Gastritis and gastric ulcer were known to be induced by gastic acid, stress, ethanol, Helicobacter pylori and free radical, etc. This study was performed for the development of a new drug or nutraceutical from medicinal plants or natural products with anti-gastritis, anti-ulcerative and gastroprotective activities. The water extract of Scutellaria baicalensis was exhibited potent inhibition in HCl ethanol-induced gastric lesion, acetic acid-induced and Shay ulcers, indicating the effects on gastric lesion and ulcer in rats. The water extract of Scutellaria baicalensis significantly inhibited HCl ethanol-induced gastric lesions at the oral dose of 300, 500 mg/kg. In pylorus ligated rats, the treatments of the water extract from Scutellaria baicalensis showed decrease in the volume of gastric secretion and acid output and increase pH at oral dose of 300, 500 mg/kg. And significantly reduced acetic acid-induced ulcer at the oral dose of 500 mg/kg for 12 days. In this study, we have found that the water extract from Scutellaria baicalensis had significant improvement in acute gastritis and ulcer at the dose of 300, 500 mg/kg and in chronic gastritis and ulcer at the dose of 500 mg/kg. Also we evaluated the antibacterial activity against Helicobacter pylori treated with Scutellaria baicalensis. Scutellaria baicalensis had a equivalent antibacterial activity with ampicilin against H. pylori at the dose of $100\;{\mu}/ml$. In histological examination, the water extract of Scutellaria baicalensis drastically restored gastric damages induced by HCl ethanol solution, pylorus- ligature and acetic acid. Therefore, we may use the water extract from Scutellaria baicalensis as antigastritic and antiulcerative agent for the purpose of the improvement or treatment of gastritis and gastric ulcer.
Recent studies have suggested that the RAS protein activator like-1 (RASAL1) functions as a tumor suppressor in vitro and may play an important role in the development of gastric cancer. However, whether or not RASAL1 suppresses tumor growth in vivo remains to be determined. In the present study, we investigated the role of RASAL1 in gastric carcinogenesis using an in vivo xenograft model. A lentiviral RASAL1 expression vector was constructed and utilized to transfect the human poorly differentiated gastric adenocarcinoma cell line, BGC-823. RASAL1 expression levels were verified by quantitative real-time RT-PCR and Western blotting analysis. Then, we established the nude mice xenograft model using BGC-823 cells either over-expressing RASAL1 or normal. After three weeks, the results showed that the over-expression of RASAL1 led to a significant reduction in both tumor volume and weight compared with the other two control groups. Furthermore, in xenograft tissues the increased expression of RASAL1 in BGC-823 cells caused decreased expression of p-ERK1/2, a downstream moleculein the RAS/RAF/MEK/ERK signal pathway. These findings demonstrated that the over-expression of RASAL1 could inhibit the growth of gastric cancer by inactivation of the RAS/RAF/MEK/ERK pathway in vivo. This study indicates that RASAL1 may attenuate gastric carcinogenesis.
Objectives The purpose of this study was to investigate the correlation between gastric emptying measured by ultrasonography and Korean medical instruments of diagnosis and assessment in functional dyspepsia (FD) patients. Among the subgroups of FD, postprandial distress syndrome (PDS) is related to gastric motility disorder.Methods Ten patients with FD and particularly with PDS as well as 10 healthy controls were enrolled in the study from September to November 2015. The gastric emptying shown as the half-life of gastric volume (T1/2) was measured by ultrasonography. The severities of spleen qi deficiency and dyspepsia symptoms were assessed by a spleen qi deficiency questionnaire (SQDQ) and the Nepean Dyspepsia Index-Korean version (NDI-K), respectively. In addition, a food retention questionnaire (FRQ), a damum questionnaire (DQ), a cold and heat questionnaire (CHQ), a deficiency and excess questionnaire (DEQ), and a visual analogue scale (VAS) of distention and fullness were completed by every participant.Results In comparison with the control group, the FD group showed significantly higher scores for the SQDQ, NDI-K, FRQ, DQ, DEQ, and VAS of distention and fullness. T1/2 was also significantly higher in the FD group than in the control group. There were significant correlations between T1/2 and the SQDQ score. However, there were no significant correlations between T1/2 and other questionnaire scores except for one item of the NDI-K.Conclusions According to these findings, it was determined that measuring gastric emptying using ultrasonography could be a quantitative indicator to diagnose spleen qi deficiency in FD patients.
