Basic Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Mar 20, 2024; 14(1): 88518
Published online Mar 20, 2024. doi: 10.5662/wjm.v14.i1.88518
Rikkunshito increases peripheral incretin-hormone levels in humans and rats
Hiroshi Kono, Shinji Furuya, Hidenori Akaike, Katsutoshi Shoda, Yoshihiko Kawaguchi, Hidetake Amemiya, Hiromichi Kawaida, Daisuke Ichikawa
Hiroshi Kono, Shinji Furuya, Hidenori Akaike, Katsutoshi Shoda, Yoshihiko Kawaguchi, Hidetake Amemiya, Hiromichi Kawaida, Daisuke Ichikawa, The First Department of Surgery, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
Author contributions: Kono H conducting and organizing this experiment; Furuya S, assessment of samples; Akaike H, assessment of samples; Shoda K, analyzing the data; Kawaguchi Y, analyzing the data; Amemiya H, assessment of samples; Kawaida H, collecting samples; Ichikawa D advising for these experiments.
Institutional review board statement: This study was reviewed and approved by the University of Yamanashi Hospital, Institutional Review Board: ID No. 820.
Institutional animal care and use committee statement: This study is approved by the Institutional Animal Care and Committee.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at (hkouno@yamanashi.ac.jp). Participants gave informed consent for data sharing.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hiroshi Kono, MD, PhD, Adjunct Associate Professor, The First Department of Surgery, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan. hkouno@yamanashi.ac.jp
Received: September 29, 2023
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
ARTICLE HIGHLIGHTS
Research background

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. In patients undergoing pylorus-preserving pancreatico-duodenectomy (PpPD), postoperative oral food intake can be hindered by delayed gastric emptying (DGE). In addition to ghrelin, the effects of TJ-43 on gastrointestinal hormone levels are investigated herein.

Research motivation

It is necessary to resolve the issue of DGE after PpPD.

Research objectives

This basic study aimed 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.

Research methods

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 (POD) 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.

Research results

The active GIP and active GLP-1 Levels increased, and the values at POD 21 were significantly greater in the TJ-43(+) group than those in the TJ-43(-) group. In the rat model, the plasma active incretin levels significantly increased in the rTJ-43(+) group compared with those in the rTJ-43(-) group, although GIP and GLP-1 expressions were enhanced by TJ-43 treatment in both groups. Moreover, plasma insulin levels increased and blood glucose levels were blunted in the rTJ-43(+) group.

Research conclusions

The results suggest that TJ-43 is beneficial for patients who undergo pancreatic surgery.

Research perspectives

To verify the effects and clarify the mechanisms of TJ-43 after pancreatic surgery, a prospective study is required.