Gy for modeling of radiation enteritis, while rats in the control group were untreated. Animals were sacrificed at the end of the medication. NO concentration, mean height and number of villi per centimeter in their small intestinal mucosa were measured.Results: The intestinal NO concentration was significantly lower in the TCM and WM groups than that in the model group(P<0.05), while the number of villi was significantly more and the height higher in the former two groups than those in the model group (P<C0.01 for both), but no significant difference was shown between the TCM group and the WM group.Conclusion: QBD could inhibit the production of NO, increase the number and height of intestinal villi in rats with radiation enteritis, suggesting that it could reduce the inflammatory reaction of intestinal mucosa to irradiation, protect mucosa from radiation damage, and promote the regeneration of mucosa.

Treatment for radiation enteritis.

Hyperbaric oxygen might be useful for treating intestinal radiation injury, German researchers say.

放射線腸炎の病態と外科治療法

放射線腸炎の病態と外科治療法