The root extract of the African Uzara plant is used in traditional medicine as anti-diarrheal drug. It is known to act via inhibition of intestinal motility, but malabsorptive or antisecretory mechanisms are unknown yet. HT-29/B6 cells and human colonic biopsies were studied in Ussing experiments in vitro. Uzara was tested on basal as well as on forskolin- or cholera toxin-induced Cl⁻ secretion by measuring short-circuit current (I_SC) and tracer fluxes of ²²Na⁺ and ³⁶Cl⁻. Para- and transcellular resistances were determined by two-path impedance spectroscopy. Enzymatic activity of the Na⁺/K⁺-ATPase and intracellular cAMP levels (ELISA) were measured. In HT-29/B6 cells, Uzara inhibited forskolin- as well as cholera toxin-induced I_SC within 60 minutes indicating reduced active chloride secretion. Similar results were obtained in human colonic biopsies pre-stimulated with forskolin. In HT-29/B6, the effect of Uzara on the forskolin-induced I_SC was time- and dose-dependent. Analyses of the cellular mechanisms of this Uzara effect revealed inhibition of the Na⁺/K⁺-ATPase, a decrease in forskolin-induced cAMP production and a decrease in paracellular resistance. Tracer flux experiments indicate that the dominant effect is the inhibition of the Na⁺/K⁺-ATPase. Uzara exerts anti-diarrheal effects via inhibition of active chloride secretion. This inhibition is mainly due to an inhibition of the Na⁺/K⁺-ATPase and to a lesser extent to a decrease in intracellular cAMP responses and paracellular resistance. The results imply that Uzara is suitable for treating acute secretory diarrhea.

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