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Ryoo S. Low anterior resection syndrome. Ann Gastroenterol Surg 2023; 7:719-724. [PMID: 37663958 PMCID: PMC10472409 DOI: 10.1002/ags3.12695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 05/02/2023] [Accepted: 05/08/2023] [Indexed: 09/05/2023] Open
Abstract
Low anterior resection syndrome (LARS) is the distressful defecatory functional problem after sphincter-saving surgery for rectal cancer. Although the symptoms of fecal urgency, frequency, and incontinence may develop in most of the patients after surgery, there is no definitive treatments for LARS. Multifactorial etiologies and various risk factors have been identified, but the reduction of storage capacity in the rectum is one of the main reasons for LARS. Anal sphincter muscle or nerve damage during rectoanal resection or anastomosis construction, and intersphincteric resection for low-lying tumors or hand-sewing anastomosis, are the absolute risk factors for LARS. Preoperative radiotherapy, postoperative complications, such as anastomosis leakage, or longer duration of stoma, are also risk factors. The severity of LARS can be confirmed using the LARS score questionnaire. The questionnaire has been translated to numerous language versions including Korean and have been validated. Diverse empirical treatments, such as loperamide, fiber, probiotics, or enema, have been tried, but the safety and efficacy have not been verified yet. The 5-Hydroxytryptamine (5-HT) receptor antagonist, ramosetron, used for diarrhea-dominant irritable bowel syndrome, is one potential drug for relieving the symptoms of major LARS. A randomized-controlled trial suggested the use of ramosetron could be safe and efficacious for patients who have major LARS after sphincter-saving rectal cancer surgery. Novel techniques or drugs for relieving the symptoms of LARS should be developed more and further studies are necessary.
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Affiliation(s)
- Seung‐Bum Ryoo
- Division of Colorectal Surgery, Department of SurgerySeoul National University Hospital, Seoul National University College of MedicineSeoulKorea
- Colorectal Cancer CenterSeoul National University Cancer HospitalSeoulKorea
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Mokrov GV. Multitargeting in cardioprotection: An example of biaromatic compounds. Arch Pharm (Weinheim) 2023; 356:e2300196. [PMID: 37345968 DOI: 10.1002/ardp.202300196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/23/2023]
Abstract
A multitarget drug design approach is actively developing in modern medicinal chemistry and pharmacology, especially with regard to multifactorial diseases such as cardiovascular diseases, cancer, and neurodegenerative diseases. A detailed study of many well-known drugs developed within the single-target approach also often reveals additional mechanisms of their real pharmacological action. One of the multitarget drug design approaches can be the identification of the basic pharmacophore models corresponding to a wide range of the required target ligands. Among such models in the group of cardioprotectors is the linked biaromatic system. This review develops the concept of a "basic pharmacophore" using the biaromatic pharmacophore of cardioprotectors as an example. It presents an analysis of possible biological targets for compounds corresponding to the biaromatic pharmacophore and an analysis of the spectrum of biological targets for the five most known and most studied cardioprotective drugs corresponding to this model, and their involvement in the biological effects of these drugs.
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Arai T, Inoue Y. Two cases of nintedanib-induced diarrhoea treated using a 5-HT type 3 receptor antagonist. ERJ Open Res 2022; 8:00242-2022. [PMID: 36171988 PMCID: PMC9511131 DOI: 10.1183/23120541.00242-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/27/2022] [Indexed: 12/04/2022] Open
Abstract
Nintedanib has been used in the management of patients with idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF) [1, 2]. The most common adverse event associated with nintedanib is diarrhoea. In the INPULSIS and INBUILD trials, >60% of patients reported diarrhoea [1, 2]. Antidiarrhoeal medications, including loperamide, are usually administered and are adequate in some patients. However, a significant proportion of patients continue to experience frequent diarrhoea, even after antidiarrhoeal treatment. In the INBUILD trial, ∼30% of patients who experienced diarrhoea at least once required dose reduction or discontinuation of nintedanib [2]. Hence, new treatments for diarrhoea are needed to improve quality of life in these patients. Ramosetron, a serotonin (5-hydroxytryptamine) type 3 (5-HT3) receptor inhibitor used for diarrhoea-predominant irritable bowel syndrome (IBS-D), might be a suitable treatment for nintedanib-induced diarrhoea [3], and has a low risk of hard stool (1.11%) and constipation (1.11%) [4]. Nintedanib-induced diarrhoea may be controlled by ramosetron by modulation of intestinal motility as for irritable bowel syndrome #pulmonaryfibrosishttps://bit.ly/3OQVAII
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Shin HJ, Park YH, Chang M, Chae YJ, Lee HT, Lee OH, Min SK, Do SH. Effects of ramosetron orally disintegrating tablets on the prophylaxis of post-discharge nausea and/or vomiting in female patients undergoing day surgery under general anesthesia: a randomized controlled trial. Perioper Med (Lond) 2022; 11:17. [PMID: 35546414 PMCID: PMC9097429 DOI: 10.1186/s13741-022-00251-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 11/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study was performed to evaluate the effectiveness of ramosetron orally disintegrating tablets (ODTs) in preventing post-discharge nausea and/or vomiting (PDNV) in female patients following outpatient surgery under general anesthesia. METHODS This multicenter randomized study included three South Korean tertiary hospitals. Before surgery, 138 patients were randomly allocated into two groups. In the ramosetron group, ramosetron ODT 0.1 mg was administered after discharge in the morning of postoperative days 1 and 2. Metoclopramide 10 mg was administered as a rescue antiemetic (capped at 30 mg per day). In the control group, patients were administered only metoclopramide 10 mg when nausea and/or vomiting occurred. The primary outcome was the incidence of nausea during 24 h after discharge. RESULTS We found significant differences in the incidence (13% vs. 33%, P = 0.008) and severity (P = 0.011) of nausea between the ramosetron and the control groups during 24 h after discharge. In addition, the rate of rescue antiemetic (metoclopramide) administration during 24 h after discharge was lower in the ramosetron group (6%) than in the control group (18%) (P = 0.033). Patient satisfaction score was higher in the ramosetron group than in the control group (P < 0.001). CONCLUSION Ramosetron ODT reduces the incidence and severity of postoperative nausea after discharge during the first 24 h and may be a valuable option for the prevention of PDNV in female patients after day surgery under general anesthesia. TRIAL REGISTRATION ClinicalTrials.gov, NCT04297293 . Registered on 05 March 2020.
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Affiliation(s)
- Hyun-Jung Shin
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea
| | - Yong-Hee Park
- Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Minying Chang
- Department of Anesthesiology and Pain Medicine, Ajou Medical Center, Soowon-si, Republic of Korea
| | - Yun Jeong Chae
- Department of Anesthesiology and Pain Medicine, Ajou Medical Center, Soowon-si, Republic of Korea
| | - Hun-Taek Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea
| | - Oh Haeng Lee
- Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Sang-Kee Min
- Department of Anesthesiology and Pain Medicine, Ajou Medical Center, Soowon-si, Republic of Korea
| | - Sang-Hwan Do
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea. .,Seoul National University College of Medicine, Seoul, Republic of Korea.
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Sayahi Z, Komaki A, Saidi Jam M, Karimi SA, Raoufi S, Mardani P, Naderishahab M, Sarihi A, Mirnajafi-Zadeh J. Effect of ramosetron, a 5-HT 3 receptor antagonist on the severity of seizures and memory impairment in electrical amygdala kindled rats. J Physiol Sci 2022; 72:1. [PMID: 35034601 PMCID: PMC10717980 DOI: 10.1186/s12576-022-00825-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 01/04/2022] [Indexed: 11/10/2022]
Abstract
The entorhinal cortex (EC) plays a pivotal role in epileptogenesis and seizures. EC expresses high density of serotonergic receptors, especially 5-HT3 receptors. Cognitive impairment is common among people with epilepsy. The present study investigated the role of 5-HT3 receptor on the severity of seizures and learning and memory impairment by electrical kindling of amygdala in rats. The amygdala kindling was conducted in a chronic kindling manner in male Wistar rats. In fully kindled animals, ramosetron (as a potent and selective 5-HT3 receptor antagonist) was microinjected unilaterally (ad doses of 1, 10 or 100 µg/0.5 µl) into the EC 5 min before the novel object recognition (NOR) and Y-maze tests or kindling stimulations. Applying ramosetron at the concentration of 100 μg/0.5 µl (but not at 1 and 10 µg/0.5 µl) reduced afterdischarge (AD) duration and increased stage 4 latency in the kindled rats. Moreover, the obtained data from the NOR test showed that treatment by ramosetron (10 and 100 µg/0.5 µl) increased the discrimination index in the fully kindled animals. Microinjection of ramosetron (10 and 100 µg/0.5 µl) in fully kindled animals reversed the kindling induced changes in the percentage of spontaneous alternation in Y-maze task. The findings demonstrated an anticonvulsant role for a selective 5-HT3 receptor antagonist microinjected into the EC, therefore, suggesting an excitatory role for the EC 5-HT3 receptors in the amygdala kindling model of epilepsy. This anticonvulsive effect was accompanied with a restoring effect on cognitive behavior in NOR and Y-maze tests.
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Affiliation(s)
- Zeynab Sayahi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Shahid Fahmideh Street, 6517838736, Hamadan, Iran
| | - Alireza Komaki
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Shahid Fahmideh Street, 6517838736, Hamadan, Iran
- Department of Neuroscience, School of Sciences and Advanced Technology in Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Masoud Saidi Jam
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Asaad Karimi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Shahid Fahmideh Street, 6517838736, Hamadan, Iran
- Department of Neuroscience, School of Sciences and Advanced Technology in Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Safoura Raoufi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Shahid Fahmideh Street, 6517838736, Hamadan, Iran
| | - Parastoo Mardani
- Department of Biology, Faculty of Sciences, Payame Noor University, Sanandaj, Iran
| | - Marzieh Naderishahab
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Shahid Fahmideh Street, 6517838736, Hamadan, Iran
| | - Abdolrahman Sarihi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Shahid Fahmideh Street, 6517838736, Hamadan, Iran.
- Department of Neuroscience, School of Sciences and Advanced Technology in Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Javad Mirnajafi-Zadeh
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, 1411713116, Tehran, Iran.
