Gastrointestinal Motility and Improvement Efficacy of Shenhuang Plaster Application on Shenque: Identification, Evaluation, and Mechanism

Abstract

<jats:p>Constipation, a gastrointestinal function disorder, is one of the side effects of paclitaxel (PTX) chemotherapy. Shenhuang plaster (SHP) application on the Shenque acupoint promotes gut motility in clinical settings. In this study, we elucidated the ingredients in SHP and evaluated its effects on PTX-induced constipation using a tumour-bearing mouse model. SHP was prepared using the traditional Chinese plaster preparation method. The ingredients were analysed using UPLC-MS/MS and identified via screening in a standard drug database. The gastrointestinal transit was evaluated by the movement of a fluorescein-labelled dextran in the gastrointestinal tract. A histological study of the mucosa was carried out after haematoxylin and eosin staining. mRNA expression was assessed using real-time RT-PCR, and the foetal microbiota composition was elucidated through 16 s rDNA sequencing and BLAST analysis. Our results indicate that the application of SHP attenuated weight gain inhibition by PTX; however, no inhibitory effect was observed on tumour growth. PTX-induced sluggish intestine, villus, and mucosal base layer damage were significantly improved following the application of SHP. Further, SHP enhanced the stimulation efficiency of PTX on TLR4 and its downstream cytokines, as well as on IL-1<jats:italic>β</jats:italic> in intestinal cells. SHP combined with PTX reshaped the microbiota, which showed beneficial effects on health. Hence, these results provide evidence that SHP alleviates PTX-induced constipation and intestinal morphological damage but augments the effects of PTX on the expression of cytokines in the TLR4 pathway and IL-1<jats:italic>β</jats:italic>. Therefore, we propose that SHP stimulates the host immune response to eradicate cancer cells.</jats:p>

Gastrointestinal Motility and Gut Hormone Secretion in response to Shenhuang Plaster in a Postoperative Ileus Rat Model

“…It has been reported that several active ingredients in TCMs have anti-inflammatory and gastrointestinal motility effects that are compatible with SHP [21][22][23]. Our previous studies showed that SHP enhanced gastric motility and could potentially serve as a novel therapeutic agent for chemotherapeutic constipation due to its anti-inflammatory potency [11].…”

“…ese herbs were purchased from Chinese Herbal Pieces Co., Ltd. of Zhejiang Chinese Medical University, and they were qualified according to the standards noted in " e Pharmacopoeia of the People's Republic of China, 2015." e ingredient extracts and SHP were prepared by the Traditional Chinese Medicine Preparation Institute of Zhejiang Chinese Medical University, as previously described [11].…”

“…e gastrointestinal transit evaluation method was described previously [11]. e rats were fasting for 24 h before each measured time point: 6 h, 12 h, 24 h, 48 h, and 72 h. en, 200 μL of FITC-labelled dextran (6.25 mg/ml, 70 kDa) was injected into each rat through the gastric tube.…”

“…Based on TCM theory, it is the obstruction of "Qi" (energy) in the intestinal tract, or the dysfunction of "Qi" [9,10]. e Shenhuang plaster (SHP) is a "Qi"-promoting herbal formula consisting of Renshen (Ginseng Radix Et Rhizoma), Raw Dahuang (Rhei Radix Et Rhizoma), Danshen (Salviae Miltiorrhizae Radix et Rhizoma), Zhishi (Aurantii Fructus Immaturus), Houpo (Magnoliae Officinalis Cortex), Dingxiang (Caryophylli Flos), and Wuzhuyu (Evodiae Fructus) [11,12].…”

Use of Shenhuang paste on Shenque point improves chemotherapy induced gastrointestinal toxicity in breast cancer

“…Our previous studies found that Shenhuang Plaster application on Shenque point (CV8) could improve gastrointestinal symptoms after chemotherapy. [ 12 ] Based on the preliminary work, this study carries out research on acupoint application for gastrointestinal side effect after chemotherapy. Through double-blind, randomized controlled study, we will verify the effect of SHP application in regulating the chemotherapy-induced gastrointestinal toxicity.…”