PLoS ONE (Jan 2023)

Therapeutic effect and mechanism of Daikenchuto in a model of methotrexate-induced acute small intestinal mucositis.

  • Peilin Li,
  • Yusuke Inoue,
  • Daisuke Miyamoto,
  • Toshiyuki Adachi,
  • Satomi Okada,
  • Tomohiko Adachi,
  • Akihiko Soyama,
  • Masaaki Hidaka,
  • Kengo Kanetaka,
  • Shinichiro Ito,
  • Daichi Sadatomi,
  • Sachiko Mogami,
  • Naoki Fujitsuka,
  • Weili Gu,
  • Susumu Eguchi

DOI
https://doi.org/10.1371/journal.pone.0283626
Journal volume & issue
Vol. 18, no. 3
p. e0283626

Abstract

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BackgroundDaikenchuto (DKT) has positive therapeutic effects on improving various gastrointestinal disorders. The present study investigated whether or not DKT has a potential therapeutic effect on chemotherapy-induced acute small intestinal mucositis (CIM) in a rat model.MethodsIntraperitoneal injection of 10 mg/kg methotrexate (MTX) every 3 days for a total of 3 doses was used for induction of CIM in a rat model. The MTX and DKT-MTX groups were injected with MTX as above from the first day, and the DKT-MTX and DKT groups were administered 2.7% DKT via the diet at the same time. The rats were euthanized on day 15.ResultsThe DKT-MTX group showed an improvement in the body weight and conditions of gastrointestinal disorders as well as increased levels of diamine oxidase in plasma and in the small intestinal villi. The pathology results showed that small intestinal mucosal injury in the DKT-MTX group was less severe than that in the MTX group. Immunohistochemistry for myeloperoxidase and malondialdehyde and quantitative real-time polymerase chain reaction (RT-qPCR) for TGF-β1 and HIF-1α showed that DKT attenuated peroxidative damage. The crypts in the DKT-MTX group contained more Ki-67-positive cells than MTX group. The zonula occluden-1 and claudin-3 results showed that DKT promoted repair of the mucosal barrier. RT-qPCR for the amino acid transporters EAAT3 and BO+AT also confirmed that DKT promoted mucosal repair and thus promoted nutrient absorption.ConclusionDKT protected against MTX-induced CIM in a rat model by reducing inflammation, stimulating cell proliferation, and stabilizing the mucosal barrier.