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Kang HY, Kim Y, You AH, Kim YJ, Kim MK. A randomized controlled trial of the effect of ramosetron on postoperative restoration of bowel motility after gynecologic laparoscopic surgery. Int J Gynaecol Obstet 2021; 158:172-178. [PMID: 34614204 DOI: 10.1002/ijgo.13969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/16/2021] [Accepted: 10/05/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate the effect of ramosetron after gynecological laparoscopic surgery on the recovery of bowel function. METHODS A prospective randomized controlled trial conducted at Kyung Hee University hospital, South Korea, from August 2016 to September 2017. Patients were randomized to receive either 10 mg dexamethasone before induction of anesthesia (control group C), followed by intravenous administration of patient-controlled analgesia (IV-PCA) or 2 ml normal saline before induction of anesthesia and 0.6 mg ramosetron (study group R) administered with IV-PCA. RESULTS A total of 88 patients were enrolled. Times to first flatus (group C 23.98 ± 6.31 vs. group R 27.14 ± 9.56 h; P = 0.148) and first defecation (group C 36.16 ± 16.04 vs. group R 43.41 ± 20.01 h; P = 0.138) showed no statistically significant differences. No significant differences were observed in the frequency of postoperative nausea and vomiting (PONV) and demand for additional analgesics. Multiple linear regression for analysis of factors affecting time to first flatus revealed no significant results. CONCLUSION Ramosetron did not delay bowel movement recovery after gynecologic laparoscopic surgery and was as effective as dexamethasone in regulating PONV. Ramosetron can be used with IV-PCA without concerns about delay in recovery of bowel function. ClinicalTrials.gov registration number: NCT02849483.
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Affiliation(s)
- Hee Yong Kang
- Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital, Seoul, South Korea
| | - Youngsoon Kim
- Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital, Seoul, South Korea
| | - Ann Hee You
- Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital, Seoul, South Korea
| | - Yeon Jin Kim
- Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital, Seoul, South Korea
| | - Mi Kyeong Kim
- Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital, Seoul, South Korea
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Ryoo SB, Park JW, Lee DW, Lee MA, Kwon YH, Kim MJ, Moon SH, Jeong SY, Park KJ. Anterior resection syndrome: a randomized clinical trial of a 5-HT3 receptor antagonist (ramosetron) in male patients with rectal cancer. Br J Surg 2021; 108:644-651. [PMID: 33982068 DOI: 10.1093/bjs/znab071] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/31/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND No effective treatment exists for anterior resection syndrome (ARS) following sphincter-saving surgery for rectal cancer. This RCT assessed the safety and efficacy of a 5-HT3 receptor antagonist, ramosetron, for ARS. METHODS A single-centre, randomized, controlled, open-label, parallel group trial was conducted. Male patients with ARS 1 month after rectal cancer surgery or ileostomy reversal were enrolled and randomly assigned (1 : 1) to 5 μg of ramosetron (Irribow®) daily or conservative treatment for 4 weeks. Low ARS (LARS) score was calculated after randomization and 4 weeks after treatment. The study was designed as a superiority test with a primary endpoint of the proportion of patients with major LARS between the groups. Primary outcome analysis was based on the modified intention-to-treat population. Safety was assessed by monitoring adverse events during the study. RESULTS : A total of 100 patients were randomized to the ramosetron (49 patients) or conservative treatment group (51 patients). Two patients were excluded, and 48 and 50 patients were analysed in the ramosetron and control groups, respectively. The proportion of major LARS after 4 weeks was 58 per cent (28 of 48 patients) in the ramosetron group versus 82 per cent (41 of 50 patients) in the control group, with a difference of 23.7 per cent (95 per cent c.i. 5.58 to 39.98, P = 0.011). There were minor adverse events in five patients, which were hard stool, frequent stool or anal pain. These were not different between the two groups. There were no serious adverse events. CONCLUSION : Ramosetron could be safe and feasible for male patients with ARS. TRIAL REGISTRATION NUMBER NCT02869984 (http://www.clinicaltrials.gov).
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Affiliation(s)
- S-B Ryoo
- Division of Colorectal Surgery, Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Colorectal Cancer Centre, Seoul National University Cancer Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - J W Park
- Division of Colorectal Surgery, Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Colorectal Cancer Centre, Seoul National University Cancer Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - D W Lee
- Centre for Colorectal Cancer, Research Institute and Hospital, National Cancer Centre, Goyang, Korea
| | - M A Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Colorectal Cancer Centre, Seoul National University Cancer Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Y-H Kwon
- Division of Colorectal Surgery, Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - M J Kim
- Division of Colorectal Surgery, Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Colorectal Cancer Centre, Seoul National University Cancer Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - S H Moon
- Division of Colorectal Surgery, Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Colorectal Cancer Centre, Seoul National University Cancer Hospital, Seoul, Korea
| | - S-Y Jeong
- Division of Colorectal Surgery, Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Colorectal Cancer Centre, Seoul National University Cancer Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - K J Park
- Division of Colorectal Surgery, Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Colorectal Cancer Centre, Seoul National University Cancer Hospital, Seoul, Korea
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Roberts A, Grafton G, Powell AD, Brock K, Chen C, Xie D, Huang J, Liu S, Cooper AJ, Brady CA, Qureshi O, Stamataki Z, Manning DD, Moore NA, Sargent BJ, Guzzo PR, Barnes NM. CSTI-300 (SMP-100); a Novel 5-HT 3 Receptor Partial Agonist with Potential to Treat Patients with Irritable Bowel Syndrome or Carcinoid Syndrome. J Pharmacol Exp Ther 2020; 373:122-134. [PMID: 32102919 DOI: 10.1124/jpet.119.261008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 01/24/2020] [Indexed: 12/12/2022] Open
Abstract
The 5-hydroxytryptamine (5-HT) (serotonin) 5-HT3 receptor represents a clinical target for antagonists to deliver symptomatic relief to patients with diarrhea-predominant irritable bowel syndrome (IBS-d) or carcinoid syndrome. Unfortunately, this pharmacological strategy can present side effects (e.g., severe constipation). The present study investigates the potential of a novel 5-HT3 receptor partial agonist, CSTI-300, to treat patients with IBS-d and other conditions associated with discomfort from colonic distension, with a predicted reduced side-effect profile. The in vitro and in vivo preclinical pharmacology of the drug CSTI-300 was investigated to explore the potential to treat patients with IBS-d. CSTI-300 displayed selective high affinity for the human and rat 5-HT3 receptor (Ki approximately 2.0 nM) and acted as a partial agonist (approximately 30%-50% intrinsic efficacy) in vitro. In an in vivo model of IBS-d, the rat colon distension model, CSTI-300 displayed dose-dependent efficacy. In addition, oral administration of CSTI-300 to dogs that achieved plasma levels of the drug exceeding the Ki value for the 5-HT3 receptor failed to either evoke emesis or alter the state of feces. Pharmacokinetics for CSTI-300 in rat and dog identified high levels of oral availability with t 1/2 range of 1.6-4.4 hours. The preclinical pharmacology of the lead candidate drug, CSTI-300, supports the potential of this novel drug to offer symptomatic relief to patients with irritable bowel syndrome and carcinoid syndrome with a rationale for a reduced "on-target" side-effect profile relative to 5-HT3 receptor antagonists, such as alosetron. SIGNIFICANCE STATEMENT: There is a lack of effective current treatment for diarrhea-predominant irritable bowel syndrome and carcinoid syndrome, and in both conditions, overactivity of the 5-hydroxytryptamine (5-HT) 5-HT3 receptor is thought to be implicated in the pathophysiology. Because 5-HT3 receptor blockade with antagonists results in significant side effects, we present evidence that treatment with a suitable 5-HT3 receptor partial agonist will alleviate some symptoms associated with these conditions yet, without fully inhibiting the receptor, predict a less pronounced side-effect profile associated with this therapeutic strategy.
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Affiliation(s)
- Alexander Roberts
- Neuropharmacology Research Group, Institute of Clinical Sciences (A.R., G.G., A.J.C., C.A.B., O.Q., N.M.B.) and Institute of Immunology and Immunotherapy (Z.S.), College of Medical and Dental Sciences and DB - Diagnostics, Drugs, Devices and Biomarkers, Cancer Research UK Clinical Trials Unit (K.B.), University of Birmingham, Edgbaston, Birmingham, United Kingdom; Department of Life Science, School of Health Sciences, Birmingham City University, Birmingham, United Kingdom (A.D.P.); Shanghai Medicilon Inc., Shanghai, China (C.C.); Chengdu SciMount Pharmatech Co. Ltd., Chengdu, China (D.X., J.H.); ConSynance Therapeutics, Inc., Rensselaer, New York (S.L., P.R.G.); Albany Molecular Research, Inc., Albany, New York (D.D.M., N.A.M.); and Sargent Consulting, Hendersonville, North Carolina (B.J.S.)
| | - Gillian Grafton
- Neuropharmacology Research Group, Institute of Clinical Sciences (A.R., G.G., A.J.C., C.A.B., O.Q., N.M.B.) and Institute of Immunology and Immunotherapy (Z.S.), College of Medical and Dental Sciences and DB - Diagnostics, Drugs, Devices and Biomarkers, Cancer Research UK Clinical Trials Unit (K.B.), University of Birmingham, Edgbaston, Birmingham, United Kingdom; Department of Life Science, School of Health Sciences, Birmingham City University, Birmingham, United Kingdom (A.D.P.); Shanghai Medicilon Inc., Shanghai, China (C.C.); Chengdu SciMount Pharmatech Co. Ltd., Chengdu, China (D.X., J.H.); ConSynance Therapeutics, Inc., Rensselaer, New York (S.L., P.R.G.); Albany Molecular Research, Inc., Albany, New York (D.D.M., N.A.M.); and Sargent Consulting, Hendersonville, North Carolina (B.J.S.)
