title: Orengedokuto and berberine improve indomethacin-induced small intestinal injury via adenosine.
abstract: BACKGROUND
  Recent endoscopic technology has revealed that small intestinal injury is a serious threat to patients receiving nonsteroidal anti-inflammatory drugs (NSAIDs). We previously showed that Japanese herbal medicine, Orengedokuto (OGT; Huang-Lian-Jie-Du-Tang in Chinese), protects mice from lethal indomethacin (IND)-induced enteropathy. To elucidate the mechanism of the protective effect of OGT, we performed microarray analyses and high power statistical analyses of microarray data using new bioinformatics tools.
  
  
  METHODS
  Female BALB/c mice were subcutaneously injected with IND (20 mg/kg) once a day for 2 days. OGT-treated mice received a diet containing OGT from the first IND injection until the end of the experiment. Gene expression signals of small intestine were obtained with GeneChip. Analyses for overrepresentation of Gene Ontology categories were conducted using MetaGene Profiler (MGP) and the changes were visualized by Cell Illustrator Online (CIO). Furthermore, active ingredients of OGT were investigated.
  
  
  RESULTS
  MGP and CIO suggested a critical role for the adenosine system, especially adenosine deaminase (ADA), a key enzyme of adenosine catabolism. Quantitative real time RT-PCR and in situ hybridization showed that OGT decreased the expression of ADA, which possibly resulted in the elevation of the anti-inflammatory nucleoside adenosine. Blockade of the adenosine A2a receptor abrogated the protective effect of OGT. Berberine, a major ingredient of OGT, suppressed ADA expression and reduced the incidence of lethality.
  
  
  CONCLUSIONS
  OGT may prevent IND-induced enteropathy by decreasing ADA which results in the elevation of adenosine. Modulation of the adenosine system may be an efficient therapeutic strategy for NSAID-induced enteropathy.
authors.affiliation: Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Watanabe-Fukuda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Naoko
authors.initials: N
authors.lastname: Miura
authors.forename: Masato
authors.initials: M
authors.lastname: Fukutake
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ishige
authors.forename: Rui
authors.initials: R
authors.lastname: Yamaguchi
authors.forename: Masao
authors.initials: M
authors.lastname: Nagasaki
authors.forename: Ayumu
authors.initials: A
authors.lastname: Saito
authors.forename: Seiya
authors.initials: S
authors.lastname: Imoto
authors.forename: Satoru
authors.initials: S
authors.lastname: Miyano
authors.forename: Junzo
authors.initials: J
authors.lastname: Takeda
authors.forename: Kenji
authors.initials: K
authors.lastname: Watanabe