Constipation and fecal impaction are frequent and distressing complaints in pediatric gastroenterology. Especially in neurologically handicapped children, treatment of severe forms of slow-transit constipation (STC) c...Constipation and fecal impaction are frequent and distressing complaints in pediatric gastroenterology. Especially in neurologically handicapped children, treatment of severe forms of slow-transit constipation (STC) can be difficult. In the majority of cases, STC is of unknown etiology. However, in recent years, there is growing evidence that interstitial cells of Cajal (ICCs), which serve as electrical pacemakers and generate spontaneous electrical slow waves in the gastrointestinal tract, might play an important role in the pathophysiology of STC. It remains unclear whether morphological ICC alterations seen in affected patients are based on congenital developmental anomalies, or whether they are a consequence of long-term constipation with secondary damage of the gastrointestinal nervous system. To the best of our knowledge, we present the first case of a patient with histological alterations in ICC morphology who displayed multiple alterations of c-kit at the level of mRNA. The protein encoded by c-kit is the receptor tyrosine kinase Kit (CD117), which is crucial for development and function of ICCs. Therefore, these findings provide a new explanation for congenital alterations of ICC development that result in gastrointestinal motility disorders.展开更多
目的:探究白术破壁饮片对慢传输型便秘(slow transit constipation,STC)小鼠肠神经递质、Cajal间质细胞(interstitial cells of Cajal,ICC)的干细胞因子(stem cell factor,SCF)/干细胞生长因子受体(c-kit)信号通路的影响。方法:采用皮...目的:探究白术破壁饮片对慢传输型便秘(slow transit constipation,STC)小鼠肠神经递质、Cajal间质细胞(interstitial cells of Cajal,ICC)的干细胞因子(stem cell factor,SCF)/干细胞生长因子受体(c-kit)信号通路的影响。方法:采用皮下注射2.5 mg/(kg·d)盐酸吗啡注射液法复制STC小鼠模型,选取48只雌雄各半昆明小鼠随机分为正常组,模型组,白术破壁饮片低、中、高剂量组(25、50、100 mg/kg)和莫沙必利组(1.5 mg/kg),每组8只。各组予以不同药物干预1周后,检测造模后和给药后各组小鼠粪便性状、肠道推进率;采用酶联免疫反应(enzyme-linked immunosorbent assay,ELISA)测定各组小鼠结肠神经递质P物质(substance P,SP)、乙酰胆碱(acetylcholine,Ach)、血管活性肠肽(vasoactive intestinal peptide,VIP)、一氧化氮(nitric oxide,NO)和5-羟色胺(5-hydroxytrytamine,5-HT)含量;采用Western blot检测小鼠结肠组织SCF和c-kit蛋白的表达。结果:ELISA结果显示,与正常组比较,模型组SP和Ach含量均明显降低(SP:230.41±16.41 vs. 146.69±15.59;Ach:577.68±39.35 vs. 281.50±39.40)。与模型组比较,白术破壁饮片低剂量组、白术破壁饮片中剂量组和白术破壁饮片高剂量组SP含量均明显升高(146.69±15.59 vs. 188.25±4.60;146.69±15.59 vs. 201.78±4.44;146.69±15.59 vs. 307.51±16.94);白术破壁饮片高剂量组和莫沙必利组Ach含量均明显升高(281.50±39.40 vs. 400.93±12.21;281.50±39.40 vs. 422.22±22.70)。