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Traserra S, Alcalá-González LG, Barber C, Landolfi S, Malagelada C, Lange R, Forestier S, Corsetti M, Jimenez M. New insights into the characterization of the mechanism of action of hyoscine butylbromide in the human colon ex vivo. Eur J Pharmacol 2024; 972:176550. [PMID: 38570081 DOI: 10.1016/j.ejphar.2024.176550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/20/2024] [Accepted: 03/28/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION Hyoscine butylbromide (HBB) is one of the most used antispasmodics in clinical practice. Recent translational consensus has demonstrated a similarity between human colonic motor patterns studied ex vivo and in vivo, suggesting ex vivo can predict in vivo results. It is unclear whether the mechanism of action of antispasmodics can predict different use in clinical practice. The aim of the present study is to bridge this gap dissecting HBB's role in excitatory and inhibitory neural pathways. METHODS 309 colon samples from 48 patients were studied in muscle bath experiments. HBB was tested on: 1-spontaneous phasic contractions (SPCs); 2-carbachol-induced contractility; electrical field stimulation (EFS)-induced selective stimulation of 3-excitatory and 4-inhibitory pathways and 5- SPCs and EFS-induced contractions enhanced by neostigmine. Atropine, AF-DX116 (M2 blocker) and DAU-5884 (M3 blocker) were used as comparators. RESULTS In the presence of tetrodotoxin (TTX), HBB and atropine 1 μM reduced SPCs. HBB and atropine concentration-dependently reduced carbachol- and EFS-induced contractions. Inhibitory effects of DAU-5884 on EFS-induced contractions were more potent than of AF-DX116. HBB did not affect the off-response associated to neural inhibitory responses. Neostigmine enhanced both SPCs and EFS-induced contractions. In the presence of TTX and ω-conotoxin (GVIA), neostigmine still enhanced SPCs. Addition of HBB and atropine reduced these responses. CONCLUSIONS This study demonstrates that HBB inhibits neural cholinergic contractions associated to muscarinic (mainly M3) receptors. HBB has a potential role in reducing colonic spasm induced by the release of acetylcholine from enteric motor neurons and from an atypical source including a potential non-neuronal origin.
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Affiliation(s)
- Sara Traserra
- Universitat Autònoma de Barcelona, Department of Cell Biology, Physiology and Immunology, Barcelona, Spain
| | | | - Claudia Barber
- Vall D'Hebron University Hospital, Digestive System Research Unit, Barcelona, Spain
| | - Stefania Landolfi
- Valld'Hebron University Hospital, Department of Pathology, Barcelona, Spain
| | - Carolina Malagelada
- Vall D'Hebron University Hospital, Digestive System Research Unit, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
| | | | | | - Maura Corsetti
- Nottingham University Hospitals NHS Trust and the University of Nottingham, NIHR Nottingham Biomedical Research Centre (BRC), Nottingham, United Kingdom; University of Nottingham, Nottingham Digestive Diseases Centre, Nottingham, United Kingdom
| | - Marcel Jimenez
- Universitat Autònoma de Barcelona, Department of Cell Biology, Physiology and Immunology, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain.
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Ullmann O, Ranti D, Georgiadou E, Hillemacher T, Schmidt A, von Hahn T. Provider-reported use of butylscopolamine in gastrointestinal endoscopy in Germany. Endosc Int Open 2024; 12:E36-E42. [PMID: 38188926 PMCID: PMC10769577 DOI: 10.1055/a-2189-0373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/14/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction The anti-cholinergic agent hyoscine-N-butylbromide (HBB) is used in gastrointestinal (GI) endoscopy to decrease motility and facilitate endoscopic procedures. Data from clinical studies to support this practice is limited especially for therapeutic procedures. Likewise, patterns of use among endoscopist are largely unclear. This study sought to assess usage of HBB among German-speaking endoscopists. Material and Methods We conducted an anonymous online survey among endoscopists in German-speaking countries. Results A total of 207 physicians participated in the survey. The majority (76.9%) were experienced endoscopists and 92.3% of respondents use HBB at least occasionally during procedures. The reported median stated frequency of HBB use varied greatly between different types of procedures and increased with the complexity of the procedure being performed. HBB was rarely used in diagnostic esophagogastroduodenoscopies (EGD) (median stated frequency 1% of procedures), while use frequency was significantly higher in EGD with endoscopic mucosal resection (EMR) (10%; p=0.002) and EGD with endoscopic submucosal dissection (ESD) (20%; p<0.001). Similarly, use frequency during diagnostic colonoscopy was lower (5%) compared to colonoscopy with EMR (20%, p=0.005) or ESD (42.5%, p<0.001). The highest use frequency was reported for ERCP (50%). The most frequently stated reason to use HBB was facilitation of the procedure (80.6%) followed by increasing diagnostic yield (58.3%). Conclusion German-speaking endoscopists commonly use HBB, most frequently to facilitate complex therapeutic procedures. Given there is almost no data supporting HBB use in therapeutic endoscopy, we suggest that more research is needed to evaluate benefits and risks of this practice.
