• Korean Journal of Acupuncture
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• v.36 no.2
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• pp.93-103
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• 2019

Objectives : The aim of this study is to review the current trends in experimental studies on the acupuncture moxibustion treatment for visceral hypersensitivity. Methods : PubMed was searched for experimental studies about visceral hypersensitivity and acupuncture/moxibustion. Data were extracted and tabulated from the selected articles about experimental method, intervention, result and mechanism. Results : Total 23 articles were reviewed. Chronic visceral hypersensitivity animal model was applied in 17 studies (74%). Visceral hypersensitivity was measured by abdominal withdrawal reflex scoring or/and abdominal electromyogram. Acupoints like ST25, ST36, ST37, BL25, LI11, BL32 and PC6 were treated by electroacupuncture or moxibustion. All articles reported that electroacupuncture or moxibustion treatment is significantly effective in reducing visceral hypersensitivity. Treatment mechanisms were studied, related to mast cell, serotonin (5-HT) and receptor (5-HT3R and 5-HT4R), substance P (SP), vasoactive intestinal polypeptide (VIP), c-fos positive cell, corticotropin-releasing hormone (CRH), purinergic 2X (P2X)2, P2X3, P2X4, P2X7, N-methyl-D-aspartate (NMDA) receptor (NR1 and NR2B), prokinectin (PK) 1 and PK2. Conclusions : Evidences on acupuncture/moxibustion treatment for visceral hypersensitivity in animal studies warrant more research on effective acupoins, electro-acupuncture methods and treatment durations.

• Journal of Neurogastroenterology and Motility
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• v.24 no.4
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• pp.656-668
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• 2018

Background/Aims MicroRNAs (miRNAs) were reported to be responsible for intestinal permeability in diarrhea-predominant irritable bowel syndrome (IBS-D) rats in our previous study. However, whether and how miRNAs regulate visceral hypersensitivity in IBS-D remains largely unknown. Methods We established the IBS-D rat model and evaluated it using the nociceptive visceral hypersensitivity test, myeloperoxidase activity assay, restraint stress-induced defecation, and electromyographic (EMG) activity. The distal colon was subjected to miRNA microarray analysis followed by isolation and culture of colonic epithelial cells (CECs). Bioinformatic analysis and further experiments, including dual luciferase assays, quantitative real-time polymerase chain reaction, western blot, and enzyme-linked immunosorbent assay, were used to detect the expression of miRNAs and how it regulates visceral hypersensitivity in IBS-D rats. Results The IBS-D rat model was successfully established. A total of 24 miRNAs were differentially expressed in the distal colon of IBS-D rats; 9 were upregulated and 15 were downregulated. Among them, the most significant upregulation was miR-200a, accompanied by downregulation of cannabinoid receptor 1 (CNR1) and serotonin transporter (SERT). MiR-200a mimic markedly inhibited the expression of CNR1/SERT. Bioinformatic analysis and luciferase assay confirmed that CNR1/SERT are direct targets of miR-200a. Rescue experiments that overexpressed CNR1/SERT significantly abolished the inhibitory effect of miR-200a on the IBS-D rats CECs. Conclusions This study suggests that miR-200a could induce visceral hyperalgesia by targeting the downregulation of CNR1 and SERT, aggravating or leading to the development and progression of IBS-D. MiR-200a may be a regulator of visceral hypersensitivity, which provides potential targets for the treatment of IBS-D.

• Biomolecules & Therapeutics
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• v.21 no.3
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• pp.181-189
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• 2013

Motilitone$^{(R)}$ (DA-9701) is a new herbal drug that was launched for the treatment of functional dyspepsia in December 2011 in Korea. The heterogeneous symptom pattern and multiple causes of functional dyspepsia have resulted in multiple drug target strategies for its treatment. DA-9701, a compound consisting of a combination of Corydalis Tuber and Pharbitidis Semen, has being developed for treatment of functional dyspepsia. It has multiple mechanisms of action such as fundus relaxation, visceral analgesia, and prokinetic effects. Furthermore, it was found to significantly enhance meal-induced gastric accommodation and increase gastric compliance in dogs. DA-9701 also showed an analgesic effect in rats with colorectal distension induced visceral hypersensitivity and an antinociceptive effect in beagle dogs with gastric distension-induced nociception. The pharmacological effects of DA-9701 also include conventional effects, such as enhanced gastric emptying and gastrointestinal transit. The safety profile of DA-9701 is also preferable to that of other treatments.

