Studies show that gastrointestinal motility abnormalities are common characteristics in constipation patients [1, 2]. Abnormal energy metabolism and mitochondrial function may be associated with the pathogenesis of constipation. Mitochondria are the main site of intracellular oxidative phosphorylation and ATP formation. Correcting mitochondrial dysfunction and improving energy metabolism disorders may be the key to enhance intestinal peristalsis. Zensun has been the first to realize the relevance between cellular energy metabolism and functional constipation. In-depth studies of the pathogenic mechanism led Zensun scientists to propose a new treatment strategy. The compound drug ZS-06, which targets multiple pathways associated with energy metabolism, was developed to utilize this strategy.
    Our preclinical studies showed that ZS-06 significantly improves both the small intestine propulsion rate and defecation in animals with constipation. If the efficacy of ZS-06 is validated for the prevention and treatment of gastrointestinal motility in clinical trials, it would be useful for reducing the pain and enhancing the quality of life for patients with constipation. All ingredients in ZS-06 have been proven to be tolerable and safe in the clinic for many years, which makes it likely to be a druggable candidate, with a shorter development cycle and lower R & D costs.
About functional constipation
    Functional constipation (FC), also known as chronic idiopathic constipation (CIC), is a common condition affecting the gastrointestinal (GI) tract, with an estimated prevalence of between 4% and 20% in cross-sectional community surveys [3–6]. This functional disorder is defined as the infrequent and difficult passage of stools in the absence of any physiological abnormality [7]. The condition is more common in women, the elderly, and those with lower income [6, 8, 9] and is associated with reduced quality of life[10].
    Epidemiological studies have shown the prevalence of FC in North America as 16.7% and 14.9%, respectively, using the Rome I or Rome II diagnostic criteria [11]. Studies of the Asian population show that the prevalence of self-reported constipation is 16.5%, the prevalence of functional constipation diagnosed by Rome II is 9.2%, and the prevalence in women is greater than that in men [12]. In China, the prevalence in people over 60 years of age is 22% in recent years and the incidence has increased over the years in young people [13].
    At present, the traditional treatments for constipation are mainly laxatives and gastrointestinal motility drugs, which have side effects and can easily lead to diarrhea as a side effect. Therefore, it is urgent to develop drugs with high safety, high efficacy, and fewer side effects.
[1]Madrid A M, Defilippi C. Disturbances of small intestinal motility in patients with chronic constipation. Rev Med Chil, 2006, 134(2): 181-186. [2]Bassotti G, Stanghellini V, Chiarioni G, et al. Upper gastrointestinal motor activity in patients with slow-transit constipation. Dig Diseases Sci 1996, 41(10): 1999-2005. [3]Drossman DA, Li Z, Andruzzi E, et al. U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci 1993; 38: 1569–80. [4]Stewart WF, Liberman JN, Sandler RS, et al. Epidemiology of constipation (EPOC) study in the United States: relation of clinical subtypes to sociodemographic features. Am J Gastroenterol 1999; 94: 3530–40. [5]Talley NJ, Weaver AL, Zinsmeister AR, Melton LJ III. Functional constipation and outlet delay: a population-based study. Gastroenterology 1993; 105: 781–90. [6]Wald A, Scarpignato C, Mueller-Lissner S, et al. A multinational survey of prevalence and patterns of laxative use among adults with self-defined constipation. Aliment Pharmacol Ther 2008; 28: 917–30. [7]Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology 2006; 130: 1480–91. [8]Everhart JE, Go VL, Johannes RS, Fitzsimmons SC, Roth HP, White LR. A longitudinal survey of self-reported bowel habits in the United States. Dig Dis Sci 1989; 34: 1153–62. [9]Johanson JF, Sonnenberg A, Koch TR. Clinical epidemiology of chronic constipation. J Clin Gastroenterol 1989; 11: 525–36. [10]Wald A, Scarpignato C, Kamm MA, et al. The burden of chronic constipation on quality of life: results of a multinational survey. Aliment Pharmacol Ther 2007; 26: 227–36. [11] Pare P, Ferrazzi S, Thompson W G, et al. An epidemiological survey of constipation in Canada: definitions, rates, demographics, and predictors of health care seeking. Am J Gastroenterol, 2001, 96(11): 3130-3137. [12]Jun D W, Park H Y, Lee O Y, et al. A population-based study on bowel habits in a Korean community: prevalence of functional constipation and self-reported constipation. Dig Dis Sci, 2006, 51(8): 1471-1477. [13] Gastrointestinal Motility Group of Digestive Disease Association, Chinese Medical Association (CMA). Guidelines for the diagnosis and treatment of chronic constipation in China (Wuhan). Diss. 2013.
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