| Slow transit constipation (STC) is a kind of intractable constipationcaused by motor disorder of colon. It is characterized in passing timeextension of colon and colonic motility decline. Since the etiology andpathogenesis of STC is not entirely clear, it has been a problem in clinicaltreatment. Prucalopride is a kind of highly selective5-hydroxtrptaminereceptor4agonist, listing December,2012. Clinical studies have confirmedthat Prucalopride can improve gastrointestinal symptoms associated withconstipation. It has a significant effect on the treatment of constipation.After Prucalopride treatment, if there is effect to the pacemaker cell of thegastrointestinal tract—interstitial cell of Cajal (ICC) which shows numberdecrease and function disorder in gastrointestinal motility disorders, it hasnot been reported. Therefore, this study aimed to explore the treatmentmechanism of Prucalopride to chronic constipation by observing thechange of transit function of the gastrointestinal trace and ICC in musclelayer of rat with slow transit constipation, after Prucalopride treatment.33healthy male Wistar rats were chosen and divided randomly intocontrol group, constipation group and treatment group,11each group. Inconstipation group and treatment group, Rhein suspension wasadministered intragastricly to established animal model of STC. In controlgroup and constipation group, the discharge time of the first black faeceswas observed after infusion of activated Carbon, after modeling. Gastricmotility and transit functions of intestinal movement were examined byadministering intragastricly of semi-solid nutrition paste. The ICC changes in terms of the number and volume were observed byimmunohistochemical method. In treatment group, Prucalopride wasadministered intragastricly, after modeling. Two weeks later, the dischargetime of the first black faeces, Gastric motility and transit functions ofintestinal movement were examined, in treatment group. The ICC changesin terms of the number and volume were observed, in the same way.The result of transit function of the gastrointestinal trace: aftermodeling, the discharge time of the first black faeces of control group andconstipation group was (343.55±103.84) min,(471.43±59.43) min,respectively. Gastric residual weight was (0.88±0.126) g,(1.60±0.20) g,respectively. The actived carbon pushing length was (69.10±4.23) cm,(45.40±3.24) cm, respectively. The discharge time of the first black faecesin constipation group was significantly longer than that in the control group(P<0.05). Gastric residual weight was more heavier than that in the controlgroup (P<0.05). The actived carbon pushing length of constipation groupwas significantly shorter than in the control group (P<0.05). Aftertreatment by Prucalopride, the discharge time of the first black faeces andthe actived carbon pushing length in treatment group were (351.04±100.05)min,(66.00±9.07) cm, respectively. Those were no significant differencewith that in the control group (P>0.05). Gastric residual weight in treatmentwas still more heavier than that in the control group (P<0.05). The analysisabout volume change of c-kit positive cell in the gastrointestinal trace: incontrol group and constipation, the volume of c-kit positive cell in GastricAntrum was no significant difference (P>0.05), after modeling. In theconstipation group, the volume of c-kit positive cell in Duodenum andColon were significantly smaller than that in the control group (P<0.01).After treatment by Prucalopride, the volume of c-kit positive cell inDuodenum in the constipation group increased slightly, but it was nosignificant difference with the control group (P>0.05). The volume of c-kitpositive cell colon in the constipation group increased to (24778.88±2951.16) μm2. It was more larger than that in the constipationgroup (p<0.01).This study found that: slow transit constipation is a fullgastrointestinal motility disorder. The reduction of ICC volume in smallintestine and colon play an important role in the pathogenesis of STC. Butthe incidence of STC may have no direct correlation with ICC does instomach. The new5-HT4agonist—Prucalopride has a positive effect forthe volume recovery of ICC in colon and the positive effect to transitfunction of intestinal movement may partially achieve through the volumerecovery of ICC in colon. |
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