OBJECTIVE: To observe the effect of moxibustion on small intestinal mucosal immune barrier in rats with diarrhea-predominant irritable bowel syndrome (IBS-D) and explore its underlying mechanisms. METHODS: Of 38 newborn rats from 4 healthy SPF pregnant rats, 12 neonatal rats were randomly selected in a normal group. IBS-D model was prepared by the combined measures for the rest rats, including neonatal maternal separation, acetic acid enema and chronic restraint stress. Twenty-four successfully-modeled rats were randomized into a model group and a moxibustion group, 12 rats in each one. In the moxibustion group, suspending moxibustion was delivered at bilateral "Tianshu" (ST25) and "Shangjuxu" (ST37), 20 min each time, once daily and for 7 consecutive days. Separately, before acetic acid enema (aged 35 days), after modeling (aged 45 days) and after intervention (aged 53 days), the body mass, loose stool rate (LSR) and and the minimum volume threshold when abdominal withdrawal reflex (AWR) scored 3 were observed in the rats of each group. After intervention (aged 53 days), using HE and PAS staining, the morphology of duodenum was observed, the length of villus and the depth of crypt were measured, the ratio of the length of villus to the depth of crypt was calculated; and the numbers of mucosal intraepithelial lymphocytes (IELs) and goblet cells were counted. With ELISA adopted, the contents of γ-interferon (IFN-γ), interleukin-4 (IL-4) and secretory immunoglobulin A (sIgA) in duodenal mucosa of rats were detected. The proportion of T cell subsets in duodenal mucosa was detected using flow cytometry. The microvilli and tight junctions of duodenal mucosal epithelial cells were observed by transmission electron microscopy, and the integrity of duodenal mucosa observed by scanning electron microscopy. RESULTS: Compared with the normal group, for the rats in the model group, the body mass, the minimum volume threshold when AWR scored 3, the length of duodenal villus and the the ratio of the length of villus to the depth of crypt, as well as the proportion of CD₈⁺ T subset were all reduced (P<0.01, P<0.05), the counts of goblet cells in duodenal mucosa decreased (P<0.01); LRS, the proportion of CD₄⁺ T subset and CD₄⁺/CD₈⁺, as well as the contents of IFN-γ, IL-4 and sIgA in duodenal mucosa and IFN-γ/IL-4 were all elevated (P<0.01); and the numbers of IELs rose (P<0.01). The morphology of duodenal mucosa was irregular, the villi got shorter, sparse and scattered, with uneven density. The morphology of epithelial cells was destroyed and the tight junctions damaged, with larger spaces. When compared with the model group, in the moxibustion group, the body mass, the minimum volume threshold when AWR scored 3, the length of duodenal villus and the ratio of the length of villus to the depth of crypt, as well as the counts of goblet cells in duodenal mucosa increased (P<0.01); LRS, the proportion of CD₄⁺ T subset, and CD₄⁺/CD₈⁺, as well as the contents of IFN-γ, IL-4 and sIgA in duodenal mucosa and IFN-γ/IL-4 were reduced (P<0.01); and the numbers of IELs was dropped (P<0.01). The morphology of duodenal mucosa was more regular, the villi were grew, got longer and arranged regularly, with even density. The morphology of epithelial cells was slightly destroyed, and the tight junctions partially damaged. CONCLUSION Moxibustion at "Tianshu" (ST25) and "Shangjuxu" (ST37) can reduce visceral hypersensitivity in IBS-D rats and relieve abdominal pain, diarrhea and other symptoms. Its effect mechanism may be related to the repair of small intestinal mucosal immune barrier and the improvement in the immune function in IBS-D.
Animals ; Irritable Bowel Syndrome/immunology* ; Rats ; Moxibustion ; Intestinal Mucosa/immunology* ; Female ; Diarrhea/therapy* ; Intestine, Small/immunology* ; Male ; Humans ; Rats, Sprague-Dawley ; Disease Models, Animal

OBJECTIVETo observe clinical therapeutic effects of acupuncture for pattern of liver-stagnation and spleen-deficiency in diarrhea-predominant irritable bowel syndrome (D-IBS) and its impact on cell factors.

METHODSForty cases were selected and divided into an acupuncture group (21 cases) in which acupuncture was applied and a medicine group (19 cases) in which oral administration of dicetel and bifidobacterium lactobacillus triple viable capsules were applied. The symptom scores, level of Th1-type cytokine (IFN-gamma, IL-2) and Th2-type cytokine (IL-4, IL-10) and ratio of IFN-gamma to IL-4 were compared in two groups before and after treatment to analyze acupuncture effect.

