Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
Neurogastroenterol Motil. 2018 Oct;30(10):e13385. doi: 10.1111/nmo.13385. Epub 2018 Jul 4.
Postoperative ileus (POI) is abdominal surgery-induced impaired gastrointestinal (GI) motility. We aimed to investigate the effects of DA-9701, a prokinetic agent formulated from Pharbitis Semen and Corydalis tuber, likely mediated via corticotrophin-releasing factor (CRF) pathways, in a POI model.
A laparotomy with cecal manipulation was performed to induce POI in guinea pigs. GI transit was measured based on charcoal migration after intragastric administration of DA-9701 1, 3, and 10 mg kg . CRF1 receptor antagonist, CP-154 526 (subcutaneous) or agonist, human/rat (h/r) CRF (intraperitoneal) was injected. Then, plasma adrenocorticotropic hormone (ACTH) levels were measured, and the average intensity of the CRF expression was analyzed in the proximal colon and hypothalamus, and c-Fos in the hypothalamus.
DA-9701 significantly increased delayed GI transit in POI in a dose-dependent manner and decreased plasma ACTH levels at 10 mg kg . CP-154 526 significantly decreased plasma ACTH levels but was not as effective on GI transit as DA-9701 was. h/r CRF did not significantly affect GI transit and plasma ACTH levels. No significant difference was observed in GI transit and plasma ACTH levels in both groups administered DA-9701 with h/r CRF and h/r CRF alone. CRF expression in the proximal colon decreased after DA-9701 administration, but not significantly, compared with levels in POI alone. However, CRF expression in the hypothalamus was significantly lower in the DA-9701-pretreated POI than in the untreated POI.
The DA-9701-induced improvement in GI transit and inhibition of plasma ACTH levels was mediated by the central CRF pathway.
术后肠麻痹(POI)是腹部手术后胃肠道(GI)运动受损的一种病症。我们旨在研究一种由裂叶牵牛籽和延胡索组成的促动力药物 DA-9701 在 POI 模型中的作用,这种药物可能是通过促皮质素释放因子(CRF)途径发挥作用的。
通过开腹手术和盲肠操作来诱导豚鼠发生 POI。通过胃内给予 DA-9701(1、3 和 10mg/kg)后测量胃内容物的炭迁移来评估 GI 转运。CRF1 受体拮抗剂 CP-154526(皮下注射)或激动剂 h/r CRF(腹腔内注射)被注射。然后,测量血浆促肾上腺皮质激素(ACTH)水平,并分析近端结肠和下丘脑的 CRF 表达平均强度,以及下丘脑的 c-Fos。
DA-9701 以剂量依赖性方式显著增加 POI 时的延迟 GI 转运,并降低 10mg/kg 时的血浆 ACTH 水平。CP-154526 显著降低了血浆 ACTH 水平,但对 GI 转运的作用不如 DA-9701 明显。h/r CRF 对 GI 转运和血浆 ACTH 水平没有显著影响。与单独给予 h/r CRF 和 h/r CRF 相比,给予 DA-9701 后两组的 GI 转运和血浆 ACTH 水平没有显著差异。与单独 POI 相比,给予 DA-9701 后近端结肠的 CRF 表达略有下降,但无统计学意义。然而,与未经治疗的 POI 相比,DA-9701 预处理的 POI 中下丘脑的 CRF 表达明显降低。
DA-9701 诱导的 GI 转运改善和抑制血浆 ACTH 水平是通过中枢 CRF 途径介导的。