A recent study published in the Journal of Pharmaceutical and Biomedical Analysis, led by scientists from the Lunan Pharmaceutical Group in Linyi, China, explored the effects of Shouhui Tongbian capsules (SHTBs) on slow transit constipation (STC) using ultrahigh-performance liquid chromatography-tandem mass spectrometry (UHPLC–MS/MS) (1).
Slow transit constipation occurs when there is a delay in stool moving through the colon, which can lead to constipation. It is a rare condition that causes ineffective colonic propulsion, due to deficit or abnormalities of the entric nervous system, which controls the mobility of the large intestine (2). In the United States, it is estimated that approximately 15–30% of constipated patients are affected by STC (3).
Shouhui Tongbian capsule (SHTB) is a Chinese patent medicine based on traditional Chinese medicine (TCM) prescriptions. SHTB is often used to treat functional constipation by purging turbidity and relaxing the bowels. SHTB is made of various Chinese medicinal herbs, including Aloe vera, Cassia seed, andGinseng. Each of the plants used provide a medical benefit, however some can also cause liver damage. This is an ongoing problem for many TCMS, and scientists use compatibility to help reduce the toxicity of TCMs. However, TCM compatibility is not simply a quantitative mixture of different herbs; rather, it consists of reasonable interactions between herbs with specific functions to adjust bias, reduce or eliminate toxicity, and enhance therapeutic effects. Currently, few studies have focused on SHTB; this research is important, as it can help explain the rationality of compatibility of SHTB from the perspective of chemical composition and explore its molecular biological mechanisms in the treatment of slow transit constipation STC.
For this study, the scientists explored the effects of multi-components compatibility of SHTB for efficacy enhancement and toxicity reduction and evaluate its molecular biological mechanisms in the treatment of slow transit constipation (STC). First, they used UHPLC–MS/MS to quantify 17 anthraquinone components in different compatible SHTB systems. From there, network pharmacological analysis was used to probe the potential mechanisms of SHTB for treating STC. Additionally, an animal experiment combined with western blot analysis was performed to further validate the predicted results.
Post-compatibility, the dissolution of 13 components with good effects in treating constipation increased, while the dissolution of 3 components with hepatotoxicity decreased. Overall, 145 common targets of 13 synergistic compounds and constipation were identified. Additionally, 13 synergistic compounds for treating STC were found to mainly play roles via protein phosphorylation, positive regulation of phosphorylation, phosphotransferase activity, and more. SHTB was showed to reduce the expression levels of p-p38 and p-ERK proteins in the colon tissue of the STC rats.
The findings in this study demonstrate with compatibility, efficacy enhancement and toxicity reduction of SHTB can be achieved. This expounds the connotation of compatibility theory of TCM from a chemical composition perspective, reflecting the rationality of compatibility theory. Along with the revelation of the core targets and potential molecular biological mechanisms of SHTB in treating STC, this study can serve as an important reference point for subsequent studies on the clinical applications of SHTB.
(1) Zhang, N.; Lv, F.; Xiao, H.; Yi, B.; et al. Synergistic and Attenuated Effects and Molecular Biological Mechanisms of Shouhui Tongbian Capsule in the Treatment of Slow Transit Constipation Based on UPLC-MS/MS, Network Pharmacology and Animal Experimental Validation. J. Pharm. Biomed. Anal. 2024, 239, 115846. DOI: 10.1016/j.jpba.2023.115846
(2) Slow Transit Constipation. Physiopedia 2024. https://www.physio-pedia.com/Slow_Transit_Constipation (accessed 2024-5-15)
(3) Frattini, J. C.; Nogueras, J. J. Slow Transit Constipation: A Review of a Colonic Functional Disorder. Clin. Colon Rectal Surg. 2008, 21 (2), 146–152. DOI: 10.1055/s-2008-1075864
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