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Affiliation(s)
- Octavia Ullmann
- Gastroenterology, Asklepios Klinik Barmbek, Hamburg, Germany
| | - Daniel Ranti
- Institute of Medical Education, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Ekaterini Georgiadou
- Psychiatry and Psychotherapy, Paracelsus Private Medical University - Nuremberg Campus, Nurnberg, Germany
| | - Thomas Hillemacher
- Psychiatry and Psychotherapy, Paracelsus Private Medical University - Nuremberg Campus, Nurnberg, Germany
| | - Arthur Schmidt
- Gastroenterology, Hepatology and Endocrinology, Robert Bosch Hospital, Stuttgart, Germany
| | - Thomas von Hahn
- Gastroenterology, Asklepios Klinik Barmbek, Hamburg, Germany
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Ybañez-Julca RO, Pino-Ríos R, Quispe-Díaz IM, Asunción-Alvarez D, Acuña-Tarrillo EE, Mantilla-Rodríguez E, Minchan-Herrera P, Catalán MA, Zevallos-Escobar L, Vásquez-Corales E, Yáñez O, Gutiérrez-Alvarado WO, Benites J. Antispasmodic Effect of Valeriana pilosa Root Essential Oil and Potential Mechanisms of Action: Ex Vivo and In Silico Studies. Pharmaceutics 2023; 15:2072. [PMID: 37631286 PMCID: PMC10458982 DOI: 10.3390/pharmaceutics15082072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 07/28/2023] [Accepted: 07/30/2023] [Indexed: 08/27/2023] Open
Abstract
Infusions of Valeriana pilosa are commonly used in Peruvian folk medicine for treating gastrointestinal disorders. This study aimed to investigate the spasmolytic and antispasmodic effects of Valeriana pilosa essential oil (VPEO) on rat ileum. The basal tone of ileal sections decreased in response to accumulative concentrations of VPEO. Moreover, ileal sections precontracted with acetylcholine (ACh), potassium chloride (KCl), or barium chloride (BaCl2) were relaxed in response to VPEO by a mechanism that depended on atropine, hyoscine butylbromide, solifenacin, and verapamil, but not glibenclamide. The results showed that VPEO produced a relaxant effect by inhibiting muscarinic receptors and blocking calcium channels, with no apparent effect on the opening of potassium channels. In addition, molecular docking was employed to evaluate VPEO constituents that could inhibit intestinal contractile activity. The study showed that α-cubebene, β-patchoulene, β-bourbonene, β-caryophyllene, α-guaiene, γ-muurolene, valencene, eremophyllene, and δ-cadinene displayed the highest docking scores on muscarinic acetylcholine receptors and voltage-gated calcium channels, which may antagonize M2 and/or M3 muscarinic acetylcholine receptors and block voltage-gated calcium channels. In summary, VPEO has both spasmolytic and antispasmodic effects. It may block muscarinic receptors and calcium channels, thus providing a scientific basis for its traditional use for gastrointestinal disorders.
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Affiliation(s)
- Roberto O. Ybañez-Julca
- Facultad de Farmacia y Bioquímica, Universidad Nacional de Trujillo, Trujillo 13011, Peru; (I.M.Q.-D.); (D.A.-A.); (E.E.A.-T.); (E.M.-R.); (P.M.-H.)
| | - Ricardo Pino-Ríos
- Química y Farmacia, Facultad de Ciencias de la Salud, Universidad Arturo Prat, Casilla 121, Iquique 1100000, Chile;
- Instituto de Estudios de la Salud, Universidad Arturo Prat, Casilla 121, Iquique 1100000, Chile
| | - Iván M. Quispe-Díaz
- Facultad de Farmacia y Bioquímica, Universidad Nacional de Trujillo, Trujillo 13011, Peru; (I.M.Q.-D.); (D.A.-A.); (E.E.A.-T.); (E.M.-R.); (P.M.-H.)
| | - Daniel Asunción-Alvarez
- Facultad de Farmacia y Bioquímica, Universidad Nacional de Trujillo, Trujillo 13011, Peru; (I.M.Q.-D.); (D.A.-A.); (E.E.A.-T.); (E.M.-R.); (P.M.-H.)