| | - Andrew D Powell
- Neuropharmacology Research Group, Institute of Clinical Sciences (A.R., G.G., A.J.C., C.A.B., O.Q., N.M.B.) and Institute of Immunology and Immunotherapy (Z.S.), College of Medical and Dental Sciences and DB - Diagnostics, Drugs, Devices and Biomarkers, Cancer Research UK Clinical Trials Unit (K.B.), University of Birmingham, Edgbaston, Birmingham, United Kingdom; Department of Life Science, School of Health Sciences, Birmingham City University, Birmingham, United Kingdom (A.D.P.); Shanghai Medicilon Inc., Shanghai, China (C.C.); Chengdu SciMount Pharmatech Co. Ltd., Chengdu, China (D.X., J.H.); ConSynance Therapeutics, Inc., Rensselaer, New York (S.L., P.R.G.); Albany Molecular Research, Inc., Albany, New York (D.D.M., N.A.M.); and Sargent Consulting, Hendersonville, North Carolina (B.J.S.)
| | - Kristian Brock
- Neuropharmacology Research Group, Institute of Clinical Sciences (A.R., G.G., A.J.C., C.A.B., O.Q., N.M.B.) and Institute of Immunology and Immunotherapy (Z.S.), College of Medical and Dental Sciences and DB - Diagnostics, Drugs, Devices and Biomarkers, Cancer Research UK Clinical Trials Unit (K.B.), University of Birmingham, Edgbaston, Birmingham, United Kingdom; Department of Life Science, School of Health Sciences, Birmingham City University, Birmingham, United Kingdom (A.D.P.); Shanghai Medicilon Inc., Shanghai, China (C.C.); Chengdu SciMount Pharmatech Co. Ltd., Chengdu, China (D.X., J.H.); ConSynance Therapeutics, Inc., Rensselaer, New York (S.L., P.R.G.); Albany Molecular Research, Inc., Albany, New York (D.D.M., N.A.M.); and Sargent Consulting, Hendersonville, North Carolina (B.J.S.)
| | - Chunlin Chen
- Neuropharmacology Research Group, Institute of Clinical Sciences (A.R., G.G., A.J.C., C.A.B., O.Q., N.M.B.) and Institute of Immunology and Immunotherapy (Z.S.), College of Medical and Dental Sciences and DB - Diagnostics, Drugs, Devices and Biomarkers, Cancer Research UK Clinical Trials Unit (K.B.), University of Birmingham, Edgbaston, Birmingham, United Kingdom; Department of Life Science, School of Health Sciences, Birmingham City University, Birmingham, United Kingdom (A.D.P.); Shanghai Medicilon Inc., Shanghai, China (C.C.); Chengdu SciMount Pharmatech Co. Ltd., Chengdu, China (D.X., J.H.); ConSynance Therapeutics, Inc., Rensselaer, New York (S.L., P.R.G.); Albany Molecular Research, Inc., Albany, New York (D.D.M., N.A.M.); and Sargent Consulting, Hendersonville, North Carolina (B.J.S.)
| | - Dejian Xie
- Neuropharmacology Research Group, Institute of Clinical Sciences (A.R., G.G., A.J.C., C.A.B., O.Q., N.M.B.) and Institute of Immunology and Immunotherapy (Z.S.), College of Medical and Dental Sciences and DB - Diagnostics, Drugs, Devices and Biomarkers, Cancer Research UK Clinical Trials Unit (K.B.), University of Birmingham, Edgbaston, Birmingham, United Kingdom; Department of Life Science, School of Health Sciences, Birmingham City University, Birmingham, United Kingdom (A.D.P.); Shanghai Medicilon Inc., Shanghai, China (C.C.); Chengdu SciMount Pharmatech Co. Ltd., Chengdu, China (D.X., J.H.); ConSynance Therapeutics, Inc., Rensselaer, New York (S.L., P.R.G.); Albany Molecular Research, Inc., Albany, New York (D.D.M., N.A.M.); and Sargent Consulting, Hendersonville, North Carolina (B.J.S.)
| | - Jinkun Huang
- Neuropharmacology Research Group, Institute of Clinical Sciences (A.R., G.G., A.J.C., C.A.B., O.Q., N.M.B.) and Institute of Immunology and Immunotherapy (Z.S.), College of Medical and Dental Sciences and DB - Diagnostics, Drugs, Devices and Biomarkers, Cancer Research UK Clinical Trials Unit (K.B.), University of Birmingham, Edgbaston, Birmingham, United Kingdom; Department of Life Science, School of Health Sciences, Birmingham City University, Birmingham, United Kingdom (A.D.P.); Shanghai Medicilon Inc., Shanghai, China (C.C.); Chengdu SciMount Pharmatech Co. Ltd., Chengdu, China (D.X., J.H.); ConSynance Therapeutics, Inc., Rensselaer, New York (S.L., P.R.G.); Albany Molecular Research, Inc., Albany, New York (D.D.M., N.A.M.); and Sargent Consulting, Hendersonville, North Carolina (B.J.S.)
| | - Shuang Liu
- Neuropharmacology Research Group, Institute of Clinical Sciences (A.R., G.G., A.J.C., C.A.B., O.Q., N.M.B.) and Institute of Immunology and Immunotherapy (Z.S.), College of Medical and Dental Sciences and DB - Diagnostics, Drugs, Devices and Biomarkers, Cancer Research UK Clinical Trials Unit (K.B.), University of Birmingham, Edgbaston, Birmingham, United Kingdom; Department of Life Science, School of Health Sciences, Birmingham City University, Birmingham, United Kingdom (A.D.P.); Shanghai Medicilon Inc., Shanghai, China (C.C.); Chengdu SciMount Pharmatech Co. Ltd., Chengdu, China (D.X., J.H.); ConSynance Therapeutics, Inc., Rensselaer, New York (S.L., P.R.G.); Albany Molecular Research, Inc., Albany, New York (D.D.M., N.A.M.); and Sargent Consulting, Hendersonville, North Carolina (B.J.S.)
| | - Alison J Cooper
- Neuropharmacology Research Group, Institute of Clinical Sciences (A.R., G.G., A.J.C., C.A.B., O.Q., N.M.B.) and Institute of Immunology and Immunotherapy (Z.S.), College of Medical and Dental Sciences and DB - Diagnostics, Drugs, Devices and Biomarkers, Cancer Research UK Clinical Trials Unit (K.B.), University of Birmingham, Edgbaston, Birmingham, United Kingdom; Department of Life Science, School of Health Sciences, Birmingham City University, Birmingham, United Kingdom (A.D.P.); Shanghai Medicilon Inc., Shanghai, China (C.C.); Chengdu SciMount Pharmatech Co. Ltd., Chengdu, China (D.X., J.H.); ConSynance Therapeutics, Inc., Rensselaer, New York (S.L., P.R.G.); Albany Molecular Research, Inc., Albany, New York (D.D.M., N.A.M.); and Sargent Consulting, Hendersonville, North Carolina (B.J.S.)
| | - Catherine A Brady
- Neuropharmacology Research Group, Institute of Clinical Sciences (A.R., G.G., A.J.C., C.A.B., O.Q., N.M.B.) and Institute of Immunology and Immunotherapy (Z.S.), College of Medical and Dental Sciences and DB - Diagnostics, Drugs, Devices and Biomarkers, Cancer Research UK Clinical Trials Unit (K.B.), University of Birmingham, Edgbaston, Birmingham, United Kingdom; Department of Life Science, School of Health Sciences, Birmingham City University, Birmingham, United Kingdom (A.D.P.); Shanghai Medicilon Inc., Shanghai, China (C.C.); Chengdu SciMount Pharmatech Co. Ltd., Chengdu, China (D.X., J.H.); ConSynance Therapeutics, Inc., Rensselaer, New York (S.L., P.R.G.); Albany Molecular Research, Inc., Albany, New York (D.D.M., N.A.M.); and Sargent Consulting, Hendersonville, North Carolina (B.J.S.)
| | - Omar Qureshi
- Neuropharmacology Research Group, Institute of Clinical Sciences (A.R., G.G., A.J.C., C.A.B., O.Q., N.M.B.) and Institute of Immunology and Immunotherapy (Z.S.), College of Medical and Dental Sciences and DB - Diagnostics, Drugs, Devices and Biomarkers, Cancer Research UK Clinical Trials Unit (K.B.), University of Birmingham, Edgbaston, Birmingham, United Kingdom; Department of Life Science, School of Health Sciences, Birmingham City University, Birmingham, United Kingdom (A.D.P.); Shanghai Medicilon Inc., Shanghai, China (C.C.); Chengdu SciMount Pharmatech Co. Ltd., Chengdu, China (D.X., J.H.); ConSynance Therapeutics, Inc., Rensselaer, New York (S.L., P.R.G.); Albany Molecular Research, Inc., Albany, New York (D.D.M., N.A.M.); and Sargent Consulting, Hendersonville, North Carolina (B.J.S.)
| | - Zania Stamataki
- Neuropharmacology Research Group, Institute of Clinical Sciences (A.R., G.G., A.J.C., C.A.B., O.Q., N.M.B.) and Institute of Immunology and Immunotherapy (Z.S.), College of Medical and Dental Sciences and DB - Diagnostics, Drugs, Devices and Biomarkers, Cancer Research UK Clinical Trials Unit (K.B.), University of Birmingham, Edgbaston, Birmingham, United Kingdom; Department of Life Science, School of Health Sciences, Birmingham City University, Birmingham, United Kingdom (A.D.P.); Shanghai Medicilon Inc., Shanghai, China (C.C.); Chengdu SciMount Pharmatech Co. Ltd., Chengdu, China (D.X., J.H.); ConSynance Therapeutics, Inc., Rensselaer, New York (S.L., P.R.G.); Albany Molecular Research, Inc., Albany, New York (D.D.M., N.A.M.); and Sargent Consulting, Hendersonville, North Carolina (B.J.S.)
| | - David D Manning
- Neuropharmacology Research Group, Institute of Clinical Sciences (A.R., G.G., A.J.C., C.A.B., O.Q., N.M.B.) and Institute of Immunology and Immunotherapy (Z.S.), College of Medical and Dental Sciences and DB - Diagnostics, Drugs, Devices and Biomarkers, Cancer Research UK Clinical Trials Unit (K.B.), University of Birmingham, Edgbaston, Birmingham, United Kingdom; Department of Life Science, School of Health Sciences, Birmingham City University, Birmingham, United Kingdom (A.D.P.); Shanghai Medicilon Inc., Shanghai, China (C.C.); Chengdu SciMount Pharmatech Co. Ltd., Chengdu, China (D.X., J.H.); ConSynance Therapeutics, Inc., Rensselaer, New York (S.L., P.R.G.); Albany Molecular Research, Inc., Albany, New York (D.D.M., N.A.M.); and Sargent Consulting, Hendersonville, North Carolina (B.J.S.)