RESULTSThe clinical symptoms were improved after one-week treatment in the acupuncture group (P<0.05), which had faster onset than the medicine group (P<0.05). The total effective rate was 90.48% (19/21) in the acupuncture group, which was superior to 78.95% (15/19) in the medicine group (P<0.05). Compared with medicine treatment, imbalanced condition of Th1/Th2 was turning towards the direction of Th2 after acupuncture, indicating a tendency to recover the balance.

CONCLUSIONThe clinical efficacy of acupuncture for D-IBS has close relationship with effectively improving balance of Th1/Th2 in patients with liver-stagnation and spleen-deficiency.

Acupuncture Therapy ; Adult ; Aged ; Cytokines ; immunology ; Female ; Humans ; Irritable Bowel Syndrome ; immunology ; physiopathology ; therapy ; Liver ; physiopathology ; Male ; Middle Aged ; Spleen ; physiopathology ; Th1 Cells ; immunology ; Th2 Cells ; immunology ; Young Adult

Previous reviews have highlighted complementary and alternative medicine therapies that are used to treat irritable bowel syndrome (IBS) based on published clinical trial data. Here the author describes and comments on a number of potentially relevant factors that have been commonly emphasized by practitioners who treat IBS and patients who have the disease. They include gluten and other food allergies, the candida syndrome and biofilm, interference fields and post-infectious IBS, as well as mind-body factors.
Food Hypersensitivity ; complications ; immunology ; Glutens ; immunology ; Humans ; Integrative Medicine ; Irritable Bowel Syndrome ; complications ; microbiology ; pathology ; therapy ; Mind-Body Therapies ; Wound Healing

Irritable bowel syndrome (IBS) is traditionally defined as a functional disorder
Allergy and Immunology ; Animals ; Comorbidity ; Cromolyn Sodium ; Food Hypersensitivity ; Humans ; Immunoglobulin E ; Inflammation ; Irritable Bowel Syndrome ; Mast Cells ; Methacholine Chloride ; Neurons ; Pilot Projects ; Skin

OBJECTIVETo study the clinical effect of Tongxie Yaofang (TXYF) Granule in treating diarrhea-predominate irritable bowel syndrome (D-IBS) and its possible mechanism.

METHODSA total of 120 patients were assigned to two groups using stratified block randomization, 80 in the intervention group and 40 in the control group. To the intervention group the TXYF granule was given at one package each time, twice a day; the control group was treated with Miyarisan three times a day, two tablets each time. The course of treatment was 4 weeks for both groups. The total efficacy in them was compared, and data of scoring on stool (Bristol method), abdominal pain, abdominal distension, and mental condition were collected before treatment and 2 and 4 weeks after treatment. The activation of mast cells (MCs) of six patients chosen from each group was detected as well before and after treatment.

RESULTSNo significant difference between the two groups in terms of the total efficacy or the scores of symptoms before and after treatment was found (P>0.05). The number of activated MCs was decreased in the intervention group after treatment, showing significant difference as compared with that before treatment as well as with that in the control group after treatment (P<0.01).

CONCLUSIONSTXYF is an effective preparation for the treatment of D-IBS. It can quickly lessen abdominal pain and distention, improve the property of stool, and improve mental tension and depression in patients. Its mechanism of action might be through the adjustment of MCs activation to decrease visceral hypersensitivity.

Abdominal Pain ; drug therapy ; etiology ; immunology ; Administration, Oral ; Adult ; Diarrhea ; drug therapy ; etiology ; immunology ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Irritable Bowel Syndrome ; complications ; drug therapy ; immunology ; Male ; Mast Cells ; drug effects ; Middle Aged

OBJECTIVETo investigate the influence of Weichang Anwan on the treatment of IBS-D in model rats.

METHODAnimal model of compound diarrhea was induced by a lactose enriched diet in the Wistar rat, combining with restraint stress. At first, the best cycle of taking medicine was tested. In order to decide the best cycle of taking medicine, 24 female Wistar rats were randomly divided into normal control group, model group and 60 mg x kg(1) x d(-1) weichangan group. The rate of weight increase, the rate of diarrhea, the incubation period of diarrhea and the diarrhea index were observed. And then 45 female Wistar rats randomly divided into five groups: normal control group, model group and Weichang Anwan groups of high, medium and low doses( 80, 60, 40 mg x kg(-1) x d(-1)). The mast cells in mucous membrane were observed by light microscope. The level of NO in blood serum was checked by the method of nitrate reductase. 5-HT in blood serum was detected by fluorimetry. The level of SP in colon was measured by radioimmunoassay.

