Banha-sasim-tang improves gastrointestinal function in loperamide-induced functional dyspepsia mouse model

Jeon, Yoo-Jin; Lee, Jin-Seok; Cho, Yong-Rae; Lee, Sung-Bae; Kim, Youn-Jung; Roh, Seong‐Soo; Joung, Jin-Yong; Lee, Hwa Dong; Moon, Sung-Ok; Cho, Jung‐Hyo; Son, Chang‐Gue

doi:10.1016/j.jep.2019.111834

Cited by 18 publications

(21 citation statements)

References 66 publications

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“…Some clinical studies clearly have shown that ghrelin stimulates upper gastrointestinal motility (Tack et al, 2006) and circulating ghrelin levels could be altered by various stressors (Stengel et al, 2011). Our previous animal study found that BST modulates peristalsis via activation of the interstitial cells of Cajal and the smooth muscle cells in the stomach (Jeon et al, 2019). As we expected, BST administration notably improved the measurements of FD assessments compared with placebo, including VAS (with statistical significance) and NDI-K (Figures 3A,B).…”

Section: Discussionsupporting

confidence: 75%

Beneficial Potential of Banha-Sasim-Tang for Stress-Sensitive Functional Dyspepsia via Modulation of Ghrelin: A Randomized Controlled Trial

et al. 2021

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Background: Functional dyspepsia (FD) is a highly complex pathophysiologic disease, which shows low recovery and high relapse rates. Therefore, a growing number of clinicians and patients are looking for alternative herbal medicine. Banha-Sasim-Tang (BST) is an herbal prescription for treating a wide range of dyspepsia in traditional Korean medicine (TKM).Aim of the study: This study aimed to evaluate the efficacy of BST on FD in patients with psychological stress-related symptoms and to investigate the involvement of ghrelin. This study is registered at https://cris.nih.go.kr/with the identification number KCT 0002811.Materials and methods: A total of 31 participants with FD who met the Rome IV criteria and the psychological stress-related pattern were enrolled in a double-blind, randomized, and controlled study. Participants were randomly assigned to the BST group (10 g twice daily for 4 weeks) or placebo group. The primary endpoint was a change in the Nepean Dyspepsia Index–Korean (NDI-K) score. The secondary endpoints were changes in the Visual Analog Scale (VAS) scores and plasma ghrelin level.Results: All participants completed the study (n = 15 for BST, n = 16 for placebo). BST decreased NDI-K scores compared with placebo, but the difference was not statistically significant (37.40 ± 27.40 vs 22.50 ± 23.85, p = 0.12). VAS scores and plasma total ghrelin levels were significantly improved in patients who were treated with BST (3.19 ± 1.60 vs 1.38 ± 2.85, p = 0.03 for VAS and 105.69 ± 287.89 vs -142.31 ± 314.32, p = 0.03 for total ghrelin). No BST-related adverse effects were observed during the trial.Conclusion: Our results indicate the clinical potential of BST for FD patients and are the first study to show the modulation of plasma ghrelin as one of its corresponding mechanisms.Clinical Trial Registration:https://cris.nih.go.kr/, identifier KCT 0002811.

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Section: Discussionsupporting

confidence: 75%

Beneficial Potential of Banha-Sasim-Tang for Stress-Sensitive Functional Dyspepsia via Modulation of Ghrelin: A Randomized Controlled Trial

et al. 2021

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“…Molecular mechanism Depolarizers of the pacemaker potential of ICCs Gamisoyo-san [14], Citrus unshiu peel extracts [41], Dangkwisoo-san [43] Via M 3 receptor Magnolia officinalis [42] Via M 2 and M 3 receptors Banhasasim-tang [44] Via M 3 and 5-HT 3 receptors Daegeonjung-tang [45] Via M 3 and 5-HT 4 receptors Hesperidin, a citrus flavonoid [52] Via 5-HT 4 receptor Hwangryunhaedok-tang [46], Samhwangsasim-tang [47], Socheongryong-tang [48] Via 5-HT 3 and 5-HT 4 receptor Yukgunja-tang [49] Via ghrelin receptor Leejung-tang [90], Sengmek-san [50] Via PLC pathway Pyungwi-san [51] Via PKC pathway Inhibitors of the pacemaker potential of ICCs Galgeun-tang [26] Via α2-and β1-adrenoceptors Quercetin [91] Via opioid receptor signaling pathways M receptors: muscarinic acetylcholine receptors; 5-HT receptors: 5-hydroxytryptamine receptors; PLC: phospholipase C; PKC: protein kinase C. [53]. is decoction also promotes the numbers of stomach ICCs and the levels of SCF in diabetic rats [54].…”

Section: Medicinal Plants or Decoctions (Reference)mentioning

confidence: 99%

“…Herbal medicines are also able to activate c-kit and SCF, which are involved in central pathways in the growth of ICCs. Banhasasim-tang, a typical herbal decoction for patients with FD, has been found to significantly promote ICC and SCF signaling in stomach tissues in both a loperamide-induced FD mouse model and a diabetic dyspepsia rat model [ 53 , 54 ]. These herbal effects on ICCs and SCF have also been reported in other animal models, including in a trinitrobenzene sulfonic acid-induced rat colitis model treated with Shenqing recipe [ 40 ], a cirrhotic ascites rat model treated with Xiaozhang Tie [ 55 ], and a loperamide-induced constipation rat model treated with Herba Cistanche [ 56 ].…”