| | - Nicholas A Moore
- Neuropharmacology Research Group, Institute of Clinical Sciences (A.R., G.G., A.J.C., C.A.B., O.Q., N.M.B.) and Institute of Immunology and Immunotherapy (Z.S.), College of Medical and Dental Sciences and DB - Diagnostics, Drugs, Devices and Biomarkers, Cancer Research UK Clinical Trials Unit (K.B.), University of Birmingham, Edgbaston, Birmingham, United Kingdom; Department of Life Science, School of Health Sciences, Birmingham City University, Birmingham, United Kingdom (A.D.P.); Shanghai Medicilon Inc., Shanghai, China (C.C.); Chengdu SciMount Pharmatech Co. Ltd., Chengdu, China (D.X., J.H.); ConSynance Therapeutics, Inc., Rensselaer, New York (S.L., P.R.G.); Albany Molecular Research, Inc., Albany, New York (D.D.M., N.A.M.); and Sargent Consulting, Hendersonville, North Carolina (B.J.S.)
| | - Bruce J Sargent
- Neuropharmacology Research Group, Institute of Clinical Sciences (A.R., G.G., A.J.C., C.A.B., O.Q., N.M.B.) and Institute of Immunology and Immunotherapy (Z.S.), College of Medical and Dental Sciences and DB - Diagnostics, Drugs, Devices and Biomarkers, Cancer Research UK Clinical Trials Unit (K.B.), University of Birmingham, Edgbaston, Birmingham, United Kingdom; Department of Life Science, School of Health Sciences, Birmingham City University, Birmingham, United Kingdom (A.D.P.); Shanghai Medicilon Inc., Shanghai, China (C.C.); Chengdu SciMount Pharmatech Co. Ltd., Chengdu, China (D.X., J.H.); ConSynance Therapeutics, Inc., Rensselaer, New York (S.L., P.R.G.); Albany Molecular Research, Inc., Albany, New York (D.D.M., N.A.M.); and Sargent Consulting, Hendersonville, North Carolina (B.J.S.)
| | - Peter R Guzzo
- Neuropharmacology Research Group, Institute of Clinical Sciences (A.R., G.G., A.J.C., C.A.B., O.Q., N.M.B.) and Institute of Immunology and Immunotherapy (Z.S.), College of Medical and Dental Sciences and DB - Diagnostics, Drugs, Devices and Biomarkers, Cancer Research UK Clinical Trials Unit (K.B.), University of Birmingham, Edgbaston, Birmingham, United Kingdom; Department of Life Science, School of Health Sciences, Birmingham City University, Birmingham, United Kingdom (A.D.P.); Shanghai Medicilon Inc., Shanghai, China (C.C.); Chengdu SciMount Pharmatech Co. Ltd., Chengdu, China (D.X., J.H.); ConSynance Therapeutics, Inc., Rensselaer, New York (S.L., P.R.G.); Albany Molecular Research, Inc., Albany, New York (D.D.M., N.A.M.); and Sargent Consulting, Hendersonville, North Carolina (B.J.S.)
| | - Nicholas M Barnes
- Neuropharmacology Research Group, Institute of Clinical Sciences (A.R., G.G., A.J.C., C.A.B., O.Q., N.M.B.) and Institute of Immunology and Immunotherapy (Z.S.), College of Medical and Dental Sciences and DB - Diagnostics, Drugs, Devices and Biomarkers, Cancer Research UK Clinical Trials Unit (K.B.), University of Birmingham, Edgbaston, Birmingham, United Kingdom; Department of Life Science, School of Health Sciences, Birmingham City University, Birmingham, United Kingdom (A.D.P.); Shanghai Medicilon Inc., Shanghai, China (C.C.); Chengdu SciMount Pharmatech Co. Ltd., Chengdu, China (D.X., J.H.); ConSynance Therapeutics, Inc., Rensselaer, New York (S.L., P.R.G.); Albany Molecular Research, Inc., Albany, New York (D.D.M., N.A.M.); and Sargent Consulting, Hendersonville, North Carolina (B.J.S.)
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9
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Kim MJ, Min YW, Lee C, Jang YS, Kim CH, Chang DK. The effects of three novel probiotics isolated from the Korean fermented food Kimchi on the stress-induced defecation of rats. PRECISION AND FUTURE MEDICINE 2020. [DOI: 10.23838/pfm.2019.00121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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10
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Kang JH, Kwon JH, Lee YG, Park KU, An HJ, Sohn J, Seol YM, Lee H, Yun HJ, Ahn JS, Yang JH, Song H, Koo DH, Kim JY, Kim GM, Kim HJ. Ramosetron versus Palonosetron in Combination with Aprepitant and Dexamethasone for the Control of Highly-Emetogenic Chemotherapy-Induced Nausea and Vomiting. Cancer Res Treat 2020; 52:907-916. [PMID: 32192275 PMCID: PMC7373869 DOI: 10.4143/crt.2019.713] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 03/17/2020] [Indexed: 11/21/2022] Open
Abstract
PURPOSE The purpose of this study was to compare ramosetron (RAM), aprepitant (APR), and dexamethasone (DEX) [RAD] with palonosetron (PAL), APR, and DEX [PAD] in controlling highly-emetogenic chemotherapy (HEC)-induced nausea and vomiting. Materials and Methods Patients were randomly assigned (1:1) to receive RAD or PAD:RAM (0.3 mg intravenously) or PAL (0.25 mg intravenously) D1, combined with APR (125 mg orally, D1 and 80 mg orally, D2-3) and DEX (12 mg orally or intravenously, D1 and 8 mg orally, D2-4). Patients were stratified by sex, cisplatin-based chemotherapy, and administration schedule. The primary endpoint was overall complete response (CR), defined as no emesis and no rescue regimen during 5 days of HEC. Secondary endpoints were overall complete protection (CP; CR+nausea score < 25 mm) and total control (TC; CR+nausea score < 5 mm). Quality of life was assessed by Functional Living Index Emesis (FLIE) questionnaire on D0 and D6. RESULTS A total of 279 patients receiving RAD (n=137) or PAD (n=142) were evaluated. Overall CR rates in RAD and PAD recipients were 81.8% and 79.6% (risk difference [RD], 2.2%; 95% confidence interval [CI], -7.1 to 11.4), respectively. Overall CP and TC rates for RAD and PAD were 56.2% and 58.5% (RD, -2.3%; 95% CI, -13.9 to 9.4) and 47.5% vs. 43.7% (RD, 3.8%; 95% CI, -7.9 to 15.5), respectively. FLIE total score ≥ 108 (no impact on daily life) was comparable between RAD and PAD (73.9% vs. 73.4%, respectively). Adverse events were similar between the two groups. CONCLUSION In all aspects of efficacy, safety and QOL, RAD is non-inferior to PAD for the control of CINV in cancer patients receiving HEC.
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Affiliation(s)
- Jin Hyoung Kang
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
| | - Jung Hye Kwon
- Division of Hemato-Oncology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Yun-Gyoo Lee
- Division of Hematology/Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Keon Uk Park
- Division of Hematology/Oncology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - Ho Jung An
- Division of Medical Oncology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joohyuk Sohn
- Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Young Mi Seol
- Division of Hemato-Oncology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Hyunwoo Lee
- Department of Hematology-Oncology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - Hwan-Jung Yun
- Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jin Seok Ahn
- Division of Hematology & Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Hyun Yang
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
| | - Hunho Song
- Division of Hemato-Oncology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Dong-Hoe Koo
- Division of Hematology/Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Young Kim
- Division of Hematology/Oncology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - Gun Min Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hwa Jung Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Fakhfouri G, Rahimian R, Dyhrfjeld-Johnsen J, Zirak MR, Beaulieu JM. 5-HT 3 Receptor Antagonists in Neurologic and Neuropsychiatric Disorders: The Iceberg Still Lies beneath the Surface. Pharmacol Rev 2019; 71:383-412. [PMID: 31243157 DOI: 10.1124/pr.118.015487] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
5-HT3 receptor antagonists, first introduced to the market in the mid-1980s, are proven efficient agents to counteract chemotherapy-induced emesis. Nonetheless, recent investigations have shed light on unappreciated dimensions of this class of compounds in conditions with an immunoinflammatory component as well as in neurologic and psychiatric disorders. The promising findings from multiple studies have unveiled several beneficial effects of these compounds in multiple sclerosis, stroke, Alzheimer disease, and Parkinson disease. Reports continue to uncover important roles for 5-HT3 receptors in the physiopathology of neuropsychiatric disorders, including depression, anxiety, drug abuse, and schizophrenia. This review addresses the potential of 5-HT3 receptor antagonists in neurology- and neuropsychiatry-related disorders. The broad therapeutic window and high compliance observed with these agents position them as suitable prototypes for the development of novel pharmacotherapeutics with higher efficacy and fewer adverse effects.
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Affiliation(s)
- Gohar Fakhfouri
- Department of Psychiatry and Neuroscience, Faculty of Medicine, CERVO Brain Research Centre, Laval University, Quebec, Quebec, Canada (G.F., R.R.); Sensorion SA, Montpellier, France (J.D.-J.); Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran (M.R.Z.); and Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada (J.-M.B.)
| | - Reza Rahimian
- Department of Psychiatry and Neuroscience, Faculty of Medicine, CERVO Brain Research Centre, Laval University, Quebec, Quebec, Canada (G.F., R.R.); Sensorion SA, Montpellier, France (J.D.-J.); Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran (M.R.Z.); and Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada (J.-M.B.)
| | - Jonas Dyhrfjeld-Johnsen
- Department of Psychiatry and Neuroscience, Faculty of Medicine, CERVO Brain Research Centre, Laval University, Quebec, Quebec, Canada (G.F., R.R.); Sensorion SA, Montpellier, France (J.D.-J.); Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran (M.R.Z.); and Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada (J.-M.B.)
| | - Mohammad Reza Zirak
- Department of Psychiatry and Neuroscience, Faculty of Medicine, CERVO Brain Research Centre, Laval University, Quebec, Quebec, Canada (G.F., R.R.); Sensorion SA, Montpellier, France (J.D.-J.); Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran (M.R.Z.); and Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada (J.-M.B.)
| | - Jean-Martin Beaulieu
- Department of Psychiatry and Neuroscience, Faculty of Medicine, CERVO Brain Research Centre, Laval University, Quebec, Quebec, Canada (G.F., R.R.); Sensorion SA, Montpellier, France (J.D.-J.); Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran (M.R.Z.); and Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada (J.-M.B.)