与白术破壁饮片高剂量组比较,白术破壁饮片低剂量组和白术破壁饮片中剂量组SP和Ach含量均明显降低(SP:307.51±16.94 vs.188.25±4.60;307.51±16.94 vs. 201.78±4.44;Ach:400.93±12.21 vs. 283.79±11.53;400.93±12.21 vs. 327.81±14.77);莫沙必利组SP含量均明显降低(307.51±16.94 vs. 164.08±12.54)。与正常组比较,模型组VIP、NO和5-HT含量均明显升高(VIP:64.47±2.69 vs. 87.74±2.93;NO:38.21±1.76 vs. 42.78±1.69;5-HT:219.58±11.60 vs. 276.08±7.97)。与模型组比较,白术破壁饮片低剂量组、白术破壁饮片中剂量组、白术破壁饮片高剂量组和莫沙必利组VIP含量均明显降低(87.74±2.93 vs. 75.58±2.08;87.74±2.93 vs. 69.34±2.23;87.74±2.93 vs. 66.37±1.93;87.74±2.93 vs. 65.31±3.32);白术破壁饮片中剂量组、白术破壁饮片高剂量组和莫沙必利组NO和5-HT含量均明显降低(NO:42.78±1.69 vs. 39.27±1.90;42.78±1.69 vs. 37.43±1.30;42.78±1.69 vs. 35.65±2.01;5-HT:276.08±7.97 vs. 257.89±6.16;276.08±7.97 vs. 226.79±10.49;276.08±7.97 vs. 242.05±12.15)。与白术破壁饮片高剂量组比较,白术破壁饮片低剂量组VIP、NO和5-HT含量均明显升高(VIP:66.37±1.93 vs. 75.58±2.08;NO:37.43±1.30 vs.42.73±2.19;5-HT:226.79±10.49 vs. 269.87±10.91);白术破壁饮片中剂量组VIP、5-HT,莫沙必利组5-HT含量均明显升高。Western blot结果显示,与模型组比较,白术破壁饮片低剂量组c-kit蛋白含量明显升高(0.22±0.10 vs. 0.37±0.08);白术破壁饮片中剂量组、白术破壁饮片高剂量组和莫沙必利组SCF和c-kit蛋白含量均明显升高(SCF:0.60±0.19 vs. 0.99±0.28;0.60±0.19 vs. 1.17±0.34;0.60±0.19 vs. 1.02±0.30;c-kit:0.22±0.10 vs. 0.47±0.10;0.22±0.10 vs. 0.58±0.13;0.22±0.10 vs. 0.49±0.13)。结论:白术破壁饮片可通过升高STC模型小鼠结肠组织SP、Ach和SCF/c-kit含量,以及降低VIP、NO和5-HT含量,从而调节小鼠胃肠道功能,促进肠道蠕动,改善便秘症状,进而达到治疗STC的效果。展开更多
文摘Constipation and fecal impaction are frequent and distressing complaints in pediatric gastroenterology. Especially in neurologically handicapped children, treatment of severe forms of slow-transit constipation (STC) can be difficult. In the majority of cases, STC is of unknown etiology. However, in recent years, there is growing evidence that interstitial cells of Cajal (ICCs), which serve as electrical pacemakers and generate spontaneous electrical slow waves in the gastrointestinal tract, might play an important role in the pathophysiology of STC. It remains unclear whether morphological ICC alterations seen in affected patients are based on congenital developmental anomalies, or whether they are a consequence of long-term constipation with secondary damage of the gastrointestinal nervous system. To the best of our knowledge, we present the first case of a patient with histological alterations in ICC morphology who displayed multiple alterations of c-kit at the level of mRNA. The protein encoded by c-kit is the receptor tyrosine kinase Kit (CD117), which is crucial for development and function of ICCs. Therefore, these findings provide a new explanation for congenital alterations of ICC development that result in gastrointestinal motility disorders.
