The multi-herbal drug STW 5 (Iberogast) has prosecretory action in the human intestine.

Abstract

There is growing evidence that STW 5 (Iberogast), fixed combination of hydroethanolic herbal extracts), besides being effective in functional dyspepsia, also improves symptoms in irritable bowel syndrome (IBS). Clinical data indicate that modulation of mucosal secretion is a promising approach to treat intestinal disorders associated with IBS. We therefore explored the effect of STW 5 on secretion in the human intestine and the mechanisms by which it acts. The Ussing chamber technique was used to measure mucosal secretion in human intestinal mucosa/submucosa preparations and in human epithelial cell line T84. In addition, we recorded STW 5 effects on human enteric neurons with voltage sensitive dye imaging. In human tissue and T84 cells STW 5 induced a dose-dependent increase in ion secretion that was significantly reduced by the Na-K-Cl cotransporter blocker bumetanide, the adenylate cyclase inhibitor MDL-12 330, the non-specific and selective cystic fibrosis transmembrane conductance regulator (CFTR) inhibitors glibenclamide and CFTR(inh)-172, respectively, and the blocker of calcium dependent Cl(-) channels (ClCa) SITS (4-acetamido-4-isothiocyanatostilbene-2,2-disulphonic acid). It was unaffected by amiloride, a blocker of epithelial Na(+) channels. In human tissue, the nerve blocker tetrodotoxin significantly suppressed the STW 5 response. STW 5 evoked an increased spike discharge in 51% of human submucous neurons. Results suggest that STW 5 is a secretogogue in the human intestine by direct epithelial actions and through activation of enteric neurons. The prosecretory effect is due to increased epithelial Cl(-) fluxes via CFTR and Ca-dependent ClCa channels. STW 5 may be a novel option to treat secretory disorders associated with IBS and constipation.

• Authors: D Krueger, L Gruber, S Buhner, F Zeller, R Langer, S Seidl, K Michel, M Schemann
• Journal: Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society (Neurogastroenterol Motil) Vol. 21 Issue 11 Pg. 1203-e110 (Nov 2009) ISSN: 1365-2982 [Electronic] England
• PMID: 19210628 (Publication Type: Journal Article)

Chemical References

• Plant Extracts
• iberogast

Topics

• Aged
• Aged, 80 and over
• Cell Line
• Epithelial Cells (cytology, drug effects, metabolism)
• Female
• Humans
• Intestinal Mucosa (drug effects, innervation, metabolism)
• Ion Channel Gating (drug effects)
• Male
• Middle Aged
• Neurons (metabolism)
• Plant Extracts (pharmacology)