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Kawahara Y, Mitsui K, Niwa T, Morimoto N, Kawaharada S, Katsumata S. Translocator protein 18kDa antagonist ameliorates stress-induced stool abnormality and abdominal pain in rodent stress models. Neurogastroenterol Motil 2018; 30:e13425. [PMID: 30069991 DOI: 10.1111/nmo.13425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 06/18/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder characterized by abdominal pain and abnormal bowel habits, both of which are exacerbated by psychological stress. The translocator protein 18kDa (TSPO) is a marker of reactive gliosis in a number of central nervous system (CNS) diseases and responsible for many cellular functions, including neurosteroidogenesis. Although it has been reported that psychological stress disturbs neurosteroids levels, the pathophysiological relevance of TSPO in IBS is poorly understood. METHODS We examined the effects of a TSPO antagonist, ONO-2952, on stress-induced stool abnormality and abdominal pain in rats, and on anxiety-related behavior induced by cholecystokinin. KEY RESULTS Oral administration of ONO-2952 attenuated stress-induced defecation and rectal hyperalgesia in rats with an efficacy equivalent to that of a 5-HT3 receptor antagonist. In addition, ONO-2952 suppressed cholecystokinin-induced anxiety-like behavior with an efficacy equivalent to that of psychotropic drugs. On the other hand, ONO-2952 did not affect spontaneous defecation, gastrointestinal transit, visceral nociceptive threshold, and neurosteroid production in non-stressed rats even at a dose 10 times higher than its effective dose in the stress models. CONCLUSIONS AND INFERENCES These results suggest that TSPO antagonism results in antistress action, and that ONO-2952 is a promising candidate for IBS without side effects associated with current treatment.
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Affiliation(s)
- Y Kawahara
- Discovery Research Laboratories I, ONO Pharmaceutical Co., Ltd., Osaka, Japan
| | - K Mitsui
- Discovery Research Laboratories I, ONO Pharmaceutical Co., Ltd., Osaka, Japan
| | - T Niwa
- Discovery Research Laboratories I, ONO Pharmaceutical Co., Ltd., Osaka, Japan
| | - N Morimoto
- Discovery Research Laboratories I, ONO Pharmaceutical Co., Ltd., Osaka, Japan
| | - S Kawaharada
- Discovery Research Laboratories I, ONO Pharmaceutical Co., Ltd., Osaka, Japan
| | - S Katsumata
- Discovery Research Laboratories I, ONO Pharmaceutical Co., Ltd., Osaka, Japan
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Park HE, Kim MK, Kang WK. Efficacy and Safety of Ramosetron Injection for Nausea and Vomiting in Colorectal-Cancer Patients Undergoing a Laparoscopic Colectomy: A Randomized, Double-Blind, Comparative Study. Ann Coloproctol 2018. [PMID: 29535986 PMCID: PMC5847401 DOI: 10.3393/ac.2018.34.1.36] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Purpose A laparoscopic colectomy in colorectal-cancer patients is usually associated with a high risk of postoperative nausea and vomiting (PONV). The purpose of this study is to evaluate the efficacy of injection of long-acting 5-hydroxytryptamine type 3 (5-HT3) receptor antagonist for the reduction of PONV in patients with colorectal cancer. Methods A total of 48 patients scheduled to undergo a laparoscopic colectomy for colorectal cancer were randomized in a double-blinded fashion. Patients were randomly allocated to 1 of 2 groups and assigned to receive either 0.3 mg of ramosetron intravenously (group A, n = 25) or 2 mL of normal saline (placebo) (group B, n = 22) immediately after the operation. The incidence of PONV, the nausea severity scale score, the visual analogue scale (VAS) score for pain, the total amount of patient-controlled analgesia used, the recovery of bowel function, and morbidities were assessed at 1 hour and at 24, 48, and 72 hours after surgery. Results The baseline and the operative characteristics were similar between the groups (P > 0.05). The number of cases without PONV (complete response) was higher for group A (ramosetron) than group B (normal saline): 24 hours after surgery, 92.0% (23 of 25) for group A versus 54.5% (12 of 22) for group B; 48 hours after surgery, 92% (23 of 25) for group A versus 81.8% (18 of 22) for group B (both P < 0.05). No serious adverse events occurred. Conclusion Postoperative ramosetron injection is effective for the prevention of PONV after a laparoscopic colectomy in colorectal-cancer patients.
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Affiliation(s)
- Han Eol Park
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Min Ki Kim
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won-Kyung Kang
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Cervantes-Durán C, Ortega-Varela LF, Godínez-Hernández D, Granados-Soto V, Gauthereau-Torres MY. Toluene exposure enhances acute and chronic formalin-induced nociception in rats: Participation of 5-HT 3 receptors. Neurotoxicology 2017; 63:97-105. [PMID: 28947236 DOI: 10.1016/j.neuro.2017.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 09/05/2017] [Accepted: 09/18/2017] [Indexed: 10/18/2022]
Abstract
The purpose of this study was to evaluate the effect of acute toluene exposure on formalin (0.5% and 1%)-induced acute and long-lasting nociceptive hypersensitivity in rats. In addition, we sought to investigate the role of peripheral 5-HT3 receptors in the pronociceptive effect of toluene. Toluene exposure (6000ppm) for 30min enhanced 0.5% or 1% formalin-induced acute nociception and long-lasting secondary allodynia and hyperalgesia. In contrast, exposition to toluene for 30min in rats previously injected (six days before) with 1% formalin did not affect long-lasting hypersensitivy. Local peripheral pre-treatment with alosetron (5-HT3 receptor antagonist, 10-100 nmol) reduced the pronociceptive effect of toluene in acute nociception and long-lasting secondary allodynia and hyperalgesia. Alosetron (100nmol) was also able to reduce the nociceptive effects of 1% formalin in absence of toluene. Moreover, local peripheral injection of m-CPBG (5-HT3 receptor agonist, 300 nmol) enhanced 0.5% formalin-induced acute and long-lasting nociception in air- and toluene-exposed rats. Alosetron (10nmol) blocked the pronociceptive effects of m-CPBG (300nmol) on 0.5% formalin-induced acute and long-lasting hypersensitivity in rats exposed to toluene. Alosetron (at 10nmol) did not modify formalin-induced nociceptive behaviors. Finally, local peripheral pre-treatment with methiothepin (non-selective 5-HT receptor antagonist, 1.5nmol), did not affect the pronociceptive effect of toluene on 1% formalin-induced acute and long-lasting hypersensitivity. Our data demonstrate that acute exposure to toluene has pronociceptive effects in formalin-induced acute nociception and long-lasting hypersensitivity. Our data suggest that this pronociceptive effect depend on activation of peripheral 5-HT3, but not methiothepin-sensitive 5-HT, receptors.
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Affiliation(s)
- Claudia Cervantes-Durán
- División de Estudios de Posgrado, Facultad de Ciencias Médicas y Biológicas "Dr. Ignacio Chávez", Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Michoacán, Mexico
| | - Luis Fernando Ortega-Varela
- Escuela de Enfermería y Salud Pública, Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Michoacán, Mexico
| | - Daniel Godínez-Hernández
- Instituto de Investigaciones Químico-Biológicas, Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Michoacán, Mexico
| | - Vinicio Granados-Soto
- Neurobiology of Pain Laboratory, Departamento de Farmacobiología, Cinvestav, Unidad Coapa. Mexico City, Mexico
| | - Marcia Yvette Gauthereau-Torres
- División de Estudios de Posgrado, Facultad de Ciencias Médicas y Biológicas "Dr. Ignacio Chávez", Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Michoacán, Mexico.
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Maekawa Y, Sugiyama A, Takeuchi T. Lactoferrin ameliorates corticosterone-related acute stress and hyperglycemia in rats. J Vet Med Sci 2016; 79:412-417. [PMID: 27941304 PMCID: PMC5326950 DOI: 10.1292/jvms.16-0498] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We aimed to assess the effects of lactoferrin (Lf) on glycemic regulatory responses under restraint stress (RS) in rats. Bovine Lf (bLf, 100 mg/kg) was intraperitoneally administered to rats before oral saline administration or oral glucose tolerance test (OGTT) following 60 min of RS load. In the case of oral saline administration, RS significantly raised plasma glucose, but bLf did not affect the level. Plasma glucose in OGTT showed an overall lower transition in the bLf group, and the levels at 30 and 180 min or the area under the curve (AUC) were significantly decreased. Although bLf suppressed an increase in plasma corticosterone during RS, the levels of plasma insulin, epinephrine and glucagon were not changed by the bLf treatment.
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Affiliation(s)
- Yuta Maekawa
- Department of Veterinary Medicine, Tottori University, 4-101 Koyama-Minami, Tottori 680-8553, Japan
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Anti-stress effects of ONO-2952, a novel translocator protein 18 kDa antagonist, in rats. Neuropharmacology 2015; 99:51-66. [DOI: 10.1016/j.neuropharm.2015.07.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 07/09/2015] [Accepted: 07/11/2015] [Indexed: 12/11/2022]
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Wu ZS, Cheng H, Jiang Y, Melcher K, Xu HE. Ion channels gated by acetylcholine and serotonin: structures, biology, and drug discovery. Acta Pharmacol Sin 2015; 36:895-907. [PMID: 26238288 PMCID: PMC4564887 DOI: 10.1038/aps.2015.66] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 06/24/2015] [Indexed: 12/17/2022] Open
Abstract
The nicotinic acetylcholine receptors (nAChRs) and the 5-HT3 receptors (5-HT3Rs) are cation-selective members of the pentameric ligand-gated ion channels (pLGICs), which are oligomeric protein assemblies that convert a chemical signal into an ion flux through postsynaptic membrane. They are critical components for synaptic transmission in the nervous system, and their dysfunction contributes to many neurological disorders. The diverse subunit compositions of pLGICs give rise to complex mechanisms of ligand recognition, channel gating, and ion-selective permeability, which have been demonstrated in numerous electrophysiological and molecular biological studies, and unraveled by progress in studying the structural biology of this protein family. In this review, we discuss recent insights into the structural and functional basis of two cation-selective pLGICs, the nAChR and the 5-HT3R, including their subunit compositions, ligand binding, and channel gating mechanisms. We also discuss their relevant pharmacology and drug discovery for treating various neurological disorders. Finally, we review a model of two alternative ion conducting pathways based on the latest 5-HT3A crystal structure.
