G A A b st ra ct s medicine with ghrelin enhancing properties, is used to treat gastroparesis (Takahashi T et al. World J Surg 2009). Aim: To assess the brain sites activated by abdominal surgery in mice and whether rikkunshito modified this pattern and the inhibited food intake.Methods: RKT (0.5 g/kg/day) or vehicle (distilled water, 4 ml/kg) was given daily by gavage for 7 days and on day 8 at 6 h and 1 h before the surgery. Male mice (C57BL/6, 23-26 g) fasted for 6 h received laparotomy and cecal palpation under isoflurane anesthesia 2 h before the dark phase. Controls remained in home cages. For Fos immunohistochemistry in brain sections, mice were euthanized 2 h post-surgery. For food intake monitoring, mice were maintained in an automated feeding monitoring system (BioDAQ, Research Diet). Results: In vehicle-treated mice, there was moderate Fos immunoreactivity (ir) in the paraventricular nucleus (PVN), arcuate nucleus (Arc), and preoptic, lateral and dorsomedial areas of the hypothalamus, medial bed nucleus of stria terminalis and Edinger-westphal nucleus (E-W), which could be resulted from gavage and 6-h fasting. Abdominal surgery induced robust Fos-ir in the lateral septum, supraoptic nuclei (SON), PVN, Arc, lateral parabrachial nucleus, locus ceruleus, ventrolateral medulla and nucleus tractus solitarius (NTS); and moderate increase in Fos-ir in the prelimbic, insular and cingulate cortex, nucleus of accumbens, subfornical organ, E-W, periaqueductal area (PAG), Barrington's nucleus, A5 and area postrema. Compared to vehicle, RKT treatment in control mice induced significant more numbers of Fos-ir neurons of the SON (1.9±0.8 vs 6.2±1.0 cells/section) and E-W (22.7±1.1 vs 31.3±2.6). In mice received surgery, RKT induced a significant increase in Fos-ir in the lateral PAG (68.3±4.8 vs 49.5±5.4) and decrease in the NTS (82.4±4.1 vs 96.1±8.0). Abdominal surgery reduced food intake significantly at 6, 12 and 24 h by 83%, 94% and 94%, respectively compared to control. RKT resulted in a small, but significant increase in food intake at 6 and 12 h after surgery compared to vehicle plus surgery (0.31±0.04 vs 0.11±0.04, and 0.62±0.11 vs 0.37±0.01 g). Conclusion: Brain circuits of mice responsive to abdominal surgery include visceral regulatory centers, forebrain and midbrain areas involved in pain, and integrative nuclei related to stress. The partially restored food intake by RKT after abdominal surgery may reply on reducing the inhibitory inputs from the NTS related to visceral afferents and enhancing the descending pain inhibitory pathway via the PAG. Supported by Tsumura &Co., and NIH DDK-41303
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