RESULTAfter taking Weichang Anwan for 4 days, the rate of weight increase in Weichangan group was higher than the model group's. And the rate of diarrhea was lower significantly. So the best cycle of taking medicine was 4 days. The levels of NO and 5-HT in blood serum decreased remarkably in the model group than those of the normal control group. At the same time, the amount of the mast cells and the level of SP in colon significantly increased. Compared with the model group, the levels of NO and 5-HT in blood serum increased remarkably in the groups of high doses and medium doses. Meanwhile, the amount of the mast cells and the level of SP in colon decreased significantly.

CONCLUSIONWeichang Anwan has the effect of antidiarrhea. It can adjust the levels of NO and 5-HT in blood serum and can inhibit the expression of SP in colon which can active the mast cell. Weichangan can also decrease the amount of the mast cells directly.

Animals ; Colon ; drug effects ; immunology ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Irritable Bowel Syndrome ; drug therapy ; immunology ; metabolism ; Mast Cells ; immunology ; Nitric Oxide ; blood ; Random Allocation ; Rats ; Rats, Wistar ; Serotonin ; blood ; Substance P ; metabolism

OBJECTIVETo investigate the T lymphocyte subgroups and the levels of serum zinc (Zn), selenium (Se), iron (Fe), copper (Cu) in patients with diarrhea type of irritable bowel syndrome (D-IBS).

METHODSA total of 30 D-IBS patients and 30 control subjects were enrolled in this study, and their peripheral blood samples were collected. The percentage of peripheral CD3, CD4, CD8 T lymphocytes were analyzed by flow cytometry, and the ratio of CD4/CD8 was calculated. Serum Zn, Fe and Cu levels were determined by atomic absorption spectrometry(AAS), and the Se level by atomic fluorometry.

RESULTCompared with control group,the percentage of CD4 T lymphocyte and the ratio of CD4/CD8 in D-IBS group were significantly lower (P<0.01). However, there was no significant difference in serum Zn, Se, Fe, Cu levels between two groups (P>0.05).

CONCLUSIONThe declines of peripheral blood CD4 T lymphocytes and the ratio of CD4/CD8 may suggest a cellular immune abnormality in D-IBS patients. There was no significant difference in trace elements levels between the two groups.

Adult ; CD4-CD8 Ratio ; Case-Control Studies ; Copper ; blood ; Diarrhea ; etiology ; Female ; Humans ; Iron ; blood ; Irritable Bowel Syndrome ; blood ; complications ; immunology ; Male ; Middle Aged ; Selenium ; blood ; T-Lymphocyte Subsets ; immunology ; Trace Elements ; blood ; Zinc ; blood

The involvement of mucosal mast cells (MMC) in the pathophysiology of irritable bowel syndrome (IBS) is still controversial. We aimed to re-evaluate the role of MMC in visceral hypersensitivity associated with IBS using a rat IBS model that develops the IBS symptom after a subsidence of acetic acid-induced colitis. No significant difference in the number of MMC was observed between normal rat colon and IBS rat colon. (61.7 +/-2.9/mm 2 in normal vs. 88.7 +/-13.3/mm 2 in IBS, p >0.29). However, the degranulation rate of MMC was significantly higher in IBS rat colon (49.5 +/-2.4% in normal vs. 68.8 +/-3.4% in IBS, p >0.05). Pretreatment of a mast cell stabilizer, doxantrazole (5 mg/kg, i.p.), reduced the degranulation rate of MMC and significantly attenuated visceral hypersensitivity to rectal distension in IBS rat, whereas it had no effect on the visceral sensory responses in normal rat. These results suggest that, although the number of MMC is not significantly changed in IBS rat colon, the higher degranulation rate of MMC is responsible for visceral hypersensitivity in this model IBS.
Acetic Acid/toxicity ; Animals ; Cell Count ; Colitis/chemically induced/*pathology ; Hypersensitivity/*pathology ; Image Processing, Computer-Assisted ; Intestinal Mucosa/*pathology ; Irritable Bowel Syndrome/*pathology ; Male ; Mast Cells/drug effects/*pathology ; Models, Theoretical ; Phosphodiesterase Inhibitors/pharmacology ; Rats ; Rats, Sprague-Dawley ; Thioxanthenes/pharmacology ; Viscera/immunology ; Xanthones/pharmacology