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Agarkar S, Chatterjee AS. Comparison of ramosetron with ondansetron for the prevention of post-operative nausea and vomiting in high-risk patients. Indian J Anaesth 2015; 59:222-7. [PMID: 25937648 PMCID: PMC4408650 DOI: 10.4103/0019-5049.154999] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background and Aims: Post-operative nausea and vomiting (PONV) has an 80% incidence in high-risk patients. This is despite the availability of several antiemetic drugs. Selective 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists are considered first-line for prophylaxis, ondansetron being the most commonly used agent. Ramosetron, another selective 5-HT3 receptor antagonist, is more potent and longer acting than ondansetron. This study was conducted to evaluate the antiemetic efficacy of ramosetron in comparison with ondansetron in patients at a high risk of PONV. Methods: This was a prospective randomised double-blind study carried out over a 6-month period in which 206 patients with at least two risk factors for PONV were randomised to receive ramosetron 0.3 mg or ondansetron 8 mg, 30 min before the end of surgery. The incidence of PONV, severity of nausea and need for rescue antiemetic were recorded over the next 24 h. Primary outcome was the incidence of PONV. Secondary outcomes included severity of nausea and need for rescue. The data were analysed using the Predictive Analytics Software (PASW, version 18: Chicago, IL, USA). Results: The incidence of PONV was found to be 35% in the ramosetron group as opposed to 43.7% in the ondansetron group (P = 0.199). Need for rescue antiemetic was 23.3% in the ramosetron group and 32% in the ondansetron group (P = 0.156) in the 24 h following surgery. Conclusion: Ramosetron 0.3 mg and ondansetron 8 mg were equally effective in reducing the incidence of PONV in high risk patients.
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Affiliation(s)
- Sandip Agarkar
- Department of Anesthesia, Critical Care and Pain, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Aparna S Chatterjee
- Department of Anesthesia, Critical Care and Pain, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
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Min YW, Rhee PL. The clinical potential of ramosetron in the treatment of irritable bowel syndrome with diarrhea (IBS-D). Therap Adv Gastroenterol 2015; 8:136-42. [PMID: 25949526 PMCID: PMC4416292 DOI: 10.1177/1756283x15572580] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Irritable bowel syndrome (IBS) is a highly prevalent functional bowel disorder. Serotonin (5-HT) is known to play a physiological and pathophysiological role in the regulation of gastrointestinal function. In experimental studies, 5-HT3 receptor antagonists have been reported to slow colon transit, to blunt gastrocolonic reflex, and to reduce rectal sensitivity. Alosetron and cilansetron, potent and selective 5-HT3 receptor antagonists, have proven efficacy in the treatment of IBS with diarrhea (IBS-D). However, alosetron was voluntarily withdrawn due to postmarketing reports of ischemic colitis and complications of constipation, and cilansetron was never marketed. Currently alosetron is available under a risk management program for women with severe IBS-D. Ramosetron is another potent and selective 5-HT3 receptor antagonist, which has been marketed in Japan, South Korea, and Taiwan. In animal studies, ramosetron reduced defecation induced by corticotrophin-releasing hormone and had inhibitory effects on colonic nociception. In two randomized controlled studies including 957 patients with IBS-D, ramosetron increased monthly responder rates of patient-reported global assessment of IBS symptom relief compared with placebo. Ramosetron was also as effective as mebeverine in male patients with IBS-D. In a recent randomized controlled trial with 343 male patients with IBS-D, ramosetron has proved effective in improving stool consistency, relieving abdominal pain/discomfort, and improving health-related quality of life. Regarding safety, ramosetron is associated with a lower incidence of constipation compared with other 5-HT3 receptor antagonists and has not been associated with ischemic colitis. Although further large prospective studies are needed to assess whether ramosetron is effective for female patients with IBS-D and to evaluate its long-term safety, ramosetron appears to be one of the most promising agents for patients with IBS-D.
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Affiliation(s)
- Yang Won Min
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Poong-Lyul Rhee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea
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20
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Alexander SPH, Benson HE, Faccenda E, Pawson AJ, Sharman JL, Spedding M, Peters JA, Harmar AJ. The Concise Guide to PHARMACOLOGY 2013/14: ligand-gated ion channels. Br J Pharmacol 2014; 170:1582-606. [PMID: 24528238 PMCID: PMC3892288 DOI: 10.1111/bph.12446] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The Concise Guide to PHARMACOLOGY 2013/14 provides concise overviews of the key properties of over 2000 human drug targets with their pharmacology, plus links to an open access knowledgebase of drug targets and their ligands (www.guidetopharmacology.org), which provides more detailed views of target and ligand properties. The full contents can be found at http://onlinelibrary.wiley.com/doi/10.1111/bph.12444/full. Ligand-gated ion channels are one of the seven major pharmacological targets into which the Guide is divided, with the others being G protein-coupled receptors, ion channels, catalytic receptors, nuclear hormone receptors, transporters and enzymes. These are presented with nomenclature guidance and summary information on the best available pharmacological tools, alongside key references and suggestions for further reading. A new landscape format has easy to use tables comparing related targets. It is a condensed version of material contemporary to late 2013, which is presented in greater detail and constantly updated on the website www.guidetopharmacology.org, superseding data presented in previous Guides to Receptors and Channels. It is produced in conjunction with NC-IUPHAR and provides the official IUPHAR classification and nomenclature for human drug targets, where appropriate. It consolidates information previously curated and displayed separately in IUPHAR-DB and the Guide to Receptors and Channels, providing a permanent, citable, point-in-time record that will survive database updates.
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Affiliation(s)
- Stephen P H Alexander
- School of Life Sciences, University of Nottingham Medical School, Nottingham, NG7 2UH, UK
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21
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Garsed K, Chernova J, Hastings M, Lam C, Marciani L, Singh G, Henry A, Hall I, Whorwell P, Spiller R. A randomised trial of ondansetron for the treatment of irritable bowel syndrome with diarrhoea. Gut 2014; 63:1617-25. [PMID: 24334242 PMCID: PMC4173656 DOI: 10.1136/gutjnl-2013-305989] [Citation(s) in RCA: 159] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Irritable bowel syndrome with diarrhoea (IBS-D) is particularly debilitating due to urgency and episodic incontinence. Some 5-hydroxytryptamine 3 (5-HT3) receptor antagonists (5-HT3RAs) have proven effective but have serious side effects. Ondansetron, also a 5-HT3RA, has been widely used as an antiemetic with an excellent safety record for over two decades. Our aim was to assess its effectiveness in IBS-D. METHODS 120 patients meeting Rome III criteria for IBS-D entered a randomised, double-blind, placebo-controlled crossover study of 5 weeks of ondansetron 4 mg versus placebo with dose titration allowed, up to two tablets three times daily in the first 3 weeks. Patients completed daily diaries documenting stool consistency using the Bristol Stool Form score. Gut transit was measured in the last week of each treatment. The primary endpoint was average stool consistency in the last 2 weeks of treatment. RESULTS Ondansetron significantly improved stool consistency (mean difference in stool form between ondansetron and placebo -0.9, 95% CI -1.1 to -0.6, p<0.001). Compared with placebo, patients on ondansetron experienced fewer days with urgency (p<0.001), lower urgency scores (p<0.001), reduced frequency of defaecation (p=0.002) and less bloating (p=0.002), although pain scores did not change significantly. IBS symptom severity score fell more with ondansetron than placebo (83±9.8 vs 37±9.7, p=0.001). 65% reported adequate relief with ondansetron but not placebo compared with 14% reporting relief with placebo but not ondansetron, relative risk 4.7, 95% CI 2.6 to 8.5, p<0.001. CONCLUSIONS Ondansetron relieves some of the most intrusive symptoms of IBS-D, namely loose stools, frequency and urgency.
