Published online Mar 20, 2024. doi: 10.5662/wjm.v14.i1.88518
Peer-review started: September 29, 2023
First decision: December 6, 2023
Revised: December 27, 2023
Accepted: February 3, 2024
Article in press: February 3, 2024
Published online: March 20, 2024
Processing time: 160 Days and 1.2 Hours
It was reported that rikkunshito (TJ-43) improved the cisplatin-induced decreases in the active form of ghrelin in plasma; however, other effects on gastrointestinal hormones have not been investigated.
To investigate the effects of TJ-43 on peripheral levels of incretin hormones, including gastric inhibitory polypeptide (GIP) and glucagon-like polypeptide-1 (GLP-1), in humans and rats.
Patients were divided into two groups, namely patients who received TJ-43 immediately following surgery [TJ-43(+) group] and those who received TJ-43 on postoperative day 21 [TJ-43(-) group], and the plasma levels of active GIP and active GLP-1 were assessed. In animal experiments, rats were treated with TJ-43 [rat (r)TJ-43(+) group] or without [rTJ-43(−) group] by gavage for 4 wk, and the plasma active GIP and active GLP-1 levels were measured. The expression of incretin hormones in the gastrointestinal tract and insulin in the pancreas were investigated by immunohistochemistry. Furthermore, the cyclic adenosine monophosphate activities were assessed in pancreatic tissues from rats treated with or without TJ-43 in vivo, and the blood glucose levels and plasma insulin levels were measured in rats treated with or without TJ-43 in oral glucose tolerance tests.
In humans, the active incretin hormone levels increased, and values were significantly greater in the TJ-43(+) group compared those in the TJ-43(-) group. In rats, the plasma active incretin levels significantly increased in the rTJ-43(+) group compared with those in the rTJ-43(-) group. GIP and GLP-1 expressions were enhanced by TJ-43 treatment. Moreover, plasma insulin levels increased and blood glucose levels were blunted in the rTJ-43(+) group.
The results show that TJ-43 may be beneficial for patients who undergo pancreatic surgery.
Core Tip: This study aimed to investigate the effects of rikkunshito (TJ-43) on gastrointestinal hormones, including gastric inhibitory polypeptide and glucagon-like peptide-1, in humans and rats. As a result, TJ-43 increased incretin hormones, and insulin expression, and suppressed increases in blood glucose levels in human and animal models. Thus, TJ-43 may provide benefits after pancreatic surgery.