• The Korean Journal of Food And Nutrition
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• v.10 no.2
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• pp.186-192
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• 1997

Endoscopic diagnosis and medical management from K43 and C45 patients, whose sex, occupation, character and life patterns are quite different each other, were discussed. The K43 was patient with erosive gastritis, which may caused by maldietary habits and life stresses. Although the effective drugs such as H2-receptor antagonists with atacids, H+/K+-pump inhibitors, prokinetics, colloidal bismuth, and sucralfates, were administrated for long time, symptomatic relief of abdominal pain was not improved. The tests of clinical phathology and abdominal sonogram were normal, visceral hypersensitivity was appeared from barostat test of stomach. However C45 had taken headache during every day life, and endoscopically confirmed as a gastric·duodenal ulcer patiant, which may caused by chronic use of NSAIDs. The her ulceric symptoms were suppressed from active stage to healing stage by using combination therapy for H. pylori with traditional antipeptic ulcer drugs, where as amitriptyline was administrated to the K43 but not effective. Nonulcer dyspepsia and irritable bowel syndrome is pooly defined, and affect about 15% of the population annually in U. S. A. but don't seek medical care. Author would like to point out that statistics for visceral pains are absent in Korea.

• Journal of Korean Medicine for Obesity Research
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• v.1 no.1
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• pp.1-11
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• 2001

Obesity is a metabolic disease associated with multiple hormonal abnormalities. Therefore, obesity management aims at balancing these endocrine malfunctions nowadays. Although many studies proved interactions of hormones related with obesity, there are still lots of controversies. Most of these malfunctions are more pronounced in central, visceral obesity than in peripheral obesity. Recently, it is revealed that a central lesion of endocrine malfunction in human visceral obesity is probably related with a hypersensitivity of hypothalamopituitary-adrenal(HPA) axis. Probably associated with this axis, Insulin and cortisol promote lipid accumulation by expressing lipoprotein lipase activity, while sex hormones and growth hormone exert the opposite effects. Also reviewed was thyroid hormone which is closely related with thermogenesis. Serotonin is prescribed as antidepressant and it is applied to some eating disorders. Recently, leptin made in fat deposit also took attentions in terms of regulator of appetite and messenger of sex signal.

• Nutrition Research and Practice
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• v.15 no.4
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• pp.411-430
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• 2021

Irritable bowel syndrome (IBS) is a frequently diagnosed gastrointestinal (GI) disorder characterized by recurrent abdominal pain, bloating, and changes in the stool form or frequency without any structural changes and overt inflammation. It is not a life-threatening condition but causes a considerable level of discomfort and distress. Among the many pathophysiologic factors, such as altered GI motility, visceral hypersensitivity, and low-grade mucosal inflammation, as well as other immunologic, psychologic, and genetic factors, gut microbiota imbalance (dysbiosis), which is frequently found in IBS, has been highlighted as an etiology of IBS. Dysbiosis may affect gut mucosal homeostasis, immune function, metabolic regulation, and even visceral motor function. As diet is shown to play a fundamental role in the gut microbiota profile, this review discusses the influence of diet on IBS occurring through the modulation of gut microbiota. Based on previous studies, it appears that dietary modulation of the gut microbiota may be effective for the alleviation of IBS symptoms and, also an effective IBS management strategy based on the underlying mechanism; especially because, IBS currently has no specific treatment owing to its uncertain etiology.

• The Journal of Internal Korean Medicine
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• v.36 no.3
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• pp.308-322
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• 2015

Objectives: Whether there exists a distinct pathogenesis in subgroups of functional dyspepsia (FD), the classification of epigastric pain syndrome (EPS), and postprandial distress syndrome (PDS) remains controversial. We aimed to investigate the number of fungiform papillae (FP) in the subgroups of FD and its correlation with the severity of dyspepsia symptoms and spleen qi deficiency. Methods: Patients with FD were enrolled from August to November 2014. All patients were evaluated using a questionnaire and divided into 2 groups according to the Rome III criteria for FD. The severity of dyspepsia symptoms and spleen qi deficiency were separately assessed by Nepean Dyspepsia Index-Korean (NDI-K) version and Spleen qi deficiency questionnaire (SQDQ). The number of FP was measured on the anterior part of tongue, within an area of 9 mm ², using a digital cam Results: The NDI-K score, SQDQ score, and number of FP in the EPS group were significantly greater than those in the PDS group. Also, the EPS group had more patients diagnosed with spleen qi deficiency. The number of FP showed a significant positive correlation with epigastric pain and burning. Furthermore, the number of FP was significantly associated with the score of some items in NDI-K and SQDQ, even though not with the total score. Conclusions: Thus, measurement of the number of FP could be a new evaluation indicator for allocation into FD subtypes and to investigate the severity of dyspepsia symptoms and spleen Qi deficiency reflecting visceral hypersensitivity.