| | - Edwin E. Acuña-Tarrillo
- Facultad de Farmacia y Bioquímica, Universidad Nacional de Trujillo, Trujillo 13011, Peru; (I.M.Q.-D.); (D.A.-A.); (E.E.A.-T.); (E.M.-R.); (P.M.-H.)
| | - Elena Mantilla-Rodríguez
- Facultad de Farmacia y Bioquímica, Universidad Nacional de Trujillo, Trujillo 13011, Peru; (I.M.Q.-D.); (D.A.-A.); (E.E.A.-T.); (E.M.-R.); (P.M.-H.)
| | - Patricia Minchan-Herrera
- Facultad de Farmacia y Bioquímica, Universidad Nacional de Trujillo, Trujillo 13011, Peru; (I.M.Q.-D.); (D.A.-A.); (E.E.A.-T.); (E.M.-R.); (P.M.-H.)
| | - Marcelo A. Catalán
- Instituto de Fisiología, Facultad de Medicina, Universidad Austral de Chile, Valdivia 5090000, Chile;
| | - Liz Zevallos-Escobar
- Escuela de Farmacia y Bioquímica, Universidad Católica Los Ángeles de Chimbote, Chimbote 02801, Peru; (L.Z.-E.); (E.V.-C.)
| | - Edison Vásquez-Corales
- Escuela de Farmacia y Bioquímica, Universidad Católica Los Ángeles de Chimbote, Chimbote 02801, Peru; (L.Z.-E.); (E.V.-C.)
| | - Osvaldo Yáñez
- Facultad de Ingeniería y Negocios, Universidad de las Américas, Santiago 7500000, Chile;
| | | | - Julio Benites
- Química y Farmacia, Facultad de Ciencias de la Salud, Universidad Arturo Prat, Casilla 121, Iquique 1100000, Chile;
- Instituto de Estudios de la Salud, Universidad Arturo Prat, Casilla 121, Iquique 1100000, Chile
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Corsetti M, Forestier S, Jiménez M. Hyoscine butylbromide mode of action on bowel motility: From pharmacology to clinical practice. Neurogastroenterol Motil 2023; 35:e14451. [PMID: 35972266 DOI: 10.1111/nmo.14451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 06/25/2022] [Accepted: 08/01/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Hyoscine butylbromide (HBB) has been available for use as an antispasmodic since 1951 and is indicated for the treatment of abdominal pain associated with cramps. A previous review in 2007 summarized the evidence on the mode of action of HBB in vitro and in vivo in both animal and human studies. However, since then, novel publications have appeared within the literature and also our knowledge of what represents normal motility in humans has evolved. PURPOSE This review is the result of the collaboration between a basic scientist and clinicians with the aim of providing an updated overview of the mechanisms of action of HBB and its clinical efficacy to guide not only use in clinical practice, but also future research.
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Affiliation(s)
- Maura Corsetti
- NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham Digestive Diseases Biomedical Research Centre, Nottingham, UK
| | | | - Marcel Jiménez
- Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Barcelona, Spain
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Micucci M, Budriesi R, Mandrioli M, Tura M, Corazza I, Frosini M, Aldini R, Mattioli LB, Gallina Toschi T. Effects of turmeric powder on intestinal and biliary functions: The influence of curcuminoids concentration on spontaneous contractility. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Ota K, Kojima Y, Kakimoto K, Nouda S, Takeuchi T, Shindo Y, Ohtsuka Y, Ohtsuka N, Higuchi K. Safety, efficacy, and maneuverability of a self-propelled capsule endoscope for observation of the human gastrointestinal tract. Endosc Int Open 2021; 9:E1391-E1396. [PMID: 34466364 PMCID: PMC8382508 DOI: 10.1055/a-1507-4540] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 05/03/2021] [Indexed: 01/25/2023] Open
Abstract
Background and study aims We developed a self-propelled capsule endoscope that can be controlled from outside the body with real-time observation. To improve the device, we conducted a clinical trial of total gastrointestinal capsule endoscopy in healthy subjects to ascertain whether our first-generation, self-propelled capsule endoscope was safe and effective for observing the entire human gastrointestinal tract. Patients and methods After adequate gastrointestinal pretreatment, five healthy subjects were instructed to swallow a self-propelling capsule endoscope and the safety of a complete gastrointestinal capsule endoscopy with this device was assessed. We also investigated basic problems associated with complete gastrointestinal capsule endoscopy. Results No adverse effects of the magnetic field were identified in any of the subjects. No mucosal damage was noted in any of the subjects with the use of our first-generation, self-propelling capsule endoscope. We found that it took longer than expected to observe the stomach; the view was compromised by the swallowed saliva. The pylorus was extremely difficult to navigate, and the endoscope's fin sometimes got caught in the folds of the small intestine and colon. Conclusions To resolve the problems associated with the existing self-propelling capsule endoscope, it may be necessary to not only improve the capsule endoscopes, but also to control the environment within the gastrointestinal tract with medications and other means. Our results could guide other researchers in developing capsule endoscopes controllable from outside the body, thus allowing real-time observation.