Purpose: Various laparoscopic wedge resection (LWR) techniques requiring gastrotomy for gastrointestinal stromal tumors (GISTs) of the stomach have been applied to facilitate tumor resection and preserve the remnant gastric volume. However, there is the possibility of cancer cell dissemination during these procedures. The aim of this study was to assess the oncologic safety of LWR with gastrotomy (LWR-G) compared to LWR without luminal exposure. Materials and Methods: Clinicopathologic and operative results of 193 patients who underwent LWR for gastric GIST were retrospectively analyzed from 2003 to 2013. We stratified the patients into two groups: LWR-G and LWR without gastrotomy (LWR-C). Clinicopathologic features, short-term outcomes, and long-term outcomes were compared. Results: A total of 26 patients underwent LWR-G, and 167 patients underwent LWR-C. The LWR-G group showed significantly more anterior wall-located (n=10, 38.5%), intraluminal (n=20, 76.9%), and ulcerative (n=13, 50.0%) tumors than the LWR-C group (n=33, 19.8%; n=96, 57.5%; n=46, 27.5%, respectively). Postoperative short-term outcomes did not differ between the two groups. When tumor staging was compared, no statistical difference was noted. There was no recurrence in the LWR-G group, while 2 patients in the LWR-C group experienced recurrence. The two recurrences in the LWR-C group were found in the liver and in the remnant stomach at 63 and 12 months after the operation, respectively. No gastric GIST-related death was recorded in any group during the study period. Conclusions: LWR-G for gastric GIST is an oncologically safe procedure even for masses with ulcerations.
Purpose: To compare the clinicopathological data and long-term survival of gastric cancer patients in China and Korea. Materials and Methods: Patients who had undergone gastrectomy for gastric cancer between 1998 and 2009 in 2 high-volume institutions in both China (n=1,637) and Korea (n=2,231) were retrospectively evaluated. Clinicopathological variables, overall survival (OS), progression-free survival (PFS), and surgery-related complications were assessed for all patients and compared between the 2 institutions. Results: Chinese patients included in the study were significantly older and had a significantly lower body mass index (BMI) than the Korean patients. Esophagogastric junction tumors were more frequent in Chinese patients. However, the number of patients with stage I gastric cancer, the number of harvested lymph nodes, and the number of total gastrectomies were significantly higher in the Korean population. Korean patients also presented with fewer undifferentiated tumors than Chinese patients. Furthermore, Korean patients had prolonged OS and PFS for stage III cancers only. BMI, tumor-node-metastasis (TNM) stage, tumor invasion, number of positive lymph nodes, and distant metastases were all independent factors affecting OS and PFS. Conclusions: Although China and Korea are neighboring Asian countries, the clinicopathological characteristics of Chinese patients are significantly different from those of Korean patients. Korean gastric cancer patients had longer OS and PFS than Chinese patients. Influencing factors included TNM stage, tumor invasion, and lymph node metastasis.
Functional dyspepsia (FD) is a prevalent idiopathic upper gastrointestinal (GI) disorder characterized by diverse symptomatology including epigastric pain or discomfort, postprandial fullness, and early satiety. Although its pathophysiological mechanisms have not yet been fully established, the available studies suggest that the etiology of FD is invariably multifactorial. Benachio-F$^{(R)}$ (BF) is a proprietary liquid formulation of 7 herbal extracts that has been proposed to address this multifactorial etiology using multi-drug phytotherapy. The pharmacological effects of BF, in comparison with those of two other herbal products (Whalmyungsu$^{(R)}$; WM and Iberogast$^{(R)}$; IB) were evaluated in rats. In a laparotomy-induced rat model of delayed GI transit, BF significantly accelerated the delayed gastric emptying caused by morphine, apomorphine, and cisplatin, and also significantly increased mean gastric transit, as compared to the control animals. BF markedly increased gastric accommodation in rats and produced higher gastric volume values than did the control treatment. The effects of BF were generally comparable or superior to those of WM and IB in these models. Furthermore, BF significantly stimulated biliary flow, as compared to the control treatment. These results indicated that BF might have great potential as an effective phytotherapeutic agent capable of reducing GI symptoms and increasing quality of life in FD patients.