• Korean Journal of Acupuncture
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• v.26 no.2
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• pp.91-108
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• 2009

Objectives: Single colorectal instillation of trinitrobenzenesulphonic acid (TNBS) causes a dose-dependent increase of visceral motor response (VMR) and severity of inflammation. In this study we compared the effects of electroacupuncture in the different acupoints in the acute colitis induced by TNBS intracolonic injection in rats. Methods: In Male Sprague-Dawley rats, weighing $250{\sim}400g$, a single colorectal administration of TNBS 5mg/kg and 50% ethanol under isoflurane anaesthesia after an overnight fast. Electrodes for electromyography (EMG) recording were stitched into the external oblique musculature under general anesthesia. Acupoints of LI4, ST25, or ST36 were stimulated by electroacupuncture, respectively. The balloon was inserted intra-anally and visceral motor response (VMR) to colorectal distensioin (CRD) was quantified with an EMG recording system. Results: At an observation of the visceral hyperalgesia in the day-time series, the visceromotor response increased significantly 3 days after TNBS intra-rectalcolonic injection in rats. Electroacupuncture on either ST25 or ST36 suppressed the visceromotor response to colorectal distension, but not LI4, at 3 days after TNBS injection. Pretreatment of naltrexone (10 mg/kg, i.p.), opioids antagonist, inhibited the VMR suppress of 10Hz EA to ST36 but not phentolamine (5 mg/kg, i.p.). Pretreatment of either naltrexone or phentolamine inhibited effects of 10Hz EA to ST25. Conclusions: Data show that EA at either ST25 or ST36 potently inhibits hypersensitivity of colorectum after TNBS induced colitis and is differently mediated through the endogenous opioid system and adrenergic system.

• Korean Journal of Oriental Medicine
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• v.17 no.3
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• pp.105-114
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• 2011

Objectives : The transient inflammation has been demonstrated to alter visceral motor response (VMR) and acute mucosal inflammation may precede the manifestation of visceral hyperalgesia in animal models. The purpose of our study is to compare effects of the different frequencies applied electroacupuncture (EA) on acupoints in acute colitis induced by trinitrobenzenesulphonic acid (TNBS). Methods : In Male Sprague-Dawley rats, weighing 250~400g, a single colorectal administration of TNBS (5mg/kg) was made and electrode for electromyography (EMG) recording were stitched into the external oblique musculature. EA of either ST25 or ST36 were applied and stimulation parameter was modulated as follows: 2, 10, or 100 Hz with intensity of 2 mA and 1 ms pulse duration for 30 min. The balloon was inserted intra-anally and VMR to colorectal distension (CRD) was quantified with an EMG recording system. Results : The VMR increased significantly 3 days after TNBS intra-rectal colonic injection in rats. Both 2 Hz and 10 Hz EA on ST36 suppressed VMR to CRD in the acute colitis model but not 100 Hz. Only 10 Hz EA on ST25 suppressed VMR to CRD in the acute colitis. Conclusions : These data show that 10 Hz EA potently inhibits hypersensitivity of colorectum after TNBS induced colitis.

• Journal of Korea Association of Health Promotion
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• v.3 no.1
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• pp.46-54
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• 2005

The functional dyspepsia is a complex disease reaction that ocurs due to the presence of various factors and its pathophysiology has not been clearly verified until now. This disease is diagnosed after the organic diseases are ruled out. Therefore, the main treatments are limited down to compensating for revealed symptoms through exercising the supportive care. The international prevalence of the functional dyspepsia under the Rome I criterior is approximately 25%. For the cases of Koreans, there are very omnifarious symptoms in gastrointestinal disorders and the medical vocabularies which describe the diagnostic standard are not closely associated with the daily vocabularies, thus there would be a lot of restrictions to directly apply the Rome II criterior. However, the Korean Society of Gastrointestinal motility had decided to promote the use of the international standardized Rome II criterior in order for Korea to be comparable to the clinical studies from the other nations. There should be more extensive studies to differentiate the definitions of symptom descriptions from Korea to foreign countries. The extended researches concerning the pathophysiology are highly recommended which in return, would help enabling the reliable treatment techniques for this disease.