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Intestinal inflammation and motility: How does STW 5 influence this?
The herbal combination phytomedicine STW 5 (Iberogast) is a proven compound to ameliorate symptoms of functional dyspepsia and irritable bowel syndrome, both diseases being discussed to be based on a subclinical inflammation . The effect of STW 5 on intestinal inflammation and motility was investigated in the small intestine of adult mice. A proinflammatory cytokine cocktail (IL1β, TNFα, IFNγ) was injected into the supporting blood vessel arcades of small intestinal segments to measure the intestinal motility under local induced inflammation in the presence and absence of STW 5 (+/-). Additionally, the effect of STW 5 on systemic induced inflammation was investigated using a jugular vein injection of the proinflammatory cytokine cocktail. To do so, a cytokine cocktail was injected in the anesthetized mouse jugular vein and intestinal segments were prepared and luminal perfused (+/-STW 5) half an hour after injection. In order to evaluate the anti-inflammatory effect of STW 5 in these intestinal segments, the cytokines in the gut wall homogenates were analyzed by Multiplex-ELISA. In addition, isolated myenteric plexus was cultured and also stimulated with the cytokine cocktail (+/-STW 5). The supernatants of the myenteric plexus cultures were collected after 24h and also analyzed by Multiplex-ELISA.
A reduced motility of intestinal segments could be demonstrated as soon as a local inflammation was induced. This inhibitory effect caused by inflammation was abolished by simultaneously luminal instillation of STW 5. An increase of the proinflammatory cytokines G-CSF, GM-CSF, IL-6 and LIF under inflammatory conditions was found in both gut wall homogenates and myenteric plexus cultures. The treatment with STW 5 leads to decreased cytokine concentrations in both gut wall homogenates and myenteric plexus culture supernatants indicating an anti-inflammatory effect of STW 5.
In conclusion, as reported previously  the multi-herbal compound STW 5 recovers inflammation reduced motility. Moreover, STW 5 has an anti-inflammatory effect by influencing the amount and release of cytokines from the ENS.
 Michael S et al. Naunyn Schmiedebergs Arch Pharmacol 2012; 385: 411 – 421
 Michael S et al. Phytomedicine 2009; 16: 161 – 171