Moringa oleifera leaf alleviates functional constipation via regulating the gut microbiota and the enteric nervous system in mice

Research progress on the regulation of interstitial cell of Cajal autophagy and apoptosis crosstalk by traditional Chinese medicine in gastrointestinal motility disorders

ETHNOPHARMACOLOGICAL RELEVANCE

Gastrointestinal motility disorders (GMD) severely impact quality of life, with rising global prevalence linked to modern dietary and lifestyle changes. Traditional Chinese medicine (TCM), rooted in the "holistic regulation" philosophy and centuries of empirical application, demonstrates unique advantages in restoring gastrointestinal homeostasis. Historical records and modern clinical practices validate the efficacy of herbal compounds, bioactive phytochemicals, and external therapies in modulating intestinal pacemaker systems.

AIM OF THE STUDY

This study aims to systematically review the pathogenesis of GMD mediated by autophagy-apoptosis imbalance in interstitial cells of Cajal (ICCs), examine the therapeutic application of traditional Chinese medicine (TCM) interventions, and identify the bioactive components and molecular mechanisms underlying TCM's regulatory effects on ICCs homeostasis.

METHODS

Utilize PubMed and NCBI databases to conduct a comprehensive search on GMD , focusing on diseases such as slow transit constipation (STC), functional dyspepsia (FD), diabetic gastroparesis (DGP), gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), functional constipation (FC) and opioid-induced constipation (OIC). Additionally, explore the underlying mechanisms involving autophagy, apoptosis, molecular crosstalk, and ICC dynamics. Investigate the potential therapeutic effects of herbal medicine, TCM compounds, bioactive phytocompounds, and external TCM therapeutic modalities on these GMD.

RESULTS

The study systematically identified 24 TCM compound formulations, 3 bioactive herbal extracts, and 10 specific active components, along with external therapeutic modalities including electroacupuncture (EA) and acupuncture. These therapeutic agents demonstrated multi-pathway regulatory effects by modulating autophagy-apoptosis dynamics in ICCs, with mechanistic analyses revealing their capacity to coordinate multiple signaling pathways for restoring gastrointestinal (GI) motility homeostasis.

CONCLUSION

TCM and external therapies demonstrate significant therapeutic efficacy in ameliorating GMD. The underlying molecular mechanisms may involve the coordinated modulation of a multi-target regulatory network that restores autophagy-apoptosis homeostasis in ICCs. Given the specificity and adaptability of this mechanistic framework, future research should prioritize the development of active constituents and their corresponding molecular targets as novel therapeutic agents and intervention points. These findings provide both a theoretical foundation and translational directions for advancing precision-targeted strategies in GI motility regulation.

Bifidobacterium animalis subsp. lactis BLa80 alleviates constipation in mice through modulating the stem cell factor (SCF)/c-Kit pathway and the gut microbiota

Probiotics, as health ingredients, have attracted widespread attention. However, due to the wide variety of probiotic species, their laxative effects and the underlying mechanisms remain elusive. In this study, we investigated the laxative effect of Bifidobacterium animalis subsp. lactis BLa80 (at concentrations of 1.0 × 108, 2.0 × 108, and 4.0 × 108 CFU per mL, with a dosage of 0.2 mL each) in mice, utilizing a functional constipation mouse model induced with loperamide hydrochloride (0.2 mL, 10 mg per kg BW) for 7 consecutive days. Meanwhile, a blank group (treated with 0.2 mL of 0.9% saline) and a positive control group (treated with mosapride at a dose of 5 mg per kg BW) were also set up. The body weight, fecal water content, intestinal propulsion rate, colon tissue histology, fecal microbial composition, serum indices, and colon mRNA levels of the mice were measured, employing histological and biochemical assays, GC-MS, RT-qPCR and 16S rRNA gene sequencing etc. Results showed BLa80 could accelerate intestinal peristalsis, maintain fecal moisture, prevent intestinal barrier disruption, increase short-chain fatty acid production, prevent gut microbe dysbiosis and constipation in mice. It also helped to keep the levels of 5-hydroxytryptamine (5-HT), motilin (MTL), and substance P (SP) normal, up-regulated the mRNAs of intestinal mucin 2 (MUC2), stem cell factor (SCF), and the tyrosine kinase receptor c-Kit, and down-regulated the mRNA of aquaporins (AQPs), especially at a high-dose. This study indicated that BLa80 held the potential to emerge as a novel ingredient in functional foods designed for constipation relief and as a treatment alternative.

Lactobacillus plantarum 24-7 improves postoperative bloating and hard stools by modulating intestinal microbiota in patients with congenital heart disease: a randomized controlled trial

Gastrointestinal symptoms are a common postoperative complication in patients with congenital heart disease (CHD), affecting their postoperative recovery. Probiotic intervention may be a promising therapeutic approach to alleviate postoperative gastrointestinal symptoms. This study aimed to evaluate the potential of Lactobacillus plantarum 24-7 (L. plantarum 24-7) in mitigating postoperative gastrointestinal symptoms and promoting patient recovery. Adult CHD patients scheduled for surgical intervention were recruited. One hundred and twenty patients were randomized and received L. plantarum or placebo intervention twice daily for ten days. Gastrointestinal symptoms were assessed utilizing the Gastrointestinal Symptom Rating Scale (GSRS). Various postoperative variables were analyzed across both groups. Alterations in gut microbiota were evaluated through 16S rRNA sequencing. 112 patients completed the study, with 55 in the probiotic group and 57 in the placebo group. While the disparity in overall postoperative GSRS scores between the two groups did not reach statistical significance (P = 0.067), marked differences were observed in bloating (P = 0.004) and hard stool (P = 0.030) scores. Furthermore, individuals within the probiotic group exhibited lower postoperative neutrophil counts (P = 0.007) and concurrently higher lymphocyte counts (P = 0.001). Variations in the diversity and composition of postoperative gut microbiota were discerned between the probiotic and placebo groups. Remarkably, no probiotic-related adverse events were documented. Supplementation with L. plantarum was well-tolerated and demonstrated partial efficacy in ameliorating gastrointestinal symptoms in postoperative CHD patients. Modulating the gut microbiota may be a potential mechanism by which L. plantarum exerts clinical benefits.