The Effects of Prucalopride on Postoperative Ileus in Guinea Pigs
1
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Purpose: Postoperative ileus (POI) is an impairment of coordinated gastrointestinal (GI) motility that develops as a consequence of abdominal surgery and is a major factor contributing to patient morbidity and prolonged hospitalization. The aim of this study was to investigate the effects of different 5-hydroxytryptamine 4 (5-HT4) receptor agonists, which stimulate excitatory pathways, on a POI model. Materials and Methods: The experimental model of POI in guinea pigs was created by laparotomy, gentle manipulation of the cecum for 60 seconds, and closure by suture, all under anesthesia. Different degrees of restoration of GI transit were measured by the migration of charcoal. Colonic transit was indirectly assessed via measurement of fecal pellet output every hour for 5 hours after administration of various doses of mosapride, tegaserod, prucalopride, and 5-HT. Results: Charcoal transit assay showed that various 5-HT4 receptor agonists can accelerate delayed upper GI transit in a dose-dependent manner. However, fecal pellet output assay suggested that only prucalopride had a significant effect in accelerating colonic motility in POI. Conclusion: Although mosapride, tegaserod, and prucalopride produce beneficial effects to hasten upper GI transit in the POI model, prucalopride administered orally restores lower GI transit as well as upper GI transit after operation in a conscious guinea pig. This drug may serve as a useful candidate for examination in a clinical trial for POI.
Abstract
Purpose: Postoperative ileus (POI) is an impairment of coordinated gastrointestinal (GI) motility that develops as a consequence of abdominal surgery and is a major factor contributing to patient morbidity and prolonged hospitalization. The aim of this study was to investigate the effects of different 5-hydroxytryptamine 4 (5-HT4) receptor agonists, which stimulate excitatory pathways, on a POI model. Materials and Methods: The experimental model of POI in guinea pigs was created by laparotomy, gentle manipulation of the cecum for 60 seconds, and closure by suture, all under anesthesia. Different degrees of restoration of GI transit were measured by the migration of charcoal. Colonic transit was indirectly assessed via measurement of fecal pellet output every hour for 5 hours after administration of various doses of mosapride, tegaserod, prucalopride, and 5-HT. Results: Charcoal transit assay showed that various 5-HT4 receptor agonists can accelerate delayed upper GI transit in a dose-dependent manner. However, fecal pellet output assay suggested that only prucalopride had a significant effect in accelerating colonic motility in POI. Conclusion: Although mosapride, tegaserod, and prucalopride produce beneficial effects to hasten upper GI transit in the POI model, prucalopride administered orally restores lower GI transit as well as upper GI transit after operation in a conscious guinea pig. This drug may serve as a useful candidate for examination in a clinical trial for POI.
참고문헌 (22)
- Delaney CP, "Postoperative upper and lower gastrointestinal recovery and gastrointestinal morbidity in patients undergoing bowel resection: pooled analysis of placebo data from 3 randomized controlled trials", Am J Surg, 191, pp.315~319 (2006)
- Greenwood-Van Meerveld B, "Emerging drugs for postoperative ileus", Expert Opin Emerg Drugs, 12, pp.619~626 (2007)
- Bauer AJ, "Mechanisms of postoperative ileus", Neurogastroenterol Motil, 16(2), pp.54~60 (2004)
- Boeckxstaens GE, "Neuroimmune mechanisms in postoperative ileus", Gut, 58, pp.1300~1311 (2009)
- De Winter BY, "Effect of different prokinetic agents and a novel enterokinetic agent on postoperative ileus in rats", Gut, 45, pp.713~718 (1999)
- Briejer MR, "The in vitro pharmacological profile of prucalopride, a novel enterokinetic compound", Eur J Pharmacol, 423, pp.71~83 (2001)
- Schuurkes J, "The enterokinetic R093877 normalizes opioid-delayed fecal pellet propulsion in the isolated guinea-pig distal colon", Gastroenterology, 114, pp.A835~ (1998)
- Briejer MR, "Effects of the enterokinetic prucalopride (R093877) on colonic motility in fasted dogs", Neurogastroenterol Motil, 13, pp.465~472 (2001)
- Qi HB, "Effect of enterokinetic prucalopride on intestinal motility in fast rats", World J Gastroenterol, 9, pp.2065~2067 (2003)
- Camilleri M, "A placebo-controlled trial of prucalopride for severe chronic constipation", N Engl J Med, 358, pp.2344~2354 (2008)
- Tack J, "Prucalopride (Resolor) in the treatment of severe chronic constipation in patients dissatisfied with laxatives", Gut, 58, pp.357~365 (2009)
- Camilleri M, "Safety assessment of prucalopride in elderly patients with constipation: a double-blind, placebo-controlled study", Neurogastroenterol Motil, 21, pp.1256~e117 (2009)
- Camilleri M, "Clinical trial: the efficacy of open-label prucalopride treatment in patients with chronic constipation-follow-up of patients from the pivotal studies", Aliment Pharmacol Ther, 32, pp.1113~1123 (2010)
- Sloots CE, "Efficacy and safety of prucalopride in patients with chronic noncancer pain suffering from opioid-induced constipation", Dig Dis Sci, 55, pp.2912~2921 (2010)
- Emmanuel AV, "Randomised clinical trial: the efficacy of prucalopride in patients with chronic intestinal pseudo-obstruction--a double-blind, placebo-controlled, cross-over, multiple n = 1 study", Aliment Pharmacol Ther, 35, pp.48~55 (2012)
- Mendzelevski B, "Assessment of the cardiac safety of prucalopride in healthy volunteers: a randomized, double-blind, placebo- and positive-controlled thorough QT study", Br J Clin Pharmacol, 73, pp.203~209 (2012)
- De Maeyer JH, "5-HT4 receptor agonists: similar but not the same", Neurogastroenterol Motil, 20, pp.99~112 (2008)
- Manabe N, "New-generation 5-HT4 receptor agonists: potential for treatment of gastrointestinal motility disorders", Expert Opin Investig Drugs, 19, pp.765~775 (2010)
- Mine Y, "Comparison of effect of mosapride citrate and existing 5-HT4 receptor agonists on gastrointestinal motility in vivo and in vitro", J Pharmacol Exp Ther, 283, pp.1000~1008 (1997)
- Nguyen A, "SDZ HTF 919 stimulates canine colonic motility and transit in vivo", J Pharmacol Exp Ther, 280, pp.1270~1276 (1997)
- Yeh YC, "Pharmacologic options to prevent postoperative ileus", Ann Pharmacother, 43, pp.1474~1485 (2009)
- Kim HS, "The effect of mosapride citrate on proximal and distal colonic motor function in the guinea-pig in vitro", Neurogastroenterol Motil, 20, pp.169~176 (2008)