Purpose: A phase II study was conducted to evaluate the safety and efficacy of preoperative, intra-arterial perfusion of epirubicin, etoposide, and oxaliplatin combined with oral chemotherapy S-1 (SEEOX) for the treatment of type 4 gastric cancer. Materials and Methods: A single-center, single-arm phase II trial was conducted on 36 patients with histologically proven type 4 gastric cancer without distant peritoneal or organ metastasis. Patients received 3, 21-day courses of SEEOX preoperative chemotherapy. The primary endpoint was overall survival (OS) and the secondary outcomes assessed were chemotherapeutic response, radical resection rate, pathological regression, toxicities, postoperative morbidity, and mortality. Results: All patients were at an advanced stage of cancer (stage III or IV) and completed the entire course of treatment. Based on changes in tumor volume and peritoneal metastasis, the objective response rate was 55.6% (20/36; 95% confidence interval [CI], 38.5%-72.6%) and the disease control rate was 69.4% (25/36; 95% CI, 53.6%-85.3%). The radical resection rate was 75% (27/36; 95% CI, 60.1%-89.9%) and the proportion of R0 resections was 66.7% (21/36; 95% CI, 50.5%-82.8%). The pathological response rate was 33.3%, of which 13.9% showed complete pathological regression. The median survival was 27.1 months (95% CI, 22.24-31.97 months), and the 2-year OS was 48.5% (95% CI, 30.86%-66.1%). Conclusions: Preoperative SEEOX is a safe and effective treatment for type 4 gastric cancer. Based on these preliminary data, a phase III study will be conducted to confirm the superiority of this regimen over standard treatment.
Apoptosis is regarded as a therapeutic target because it is typically disturbed in human cancer. Silymarin from milk thistle (Silybum marianum) has been reported to exhibit anticancer properties via regulation of apoptosis as well as anti-inflammatory, antioxidant and hepatoprotective effects. In the present study, the effects of silymarin on the inhibition of proliferation and apoptosis were examined in human gastric cancer cells. The viability of AGS human gastric cancer cells was assessed by MTT assay. The migration of AGS cells was investigated by wound healing assay. Silymarin was revealed to significantly decrease viability and migration of AGS cells in a concentration-dependent manner. In addition, the number of apoptotic bodies and the rate of apoptosis were increased in a dose-dependent manner as determined by DAPI staining and Annexin V/propidium iodide double staining. The changes in the expression of silymarin-induced apoptosis proteins were investigated in human gastric cancer cells by western blotting analysis. Silymarin increased the expression of Bax, phosphorylated (p)-JNK and p-p38, and cleaved poly-ADP ribose polymerase, and decreased the levels of Bcl-2 and p-ERK1/2 in a concentration-dependent manner. The in vivo tumor growth inhibitory effect of silymarin was investigated. Silymarin (100 mg/kg) significantly decreased the AGS tumor volume and increased apoptosis, as assessed by the TUNEL assay, confirming its tumor-inhibitory effect. Immunohistochemical staining revealed elevated expression of p-JNK and p-p38 as well as reduced expression of p-ERK1/2 associated with silymarin-treatment. Silymarin was revealed to reduce tumor growth through inhibition of p-ERK and activation of p-p38 and p-JNK in human gastric cancer cells. These results indicated that silymarin has potential for development as a cancer therapeutic due to its growth inhibitory effects and induction of apoptosis in human gastric cancer cells.
It was evaluated the inhibitory action of quercetin-3-O-${\beta}$-D-glucuronopyranoside (QGC) on reflux esophagitis and gastritis in rats. QGC was isolated from the herba of Rumex Aquaticus. Reflux esophagitis or gastritis was induced surgically or by administering indomethacin, respectively. Oral QGC decreased ulcer index, injury area, gastric volume, and acid output and increased gastric pH as compared with quercetin. Furthermore, QGC significantly decreased gastric lesion sizes induced by exposing the gastric mucosa to indomethacin. Malondialdehyde levels were found to increase significantly after inducing reflux esophagitis, and were reduced by QGC, but not by quercetin or omeprazole. These results show that QGC can inhibit reflux esophagitis and gastritis in rats.
Gymnosporia rothiana (walp) Lawson (celastraceae), commonly known as Maytenus rothiana, is used in Indian folk medicine as an antiulcerogenic agent. However, there have been no scientific reports regarding its antiulcer activity. Therefore, this study was intended to evaluate the antiulcer property of petroleum ether, chloroform, and methanolic extract of leaves of Gymnosporia rothiana at different dose levels in ethanol induced and indomethacin induced gastric ulcer models. It was observed that oral administration of all the extract of Gymnosporia rothiana produces significant reduction in ulcer lesion index as well as increase in volume and pH of gastric content in both experimental models, being petroleum ether extract the most effective at dose of 250 mg/kg; it significantly reduced gastric lesion index (70.06%), in comparison to omeprazole (71.20%) and methanolic extract at a dose of 500 mg/kg (67.22%). Increased gastric mucosal defense mechanism by petroleum ether extract is probably due to its high levels of terpenoids like $\beta$ amyrin, lupeol acetate. The present results clearly shows antiulcer effect of Gymnosporia rothiana against various irritants has been mainly due to cytoprotective effect mediated through prostaglandin and partly due to free radical scavenging activity.
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