The Effect of Daikenchuto, Japanese Herbal Medicine, on Adhesion Formation Induced by Cecum Cauterization and Cecum Abrasion in Mice

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  • Wu Songtao
    Department of Surgery, Division of Hepatobiliary Pancreas Surgery, Hyogo College of Medicine
  • Uyama Naoki
    Department of Surgery, Division of Hepatobiliary Pancreas Surgery, Hyogo College of Medicine
  • Itou Rei Atono
    Department of Surgery, Division of Hepatobiliary Pancreas Surgery, Hyogo College of Medicine
  • Hatano Etsuro
    Department of Surgery, Division of Hepatobiliary Pancreas Surgery, Hyogo College of Medicine
  • Tsutsui Hiroko
    Department of Surgery, Division of Hepatobiliary Pancreas Surgery, Hyogo College of Medicine
  • Fujimoto Jiro
    Department of Surgery, Division of Hepatobiliary Pancreas Surgery, Hyogo College of Medicine

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<p>Daikenchuto (DKT) has been widely used for the treatment of postsurgical ileus in Japan. However, its effect on postsurgical adhesion formation has been obscure. In this study, the effect of DKT on postsurgical adhesion formation induced by cecum cauterization or cecum abrasion in mice was investigated. First, the expression of adhesion-related molecules in damaged ceca was investigated by quantitative (q)RT-PCR. During 24 h after surgery, mRNA expressions of interferon-γ (IFN-γ), plasminogen activator inhibitor-1 (PAI-1), interleukin-17 (IL-17), and Substance P (SP) in cauterized ceca and those of PAI-1 and IL-17 in abraded ceca were significantly up-regulated. Next, the effect of DKT on adhesion formation macroscopically evaluated with adhesion scoring standards. DKT (22.5–67.5 mg/d) was administered orally for 7 d during the perioperative period, and DKT did not reduce adhesion scores in either the cauterization model (control : DKT 67.5 mg/d, 4.8 ± 0.2 : 4.8 ± 0.2) or in the abrasion model (control : DKT 67.5 mg/d, 4.9 ± 0.1 : 4.5 ± 0.3). Histologically, collagen deposition and leukocyte accumulation were found at the adhesion areas of control mice in both models, and DKT supplementation did not alleviate them. Last, effect of DKT on expression of proadhesion moleculs was evaluated. DKT also failed to down-regulate mRNA expression levels of them in damaged ceca of both models. In conclusion, PAI-1 and IL-17 may be key molecules of postsurgical adhesion formation. Collagen deposition and leukocytes accumulation are histological characteristic feature of post-surgical adhesion formation. DKT may not have any preventive effect on postsurgical adhesion formation in mice.</p>

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