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探索黄连及小檗碱对食管下括约肌的松弛作用:食管下括约肌动力障碍的潜在治疗策略

Exploring the relaxation effects of Coptis chinensis and berberine on the lower esophageal sphincter: potential strategies for LES motility disorders.

作者信息

Koh Wen-Harn, Lin Li-Wei, Lin Ting-I, Liu Ching-Wen, Chang Li-Ching, Lin I-Chun, Wu Ming-Shiang, Tsai Ching-Chung

机构信息

Department of Pediatrics, E-Da Hospital, I-Shou University, No. 1, Yi-Da Road, Yan-Chao District, Kaohsiung City, 82445, Taiwan, R.O.C.

School of Chinese Medicine for Post Baccalaureate, I-Shou University, No. 8, Yi-Da Road, Yan-Chao District, Kaohsiung City, 82445, Taiwan, R.O.C.

出版信息

BMC Complement Med Ther. 2024 Dec 18;24(1):417. doi: 10.1186/s12906-024-04720-x.

DOI:10.1186/s12906-024-04720-x
PMID:39696287
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11658121/
Abstract

BACKGROUND

Esophageal achalasia, a primary disorder impacting the lower esophageal sphincter (LES), presents symptoms such as dysphagia, regurgitation, chest pain, and weight loss. Traditional treatments, including calcium channel blockers and nitrates, offer limited relief, prompting exploration into alternative therapies. This study examines the efficacy of Traditional Chinese Medicine (TCM), focusing on Coptis chinensis (C. chinensis) and its principal component, berberine, for modulating LES relaxation, offering a new perspective on treatment possibilities.

METHODS

This research evaluated the impact of C. chinensis extract and berberine on the relaxation of LES contraction pre-induced by carbachol, observing the effects across different concentrations. We employed a series of inhibitors, including tetrodotoxin, ω-conotoxin GVIA, rolipram, vardenafil, KT5823, KT5720, NG-nitro-L-arginine, tetraethylammonium (TEA), apamine, iberiotoxin, and glibenclamide, to investigate the underlying mechanisms of berberine-induced LES relaxation.

RESULTS

Both C. chinensis extract and berberine induced significant, concentration-dependent relaxation of the LES. The relaxation effect of berberine was significantly reduced by TEA, indicating the involvement of potassium channels in this process.

CONCLUSIONS

This study demonstrates that C. chinensis and berberine significantly promote LES relaxation, primarily through potassium channel activation. These findings provide a foundation for further investigation of these compounds' potential therapeutic applications in esophageal motility disorders, such as achalasia.

摘要

背景

食管失弛缓症是一种影响食管下括约肌(LES)的原发性疾病,表现为吞咽困难、反流、胸痛和体重减轻等症状。包括钙通道阻滞剂和硝酸盐在内的传统治疗方法缓解效果有限,促使人们探索替代疗法。本研究考察了中药,尤其是黄连及其主要成分小檗碱对调节LES舒张的功效,为治疗可能性提供了新视角。

方法

本研究评估了黄连提取物和小檗碱对卡巴胆碱预先诱导的LES收缩舒张的影响,观察不同浓度下的效果。我们使用了一系列抑制剂,包括河豚毒素、ω-芋螺毒素GVIA、咯利普兰、伐地那非、KT5823、KT5720、NG-硝基-L-精氨酸、四乙铵(TEA)、蜂毒明肽、iberiotoxin和格列本脲,以研究小檗碱诱导LES舒张的潜在机制。

结果

黄连提取物和小檗碱均能显著诱导LES产生浓度依赖性舒张。TEA显著降低了小檗碱的舒张作用,表明钾通道参与了这一过程。

结论

本研究表明,黄连和小檗碱主要通过激活钾通道显著促进LES舒张。这些发现为进一步研究这些化合物在食管动力障碍如失弛缓症中的潜在治疗应用奠定了基础。

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