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      Tong-Xie-Yao-Fang improves intestinal permeability in diarrhoea-predominant irritable bowel syndrome rats by inhibiting the NF-κB and notch signalling pathways

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          Abstract

          Background

          Tong-Xie-Yao-Fang (TXYF) has been shown to be effective in diarrhoea-predominant irritable bowel syndrome (IBS-D) patients. However, the underlying mechanism remains to be clarified. The aim of this study was to investigate the efficacy and related mechanisms of TXYF in an IBS-D rat model.

          Methods

          The IBS-D rat model was established with 4% acetic acid and evaluated by haematoxylin-eosin (HE) staining. Then, IBS-D rats were divided into control, TXYF and rifaximin groups and treated intragastrically with normal saline, TXYF and rifaximin, respectively, for 14 days. The following indicators were measured before and after treatment: defecation frequency, faecal water content (FWC) and colorectal distension (CRD). Histopathological changes in the distal colon were observed after treatment. The expression of OCLN and ZO1 in the distal colon of IBS-D rats reflected the intestinal mucosal permeability, as measured by qRT-PCR, western blot, and enzyme-linked immunosorbent assays (ELISAs). The NF-κB and Notch signalling pathways and inflammation-related factors were investigated.

          Results

          After treatment with TXYF, the defecation frequency, FWC and CRD were significantly lower than those in the model group ( P < 0.05). HE staining showed that colonic epithelial cells (CECs) in the IBS-D rats displayed significant oedema, impaired intestinal mucosal integrity and an increased influx of inflammatory cells. A significant reduction in granulocyte and CEC oedema was observed after the administration of TXYF and rifaximin compared to that of the model group and blank group ( P < 0.05). TXYF significantly upregulated the expression of OCLN and ZO-1 and downregulated inflammation-related factors (IL-6, IL-1β, and TNF-α and the chemokine KC) in IBS-D rats compared to those in the model group rats ( P < 0.05). In terms of the NF-κB and Notch signalling pathways, the expression of NICD, p-ERK, Hes-1 and p-P65 decreased significantly in the TXYF and rifaximin groups, while the expression of ATOH1 increased significantly compared to that in the model group ( P < 0.05).

          Conclusion

          TXYF can effectively improve intestinal permeability and enhance intestinal mucosal barrier function, which may be related to inhibition of the inflammatory cascade and the NF-κB and Notch signalling pathways.

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          Most cited references26

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          Increased human intestinal barrier permeability plasma biomarkers zonulin and FABP2 correlated with plasma LPS and altered gut microbiome in anxiety or depression

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            Intestinal permeability defects: is it time to treat?

            An essential role of the intestinal epithelium is to separate luminal contents from the interstitium, a function primarily determined by the integrity of the epithelium and the tight junction that seals the paracellular space. Intestinal tight junctions are selectively permeable, and intestinal permeability can be increased physiologically in response to luminal nutrients or pathologically by mucosal immune cells and cytokines, the enteric nervous system, and pathogens. Compromised intestinal barrier function is associated with an array of clinical conditions, both intestinal and systemic. Although most available data are correlative, some studies support a model where cycles of increased intestinal permeability, intestinal immune activation, and subsequent immune-mediated barrier loss contribute to disease progression. This model is applicable to intestinal and systemic diseases. However, it has not been proven, and both mechanistic and therapeutic studies are ongoing. Nevertheless, the correlation between increased intestinal permeability and disease has caught the attention of the public, leading to a rise in popularity of the diagnosis of "leaky gut syndrome," which encompasses a range of systemic disorders. Proponents claim that barrier restoration will cure underlying disease, but this has not been demonstrated in clinical trials. Moreover, human and mouse studies show that intestinal barrier loss alone is insufficient to initiate disease. It is therefore uncertain whether increased permeability in these patients is a cause or effect of the underlying disorder. Although drug targets that may mediate barrier restoration have been proposed, none have been proven effective. As such, current treatments for barrier dysfunction should target the underlying disease. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.
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              The Canonical Notch Signaling Pathway: Structural and Biochemical Insights into Shape, Sugar, and Force.

              The Notch signaling pathway relies on a proteolytic cascade to release its transcriptionally active intracellular domain, on force to unfold a protective domain and permit proteolysis, on extracellular domain glycosylation to tune the forces exerted by endocytosed ligands, and on a motley crew of nuclear proteins, chromatin modifiers, ubiquitin ligases, and a few kinases to regulate activity and half-life. Herein we provide a review of recent molecular insights into how Notch signals are triggered and how cell shape affects these events, and we use the new insights to illuminate a few perplexing observations.
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                Author and article information

                Contributors
                simonhan74@126.com
                liufb163@126.com
                Journal
                BMC Complement Altern Med
                BMC Complement Altern Med
                BMC Complementary and Alternative Medicine
                BioMed Central (London )
                1472-6882
                27 November 2019
                27 November 2019
                2019
                : 19
                : 337
                Affiliations
                [1 ]GRID grid.412595.e, Department of Gastroenterology, , The First Affiliated Hospital of Guangzhou University of Chinese Medicine, ; Guangzhou, 510405 Guangdong China
                [2 ]ISNI 0000 0004 1764 5980, GRID grid.221309.b, School of Chinese Medicine, , Hong Kong Baptist University, ; Hong Kong, China
                [3 ]ISNI 0000 0000 8848 7685, GRID grid.411866.c, Department of Orthopaedics, , The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, ; Guangzhou, China
                [4 ]ISNI 0000 0000 8848 7685, GRID grid.411866.c, Department of Preventive Medicine and Health Statistics, , Guangzhou University of Chinese Medicine, ; Guangzhou, Guangdong China
                Article
                2749
                10.1186/s12906-019-2749-4
                6882330
                31775739
                580a6ee7-e9b3-457c-9cb0-7266486ac7cc
                © The Author(s). 2019

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 28 August 2019
                : 8 November 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;
                Award ID: 81804047
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100010883, Traditional Chinese Medicine Bureau of Guangdong Province;
                Award ID: 20181095
                Award Recipient :
                Funded by: Hong Kong scholar program
                Award ID: XJ2018059
                Award Recipient :
                Funded by: Innovative Research Team Project of “Innovative Strong Institute”, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine
                Award ID: 2017TD05
                Award Recipient :
                Funded by: Guangzhou University of Traditional Chinese Medicine's first-class discipline research key project
                Award ID: A1-AFD018191A16)
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Complementary & Alternative medicine
                tong-xie-yao-fang,diarrhoea predominant-irritable bowel syndrome,intestinal permeability,nf-κb signalling,notch signalling

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