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Affiliation(s)
- Klara Garsed
- Nottingham Digestive Diseases Biomedical Research Unit, Queens Medical Centre, Nottingham, UK
| | - Julia Chernova
- Nottingham Digestive Diseases Biomedical Research Unit, Queens Medical Centre, Nottingham, UK
| | | | - Ching Lam
- Nottingham Digestive Diseases Biomedical Research Unit, Queens Medical Centre, Nottingham, UK
| | - Luca Marciani
- Sir Peter Mansfield Magnetic Resonance Imaging Centre, University of Nottingham, Nottingham, UK
| | - Gulzar Singh
- Nottingham Digestive Diseases Biomedical Research Unit, Queens Medical Centre, Nottingham, UK
| | - Amanda Henry
- Department of Molecular Medicine, School of Surgical and Medical Sciences, University of Nottingham, Nottingham, UK
| | - Ian Hall
- Department of Molecular Medicine, School of Surgical and Medical Sciences, University of Nottingham, Nottingham, UK
| | - Peter Whorwell
- Neurogastroenterology Unit, Wythenshawe Hospital, Manchester, UK
| | - Robin Spiller
- Nottingham Digestive Diseases Biomedical Research Unit, Queens Medical Centre, Nottingham, UK
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Nakata-Fukuda M, Hirata T, Keto Y, Yamano M, Yokoyama T, Uchiyama Y. Inhibitory effect of the selective serotonin 5-HT₃ receptor antagonist ramosetron on duodenal acidification-induced gastric hypersensitivity in rats. Eur J Pharmacol 2014; 731:88-92. [PMID: 24632457 DOI: 10.1016/j.ejphar.2014.02.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 02/19/2014] [Accepted: 02/28/2014] [Indexed: 12/20/2022]
Abstract
Irritable bowel syndrome (IBS) and functional dyspepsia (FD) are both functional gastrointestinal disorders and frequently co-occur in patients. While one cause of FD appears to be gastric hypersensitivity, whether the hypersensitivity is affected by IBS treatments remains unclear, given the lack of appropriate animal models for testing. Here, we established an experimental model of duodenal acidification-induced gastric hypersensitivity in conscious rats. The model involved duodenal acidification induced by the infusion of hydrochloric acid into the proximal duodenum, with the nociceptive response being determined as the change in mean arterial pressure (MAP) during gastric distension via an indwelling latex balloon. Using our model we evaluated the effects of duodenal acidification, increased distension pressure, and orally administered therapeutic agents for IBS with diarrhea (IBS-D). Duodenal acidification enhanced the pressor response during gastric distension, and pretreatment with the opioid κ-receptor agonist fedotozine (10mg/kg, intra-arterial) inhibited the pressor response. Pressure levels of 15-60 mm Hg increased MAP in response to gastric distension. The serotonin 5-HT3 receptor antagonist ramosetron (30 μg/kg) inhibited MAP increase induced by duodenal acidification, with no other IBS-D therapeutic agents showing any effect. In contrast, the serotonin 5-HT3 receptor agonist m-chlorophenylbiguanide (1mg/kg) significantly enhanced the pressor response during gastric distension. These findings indicate that the serotonin 5-HT3 receptor plays a key role in duodenal acidification-induced gastric hypersensitivity in rats, suggesting that ramosetron may reduce FD symptoms by ameliorating sensitized gastric perception.
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Affiliation(s)
- Mari Nakata-Fukuda
- Pharmacology Research Labs., Drug Discovery Research, Astellas Pharma Inc., 21 Miyukigaoka, Tsukuba, Ibaraki 305-8585, Japan; Department of Cell Biology and Neuroscience, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
| | - Takuya Hirata
- Pharmacology Research Labs., Drug Discovery Research, Astellas Pharma Inc., 21 Miyukigaoka, Tsukuba, Ibaraki 305-8585, Japan
| | - Yoshihiro Keto
- Pharmacology Research Labs., Drug Discovery Research, Astellas Pharma Inc., 21 Miyukigaoka, Tsukuba, Ibaraki 305-8585, Japan
| | - Mayumi Yamano
- Pharmacology Research Labs., Drug Discovery Research, Astellas Pharma Inc., 21 Miyukigaoka, Tsukuba, Ibaraki 305-8585, Japan
| | - Toshihide Yokoyama
- Pharmacology Research Labs., Drug Discovery Research, Astellas Pharma Inc., 21 Miyukigaoka, Tsukuba, Ibaraki 305-8585, Japan
| | - Yasuo Uchiyama
- Department of Cell Biology and Neuroscience, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
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Lummis SCR, Thompson AJ. Agonists and antagonists induce different palonosetron dissociation rates in 5-HT₃A and 5-HT₃AB receptors. Neuropharmacology 2013; 73:241-6. [PMID: 23747573 PMCID: PMC3778450 DOI: 10.1016/j.neuropharm.2013.05.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 04/19/2013] [Accepted: 05/08/2013] [Indexed: 11/30/2022]
Abstract
Palonosetron is a potent 5-HT3 receptor antagonist with a unique structure and some unusual properties. Here we explore the properties of palonosetron at heterologously expressed 5-HT3A and 5-HT3AB receptors. We used receptors expressed in HEK293 cells, and functionally analysed them using a membrane potential sensitive dye in a Flexstation, which revealed IC50s of 0.24 nM and 0.18 nM for 5-HT3A and 5-HT3AB receptors respectively. Radioligand binding studies with [3H]palonosetron revealed similar Kds: 0.34 nM for 5-HT3A and 0.15 nM for 5-HT3AB receptors. Kinetic studies showed palonosetron association and dissociation rates were slightly faster in 5-HT3AB than 5-HT3A receptors, and for both subtypes dissociation rates were ligand-dependent, with antagonists causing more rapid dissociation than agonists. Similar ligand effects were not observed for [3H]granisetron dissociation studies. These data support previous studies which show palonosetron has actions distinct to other 5-HT3 receptor antagonists, and the slow rates observed for agonist induced dissociation (t1/2 > 10 h) could at least partly explain the long duration of palonosetron effects in vivo. Palonosetron IC50s and Kds for 5-HT3A and 5-HT3AB receptors in HEK293 cells are similar. Palonosetron association and dissociation rates are slower at 5-HT3A than 5-HT3AB receptors. Agonist-induced palonosetron dissociation rates are slower than those for antagonists in both 5-HT3A and 5-HT3AB receptors. Agonist- and antagonist-induced granisetron dissociation rates are similar in both 5-HT3A and 5-HT3AB receptors. Palonosetron and granisetron have distinct actions.
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Affiliation(s)
- Sarah C R Lummis
- Department of Biochemistry, University of Cambridge, Tennis Court Road, Cambridge CB2 1QW, UK.
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24
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Chiba T, Yamamoto K, Sato S, Suzuki K. Long-term efficacy and safety of ramosetron in the treatment of diarrhea-predominant irritable bowel syndrome. Clin Exp Gastroenterol 2013; 6:123-8. [PMID: 23922505 PMCID: PMC3728153 DOI: 10.2147/ceg.s32721] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Irritable bowel syndrome (IBS) is a functional disease with persisting gastrointestinal symptoms that has been classified into four subtypes. Serotonin (5-hydroxytryptamine [5-HT]) plays important physiological roles in the contraction and relaxation of smooth muscle. Intraluminal distension of the intestine is known to stimulate the release of endogenous 5-HT from enterochromaffin cells, activating 5-HT3 receptors located on primary afferent neurons and leading to increases in intestinal secretions and peristaltic activity. Ramosetron, a potent and selective 5-HT3-receptor antagonist, has been in development for use in patients suffering from diarrhea-predominant IBS. In a double-blind, placebo-controlled, parallel-group study of 418 patients with diarrhea-predominant IBS-D, once-daily 5 μg and 10 μg doses of ramosetron increased the monthly responder rates of IBS symptoms compared to placebo. In a 12-week randomized controlled trial of 539 patients, a positive response to treatment was reported by 47% of a once-daily 5 μg dose of ramosetron-treated individuals compared to 27% of patients receiving placebo (P<0.001). Furthermore, the responder rate was increased in the oral administration of 5 μg of ramosetron for at least 28 weeks (up to 52 weeks), and long-term efficacy for overall improvement of IBS symptoms was also demonstrated. The rate was further increased subsequently. Adverse events were reported by 7% in ramosetron treatment. No serious adverse events, eg, severe constipation or ischemic colitis, were reported for long-term treatment with ramosetron. In conclusion, further studies to evaluate the long-term efficacy and safety of ramosetron are warranted in the form of randomized controlled trials.
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Affiliation(s)
- Toshimi Chiba
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Iwate, Japan
- Correspondence: Toshimi Chiba, Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Iwate Medical University, 19-1 Uchimaru Morioka, Iwate 020-8505, Japan Tel +81 19 651 5111 Fax +81 19 652 6664 Email
| | - Kazunari Yamamoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Iwate, Japan
| | - Shoko Sato
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Iwate, Japan
| | - Kazuyuki Suzuki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Iwate, Japan
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Hirata T, Keto Y, Yamano M, Yokoyama T, Sengoku T, Seki N. Inhibitory effect of ramosetron on corticotropin releasing factor- and soybean oil-induced delays in gastric emptying in rats. J Gastroenterol Hepatol 2012; 27:1505-11. [PMID: 22554268 DOI: 10.1111/j.1440-1746.2012.07172.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND AIM Symptoms of functional dyspepsia (FD) are highly prevalent in patients with irritable bowel syndrome (IBS). However, the effects of therapeutic agents for IBS on the pathophysiology of FD are unclear. In this study, therefore, we examined the effects of ramosetron, a serotonin 5-HT(3) receptor antagonist, on corticotropin releasing factor (CRF)- and soybean oil-induced delays in gastric emptying of rats, in comparison with anti-diarrheal agent and spasmolytics. The involvement of 5-HT and the 5-HT(3) receptor in delayed gastric emptying was also evaluated. METHODS Corticotropin releasing factor was administered intravenously to rats 10min before oral administration of 0.05% phenol red solution, and the amount remaining in the stomach was measured after 30min. Soybean oil was administered orally with glass beads, and the number of residual beads in the stomach was counted 1h later. RESULTS Both CRF and soybean oil inhibited gastric emptying dose-dependently. Ramosetron and itopride, a gastro-prokinetic agent, significantly reduced both CRF- and soybean oil-induced delays in gastric emptying, while an anti-diarrheal agent and spasmolytics aggravated them. Pretreatment with p-chlorophenylalanine for 2days to reduced the synthesis of endogenous 5-HT diminished the effects of both CRF and soybean oil on gastric emptying. A 5-HT(3) receptor agonist m-chlorophenylbiguanide suppressed gastric emptying of both phenol red and glass beads, and those effects were reversed by ramosetron. CONCLUSIONS These results suggest that CRF and soybean oil suppress gastric emptying in rats by activating 5-HT(3) receptors, and that by antagonizing these receptors, ramosetron may ameliorate symptoms of FD in clinical settings.
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Affiliation(s)
- Takuya Hirata
- Applied Pharmacology Research Laboratories, Drug Discovery Research, Astellas Pharma Inc., Tsukuba, Ibaraki, Japan.