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Affiliation(s)
- Kazuhiro Ota
- Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Yuichi Kojima
- Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Kazuki Kakimoto
- Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Sadaharu Nouda
- Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Toshihisa Takeuchi
- Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Osaka, Japan
| | | | | | | | - Kazuhide Higuchi
- Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Osaka, Japan
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Zhang L, Wang R, Bai T, Xiang X, Qian W, Song J, Hou X. EphrinB2/ephB2-mediated myenteric synaptic plasticity: mechanisms underlying the persistent muscle hypercontractility and pain in postinfectious IBS. FASEB J 2019; 33:13644-13659. [PMID: 31601124 DOI: 10.1096/fj.201901192r] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Patients with irritable bowel syndrome (IBS) show pain hypersensitivity and smooth muscle hypercontractility in response to colorectal distension (CRD). Synaptic plasticity, a key process of memory formation, in the enteric nervous system may be a novel explanation. This study aimed to explore the regulatory role of ephrinB2/ephB2 in enteric synaptic plasticity and colonic hyperreactive motility in IBS. Postinfectious (PI)-IBS was induced by Trichinella spiralis infection in rats. Isometric contractions of colonic circular muscle strips, particularly neural-mediated contractions, were recorded ex vivo. Meanwhile, ephrinB2/ephB2-mediated enteric structural and functional synaptic plasticity were assessed in the colonic muscularis, indicating that ephrinB2 and ephB2 were located on enteric nerves and up-regulated in the colonic muscularis of PI-IBS rats. Colonic hypersensitivity to CRD and neural-mediated colonic hypercontractility were present in PI-IBS rats, which were correlated with increased levels of cellular homologous fos protein (c-fos) and activity-regulated cystoskeleton-associated protein (arc), the synaptic plasticity-related immediate early genes, and were ameliorated by ephB2Fc (an ephB2 receptor blocker) or MK801 (an NMDA receptor inhibitor) exposure. EphrinB2/ephB2 facilitated synaptic sprouting and NMDA receptor-mediated synaptic potentiation in the colonic muscularis of PI-IBS rats and in the longitudinal muscle-myenteric plexus cultures, involving the Erk-MAPK and PI3K-protein kinase B pathways. In conclusion, ephrinB2/ephB2 promoted the synaptic sprouting and potentiation of myenteric nerves involved in persistent muscle hypercontractility and pain in PI-IBS. Hence, ephrinB2/ephB2 may be an emerging target for the treatment of IBS.-Zhang, L., Wang, R., Bai, T., Xiang, X., Qian, W., Song, J., Hou, X. EphrinB2/ephB2-mediated myenteric synaptic plasticity: mechanisms underlying the persistent muscle hypercontractility and pain in postinfectious IBS.
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Affiliation(s)
- Lei Zhang
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ruiyun Wang
- Department of Gerontology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Bai
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuelian Xiang
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Qian
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Song
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaohua Hou
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Micucci M, Gotti R, Corazza I, Tocci G, Chiarini A, De Giorgio M, Camarda L, Frosini M, Marzetti C, Cevenini M, Budriesi R. Newer Insights into the Antidiarrheal Effects of Acacia catechu Willd. Extract in Guinea Pig. J Med Food 2017; 20:592-600. [DOI: 10.1089/jmf.2016.0154] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Matteo Micucci
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum—University of Bologna, Bologna, Italy
| | - Roberto Gotti
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum—University of Bologna, Bologna, Italy
| | - Ivan Corazza
- Department of Experimental, Diagnostic and Speciality Medicine, Alma Mater Studiorum—University of Bologna, Bologna, Italy
| | | | - Alberto Chiarini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum—University of Bologna, Bologna, Italy
| | - Marta De Giorgio
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum—University of Bologna, Bologna, Italy
| | - Luca Camarda
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum—University of Bologna, Bologna, Italy
| | - Maria Frosini
- Department of Life Sciences, University of Siena, Siena, Italy
| | | | - Monica Cevenini
- Departiment of Medical and Surgical Sciences, Alma Mater Studiorum—University of Bologna, Bologna, Italy
| | - Roberta Budriesi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum—University of Bologna, Bologna, Italy
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