Section: Effects Of Herbal Products On Icc Receptors and Icc Integritymentioning

confidence: 99%

“…Banhasasim-tang depolarizes the slow-wave potentials in ICCs by regulating internal and external Ca2 + via the M 3 and 5-HT 3 receptors in a dose-dependent manner [ 44 ]. We also found that Banhasasim-tang can reverse the inactivation of c-kit and modulate oxidative stress and contraction-related genes such as the 5-HT 4 receptor, ANO1, RYR receptor 3, and smooth muscle myosin light chain kinase in a loperamide-injected mouse model [ 53 ]. This decoction also promotes the numbers of stomach ICCs and the levels of SCF in diabetic rats [ 54 ].…”

Section: Two Representative Tcms Modulating Icc: Banhasasim-tang (半夏泻心汤) and Yukgunja-tang (六君子汤)mentioning

confidence: 99%

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Interstitial Cells of Cajal: Potential Targets for Functional Dyspepsia Treatment Using Medicinal Natural Products

Joung

Choi²,

Son

2021

Evidence-Based Complementary and Alternative Medicine

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Introduction. The pathophysiology of functional dyspepsia (FD) remains uncertain, but the interstitial cells of Cajal (ICCs), pacemakers that regulate gastrointestinal motility, are garnering attention as key modulators and therapeutic targets in FD. This review comprehensively discusses the involvement of ICCs in the pharmacologic actions of FD and as therapeutic targets for herbal products for FD. Methods. A search of the literature was performed using PubMed by pairing “interstitial cells of Cajal” with “medicinal plant, herbal medicine, phytotherapy, flavonoids, or traditional Chinese medicine (TCM).” Results. From the 55 articles screened in the initial survey, 34 articles met our study criteria. The search results showed that herbal products can directly depolarize ICCs to generate pacemaker potentials and increase the expression of c-kit and stem cell factors, helping to repair ICCs. Under certain pathological conditions, medicinal plants also protect ICCs from oxidative stress and/or inflammation-induced impairment. Two representative herbal decoctions (Banhasasim-tang, 半夏泻心汤, and Yukgunja-tang, 六君子汤) have been shown to modulate ICC functions by both clinical and preclinical data. Conclusion. This review strongly indicates the potential of herbal products to target ICCs and suggests that further ICC-based studies would be promising for the development of FD treatment agents.

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“…BST was recorded in the old Chinese medical literature, Shan-han-za-bing-lin (傷寒雜病論). The indication of BST in Shan-han-za-bing-lin is "Epigastric stiffness (心下痞)" which is similar to the epigastric or upper abdominal fullness (World Health Organization, 2007;Jeon et al, 2019). In this randomized, blinded, parallel-group trial, we classified FD patients with epigastric stiffness and other related signs as "excess pattern" using a questionnaire (Kim et al, 2010) and specifically evaluated the efficacy and safety of BST syrup for the treatment of FD symptoms.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a Traditional Herbal Formula, Banha-Sasim-Tang in Functional Dyspepsia Classified as Excess Pattern

Kim

Kwon

et al. 2021

Front. Pharmacol.

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This study evaluated the efficacy and safety of Banha-sasim-tang (BST) in patients with functional dyspepsia (FD). BST (Banxia-xiexin-tang in traditional Chinese medicine and Hange-shashin-to in Kampo medicine) is traditionally prescribed for the treatment of dyspepsia with epigastric stiffness and gastric fullness in China, Japan, and Korea. Patients with FD were randomly administered an oral dose (10 g) of BST syrup or placebo, twice a day for 4 weeks. The primary outcome was the symptom checklist part of the Nepean dyspepsia index (NDI). The secondary outcomes were the quality of life (QoL) part of the NDI, functional dyspepsia-related QoL (FD-QoL), and visual analog scale (VAS). A total of 60 patients with FD were screened, and 50 were randomized into BST group (n = 25) and placebo group (n = 25). Two patients in the placebo group withdrew before the start of the treatment. Administration of BST syrup resulted in improvement in the symptom-related NDI score in the BST group compared with that in the control group; however, the difference was not significant. BST syrup significantly improved “fullness after eating” index of NDI at follow-up time point (2.88 ± 2.65 vs 4.78 ± 2.69, p = 0.0081). In the total score of the QoL section of the NDI and FD-QoL scales, there was no significant improvement in the BST group compared to that in the placebo group. With regard to improvement in overall FD symptoms, the VAS scale showed improvement in both groups, but the difference was not significant. Interestingly, follow-up investigation showed a significantly beneficial effect of BST on FD symptoms, when compared to placebo. Significant improvement observed in VAS score (39.60 ± 22.29 vs 52.17 ± 20.55, p = 0.048). This indicated that the effect of BST lasted even after the completion of the medication regimen. Overall, our data suggest that while BST showed no significant improvement in the symptom-related NDI score and the QoL related scores in NDI and FD-QoL after 4 weeks of treatment, it effectively improved the VAS score and fullness after eating-related symptoms in the follow-up visit.Clinical Trial Registration:https://cris.nih.go.kr; Identifier KCT 0002013

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Banha-sasim-tang improves gastrointestinal function in loperamide-induced functional dyspepsia mouse model

Cited by 18 publications

References 66 publications

Beneficial Potential of Banha-Sasim-Tang for Stress-Sensitive Functional Dyspepsia via Modulation of Ghrelin: A Randomized Controlled Trial

Beneficial Potential of Banha-Sasim-Tang for Stress-Sensitive Functional Dyspepsia via Modulation of Ghrelin: A Randomized Controlled Trial

Interstitial Cells of Cajal: Potential Targets for Functional Dyspepsia Treatment Using Medicinal Natural Products

Efficacy of a Traditional Herbal Formula, Banha-Sasim-Tang in Functional Dyspepsia Classified as Excess Pattern

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