文摘目的:探究白术破壁饮片对慢传输型便秘(slow transit constipation,STC)小鼠肠神经递质、Cajal间质细胞(interstitial cells of Cajal,ICC)的干细胞因子(stem cell factor,SCF)/干细胞生长因子受体(c-kit)信号通路的影响。方法:采用皮下注射2.5 mg/(kg·d)盐酸吗啡注射液法复制STC小鼠模型,选取48只雌雄各半昆明小鼠随机分为正常组,模型组,白术破壁饮片低、中、高剂量组(25、50、100 mg/kg)和莫沙必利组(1.5 mg/kg),每组8只。各组予以不同药物干预1周后,检测造模后和给药后各组小鼠粪便性状、肠道推进率;采用酶联免疫反应(enzyme-linked immunosorbent assay,ELISA)测定各组小鼠结肠神经递质P物质(substance P,SP)、乙酰胆碱(acetylcholine,Ach)、血管活性肠肽(vasoactive intestinal peptide,VIP)、一氧化氮(nitric oxide,NO)和5-羟色胺(5-hydroxytrytamine,5-HT)含量;采用Western blot检测小鼠结肠组织SCF和c-kit蛋白的表达。结果:ELISA结果显示,与正常组比较,模型组SP和Ach含量均明显降低(SP:230.41±16.41 vs. 146.69±15.59;Ach:577.68±39.35 vs. 281.50±39.40)。与模型组比较,白术破壁饮片低剂量组、白术破壁饮片中剂量组和白术破壁饮片高剂量组SP含量均明显升高(146.69±15.59 vs. 188.25±4.60;146.69±15.59 vs. 201.78±4.44;146.69±15.59 vs. 307.51±16.94);白术破壁饮片高剂量组和莫沙必利组Ach含量均明显升高(281.50±39.40 vs. 400.93±12.21;281.50±39.40 vs. 422.22±22.70)。与白术破壁饮片高剂量组比较,白术破壁饮片低剂量组和白术破壁饮片中剂量组SP和Ach含量均明显降低(SP:307.51±16.94 vs.188.25±4.60;307.51±16.94 vs. 201.78±4.44;Ach:400.93±12.21 vs. 283.79±11.53;400.93±12.21 vs. 327.81±14.77);莫沙必利组SP含量均明显降低(307.51±16.94 vs. 164.08±12.54)。与正常组比较,模型组VIP、NO和5-HT含量均明显升高(VIP:64.47±2.69 vs. 87.74±2.93;NO:38.21±1.76 vs. 42.78±1.69;5-HT:219.58±11.60 vs. 276.08±7.97)。与模型组比较,白术破壁饮片低剂量组、白术破壁饮片中剂量组、白术破壁饮片高剂量组和莫沙必利组VIP含量均明显降低(87.74±2.93 vs. 75.58±2.08;87.74±2.93 vs. 69.34±2.23;87.74±2.93 vs. 66.37±1.93;87.74±2.93 vs. 65.31±3.32);白术破壁饮片中剂量组、白术破壁饮片高剂量组和莫沙必利组NO和5-HT含量均明显降低(NO:42.78±1.69 vs. 39.27±1.90;42.78±1.69 vs. 37.43±1.30;42.78±1.69 vs. 35.65±2.01;5-HT:276.08±7.97 vs. 257.89±6.16;276.08±7.97 vs. 226.79±10.49;276.08±7.97 vs. 242.05±12.15)。与白术破壁饮片高剂量组比较,白术破壁饮片低剂量组VIP、NO和5-HT含量均明显升高(VIP:66.37±1.93 vs. 75.58±2.08;NO:37.43±1.30 vs.42.73±2.19;5-HT:226.79±10.49 vs. 269.87±10.91);白术破壁饮片中剂量组VIP、5-HT,莫沙必利组5-HT含量均明显升高。Western blot结果显示,与模型组比较,白术破壁饮片低剂量组c-kit蛋白含量明显升高(0.22±0.10 vs. 0.37±0.08);白术破壁饮片中剂量组、白术破壁饮片高剂量组和莫沙必利组SCF和c-kit蛋白含量均明显升高(SCF:0.60±0.19 vs. 0.99±0.28;0.60±0.19 vs. 1.17±0.34;0.60±0.19 vs. 1.02±0.30;c-kit:0.22±0.10 vs. 0.47±0.10;0.22±0.10 vs. 0.58±0.13;0.22±0.10 vs. 0.49±0.13)。结论:白术破壁饮片可通过升高STC模型小鼠结肠组织SP、Ach和SCF/c-kit含量,以及降低VIP、NO和5-HT含量,从而调节小鼠胃肠道功能,促进肠道蠕动,改善便秘症状,进而达到治疗STC的效果。