Published online Aug 28, 2021. doi: 10.3748/wjg.v27.i32.5392
Peer-review started: April 7, 2021
First decision: May 27, 2021
Revised: June 3, 2021
Accepted: July 20, 2021
Article in press: July 20, 2021
Published online: August 28, 2021
Processing time: 139 Days and 10.8 Hours
Chronic constipation is a common functional gastrointestinal disease that seriously affects the quality of life, especially for senile patients. Cistanche deserticola (C. deserticola) is one kind of herb that can improve constipation obviously, but the mechanism of it is unclear. Since it increases the frequency of defecation, we suppose that its therapeutic effect is due to increased intestinal motility by an important signaling pathway, stem cell factor (SCF)/C-kit, located on the surface of interstitial Cajal cells.
The treatment of chronic constipation is not encouraging, and the available drugs cannot meet the clinical needs. New drugs are needed to safely increase intestinal motility and improve symptoms. New drugs should be based on in-depth studies of the mechanisms of some foods that are currently widely and safely used. C. deserticola is one kind of herb that has been used for thousands of years in Traditional Chinese Medicine for constipation. Benefits would be evident from more studies about the treatment mechanisms.
To investigate the mechanism of how C. deserticola treats constipation, this study aimed to establish a constipation model in rats and explore the role of the SCF/C-kit signaling pathway in the treatment.
In the case of blank control group, a constipation rat model was first established. While these rats were treated with C. deserticola, a group of rats were specifically blocked from the target signaling pathway. The symptoms and defecation of these different groups of rats were observed, and the tissue and gene expression in which the target signaling pathway was located were observed to explain whether the SCF/C-kit signaling pathway plays a key role in the therapeutic effect of C. deserticola.
The model was successfully established, and the therapeutic effect of C. deserticola was also obvious. In the group where the target signaling pathway was blocked, the therapeutic effect of C. deserticola was significantly reduced, as reflected by histological and immunohistochemical changes as well as signal-pathway-related genes and proteins such as connexin 43, aquaporin 3 expression changes. C. deserticola can inhibit expression of aquaporin 3 and promote expression of connexin 43 through the SCF/C-kit pathway, thereby improving the constipation induced by loperamine and reducing colonic tissue damage in aged rats.
This study provided a good theoretical basis for clinical use of C. deserticola. Furthermore, the SCF/C-kit signal pathway plays an important role of constipation treatment of C. deserticola. There is likely more mechanisms related to it, for the effect of C. deserticola was not blocked completely.
The improvement of intestinal motility is the core point in the treatment of constipation. However, further research on intestinal dynamics is still needed. The research on intestinal dynamics of interstitial Cajal cells is still a focus of attention, but whether there is an unknown mechanism of its function is one of the directions of future research. In the meantime, herbs should also be more widely valued.