Study On The Mechanism Of Forsythia Suspensa In Preventing And Treating Chemotherapy-induced Nausea And Vomiting From The Perspective Of Anti-inflammation

Objective: To explore the mechanism of Forsythia suspensa on preventing and treating chemotherapy-induced nausea and vomiting(CINV)from the perspective of anti-inflammation,and to explore the relationship between inflammation and vomiting.Methods: Wistar male rats were randomly divided into blank control group,Forsythia suspensa normal control group,cisplatin model group,dexamethasone group,Forsythia suspensa treatment group.Each group was given distilled water,Forsythia suspensa Decoction 3.5 g/kg,distilled water,dexamethasone 0.47 mg/kg and Forsythia suspensa Decoction 3.5 g/kg twice a day for 6 days.On the third day,rats were given 6 mg/kg cisplatin intraperitoneally to establish chemotherapeutic heterophilia model,except the blank group and the normal control group of Forsythia suspensa.The general condition of rats was observed every 24 hours,and the intake of kaolin,body weight,water intake and food intake of each group were calculated.The blood samples were taken from inferior vena cava 72 hours after modeling,and the contents of TNF-?,IL-1? and PGE2 in serum were detected by ELISA.The stomach and ileum were taken to observe the general morphology of the stomach and intestines in rats.Then the stomach was put into normal saline to observe its ups and downs.Then the contents of stomach were taken and the wet weight of the contents of stomach was weighed.Histopathological changes of gastric antrum and ileum were observed by naked eyes and HE staining.The expression of NF-?B and COX-2 in gastric antrum and ileum of rats were detected by immunohistochemistry.Results: Forsythia suspensa could inhibit the intake of kaolin in chemotherapy rats;72hours after modeling,Forsythia suspensa treatment group rats' food intake and body weight were increased(P>0.05);compared with the blank group,the model group rats' serum TNF-?,IL-1?,PGE2 levels were significantly increased(P<0.01,P<0.001).Gastric dilatation,thinning of gastric wall and intestinal wall,congestion and distension were observed in the model group.Inflammatory pathological changes were observed in gastrointestinal mucosa,and the expression of NF-?B and COX-2 in gastrointestinal tissue were significantly increased in the model group.Compared with the model group,the levels of inflammatory factors in serum of rats in Forsythia suspensa treatment group were significantly lower(P<0.01,P<0.001),and the wet weight of gastric contents in Forsythia suspensa treatment group was lower than that in the model group,but there was no statistical significance(P>0.05).Forsythia suspensa treatment group can reduce the expression of NF-?B and COX-2 in gastric antrum and ileum.Conclusion:Forsythia suspensa can inhibit the occurrence of CINV through its anti-inflammatory effect.Its mechanism may be through inhibiting the inflammatory cascade reaction induced by NF-?B,inhibiting the release of COX-2,TNF-?,IL-1? and PGE2,alleviating the inflammatory reaction in rats,thus playing a therapeutic role in CINV.At the same time,Forsythia suspensa can significantly improve gastrointestinal inflammation by inhibiting the occurrence of CINV.It is suggested that vomiting is closely related to inflammation and has commonness and intersection.The interaction between vomiting and inflammation affects each other.In addition,anti-emetic drugs and anti-inflammatory drugs are also closely related: anti-emetic drugs not only have anti-emetic effect,but also have anti-inflammatory effect;some anti-inflammatory drugs have anti-inflammatory effect,but also have significant anti-emetic effect.