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Lee JW, Park HJ, Choi J, Park SJ, Kang H, Kim EG. Comparison of ramosetron's and ondansetron's preventive anti-emetic effects in highly susceptible patients undergoing abdominal hysterectomy. Korean J Anesthesiol 2011; 61:488-92. [PMID: 22220226 PMCID: PMC3249571 DOI: 10.4097/kjae.2011.61.6.488] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 05/20/2011] [Accepted: 05/31/2011] [Indexed: 12/04/2022] Open
Abstract
Background This study compared the preventive effects of ramosetron and ondansetron on postoperative nausea and vomiting (PONV) in highly susceptible patients undergoing abdominal hysterectomy. Methods In a prospective, randomized, double-blinded study, a total of 120 highly susceptible women (nonsmokers, those receiving opioid-based IV patient-controlled analgesia [PCA]) undergoing abdominal hysterectomy were included in the study. Patients were divided into 2 groups and each group received either 0.3 mg of ramosetron or 4 mg of ondansetron, IV. All patients received fentanyl-based IV PCA during the 48 h postoperative periods. The incidences of PONV and side effects of 5-HT3 antagonists (headache and dizziness) were assessed at 3 intervals (<2 h, 2-24 h and 24-48 h) postoperatively. Results Patients in the ramosetron group showed a significantly higher ratio of complete response and lower incidence of nausea during the 24-48 h interval after surgery compared with those the ondansetron group. Conclusions Ramosetron (0.3 mg) is more effective in preventing delayed PONV in highly susceptible women undergoing abdominal hysterectomy compared with ondansetron (4 mg).
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Affiliation(s)
- Jae-Woo Lee
- Deparment of Anesthesiology and Pain Medicine, Eulji General Hospital, College of Medicine, Eulji University, Seoul, Korea
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Hirata T, Funatsu T, Keto Y, Akuzawa S, Akiho H, Nishida A, Sasamata M, Miyata K. [Pharmacological and clinical profile of ramosetron hydrochloride (Irribow), a novel therapeutic agent for irritable bowel syndrome with diarrhea]. Nihon Yakurigaku Zasshi 2009; 133:281-291. [PMID: 19443966 DOI: 10.1254/fpj.133.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Preoperatively administered ramosetron oral disintegrating tablets for preventing nausea and vomiting associated with patient-controlled analgesia in breast cancer patients. Eur J Anaesthesiol 2008; 25:756-62. [DOI: 10.1017/s0265021508004262] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Hammerle CW, Surawicz CM. Updates on treatment of irritable bowel syndrome. World J Gastroenterol 2008; 14:2639-49. [PMID: 18461649 PMCID: PMC2709043 DOI: 10.3748/wjg.14.2639] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Revised: 01/17/2008] [Indexed: 02/06/2023] Open
Abstract
Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder characterized by abdominal pain and discomfort in association with altered bowel habits. It is estimated to affect 10%-15% of the Western population, and has a large impact on quality of life and (in)direct healthcare costs. IBS is a multifactorial disorder involving dysregulation within the brain-gut axis, and it is frequently associated with gastrointestinal motor and sensory dysfunction, enteric and central nervous system irregularities, neuroimmune dysregulation, and post-infectious inflammation. As with other functional medical disorders, the treatment for IBS can be challenging. Conventional therapy for those with moderate to severe symptoms is largely unsatisfactory, and the development of new and effective drugs is made difficult by the complex pathogenesis, variety of symptoms, and lack of objective clinical findings that are the hallmark of this disorder. Fortunately, research advances over the past several decades have provided insight into potential mechanisms responsible for the pathogenesis of IBS, and have led to the development of several promising pharmaceutical agents. In recent years there has been much publicity over several of these new IBS medications (alosetron and tegaserod) because of their reported association with ischemic colitis and cardiovascular disease. While these agents remain available for use under restricted prescribing programs, this highlights the need for continued development of safe and effective medication for IBS. This article provides a physiologically-based overview of recently developed and frequently employed pharmaceutical agents used to treat IBS, and discusses some non-pharmaceutical options that may be beneficial in this disorder.
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Hirata T, Keto Y, Nakata M, Takeuchi A, Funatsu T, Akuzawa S, Sasamata M, Miyata K. Effects of serotonin 5-HT3 receptor antagonists on stress-induced colonic hyperalgesia and diarrhoea in rats: a comparative study with opioid receptor agonists, a muscarinic receptor antagonist and a synthetic polymer. Neurogastroenterol Motil 2008; 20:557-65. [PMID: 18221252 DOI: 10.1111/j.1365-2982.2007.01069.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
In this study, we examined the effects of serotonin (5-HT)3 receptor antagonists (5-HT3RAs) including ramosetron, alosetron, and cilansetron on colonic nociceptive threshold in rats. Furthermore, we established a restraint stress-induced colonic hyperalgesia model in rats, and compared the inhibitory effects of 5-HT3RAs on restraint stress-induced colonic hyperalgesia and diarrhoea with those of loperamide, trimebutine, tiquizium and polycarbophil. The colonic nociceptive threshold was measured as the balloon pressure at the time the rat showed a nociceptive response during colonic distension by an intrarectally inserted balloon. Oral administration of ramosetron (3-30 microg kg(-1)), alosetron (30-300 microg kg(-1)), or cilansetron (30-300 microg kg(-1)) increased the colonic nociceptive threshold in a dose-dependent manner in non-stressed rats. Restraint stress for 1 h significantly decreased the colonic nociceptive threshold, but ramosetron (0.3-3 microg kg(-1)), alosetron (3-30 microg kg(-1)), cilansetron (3-30 microg kg(-1)) and trimebutine (100-1000 mg kg(-1)) significantly inhibited the decrease in the threshold. Loperamide (3-30 mg kg(-1)), tiquizium (100-1000 mg kg(-1)) and polycarbophil (1000 mg kg(-1)) did not affect the restraint stress-induced decrease in the colonic nociceptive threshold. All drugs tested in this study showed dose-dependent inhibition of restraint stress-induced diarrhoea in rats. These results indicate that, unlike existing antidiarrhoeal and spasmolytic agents, 5-HT3RAs have inhibitory effects on colonic nociception, and prevented restraint stress-induced both diarrhoea and hyperalgesia at almost the same doses in rats. This suggests that the 5-HT3RAs may be useful in ameliorating both colonic hyperalgesia and diarrhoea in patients with irritable bowel syndrome.
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Affiliation(s)
- T Hirata
- Applied Pharmacology Research Laboratories, Drug Discovery Research, Astellas Pharma Inc., Tsukuba, Ibaraki, Japan.
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Effects of serotonin 5-HT(3) receptor antagonists on CRF-induced abnormal colonic water transport and defecation in rats. Eur J Pharmacol 2008; 587:281-4. [PMID: 18456254 DOI: 10.1016/j.ejphar.2008.03.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2008] [Accepted: 03/20/2008] [Indexed: 11/19/2022]
Abstract
The effects of corticotropin releasing factor (CRF) and serotonin (5-HT)(3) receptor antagonists on intestinal water transport are not well understood. Hence, we established a CRF-induced abnormal water transport model in rat colon, and evaluated the effects of 5-HT(3) receptor antagonists including ramosetron, alosetron, and cilansetron, and the antidiarrheal agent loperamide, in this model. In addition, the effects of 5-HT(3) receptor antagonists and loperamide on abnormal defecation induced by CRF in rats were examined. Colonic water transport was measured in colonic loops in conscious rats. Centrally administered CRF (3-30 microg/kg) markedly decreased colonic fluid loss, whereas oral administration of ramosetron (3, 30 microg/kg), alosetron (300 microg/kg), cilansetron (300 microg/kg), or loperamide (3 mg/kg) significantly inhibited it. Ramosetron (1-10 microg/kg), alosetron (10-100 microg/kg), cilansetron (10-100 microg/kg), or loperamide (0.3-3 mg/kg) also showed dose-dependent inhibition of CRF-induced defecation in rats. These results suggest that 5-HT(3) receptors are involved in both abnormal colonic water transport and defecation induced by CRF, and that the inhibitory effects of 5-HT(3) receptor antagonists on CRF-induced abnormal defecation partly result from their ameliorating action on colonic water transport.
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Holmes A. Genetic variation in cortico-amygdala serotonin function and risk for stress-related disease. Neurosci Biobehav Rev 2008; 32:1293-314. [PMID: 18439676 DOI: 10.1016/j.neubiorev.2008.03.006] [Citation(s) in RCA: 198] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Accepted: 02/20/2008] [Indexed: 01/09/2023]
Abstract
The serotonin system is strongly implicated in the pathophysiology and therapeutic alleviation of stress-related disorders such as anxiety and depression. Serotonergic modulation of the acute response to stress and the adaptation to chronic stress is mediated by a myriad of molecules controlling serotonin neuron development (Pet-1), synthesis (tryptophan hydroxylase 1 and 2 isozymes), packaging (vesicular monoamine transporter 2), actions at presynaptic and postsynaptic receptors (5-HT1A, 5-HT1B, 5-HT2A, 5-HT2C, 5-HT3A, 5-HT4, 5-HT5A, 5-HT6, 5-HT7), reuptake (serotonin transporter), and degradation (monoamine oxidase A). A growing body of evidence from preclinical rodents models, and especially genetically modified mice and inbred mouse strains, has provided significant insight into how genetic variation in these molecules can affect the development and function of a key neural circuit between the dorsal raphe nucleus, medial prefrontal cortex and amygdala. By extension, such variation is hypothesized to have a major influence on individual differences in the stress response and risk for stress-related disease in humans. The current article provides an update on this rapidly evolving field of research.
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Affiliation(s)
- Andrew Holmes
- Section on Behavioral Science and Genetics, Laboratory for Integrative Neuroscience, National Institute on Alcoholism and Alcohol Abuse, NIH, 5625 Fishers Lane Room 2N09, Rockville, MD 20852-9411, USA.
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Hirata T, Funatsu T, Keto Y, Akuzawa S, Sasamata M, Miyata K. Inhibitory Effects of Ramosetron, a Potent and Selective 5-HT3–Receptor Antagonist, on Conditioned Fear Stress–Induced Abnormal Defecation and Normal Defecation in Rats: Comparative Studies With Antidiarrheal and Spasmolytic Agents. J Pharmacol Sci 2008; 106:264-70. [DOI: 10.1254/jphs.fp0071943] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Stacher G. Cilansetron in the treatment of diarrhea-predominant irritable bowel syndrome? Expert Rev Gastroenterol Hepatol 2007; 1:15-27. [PMID: 19072430 DOI: 10.1586/17474124.1.1.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Information on the 5-hydroxytryptamine type 3 receptor antagonist cilansetron is scarce and most studies have only been published in abstract form. Results from preclinical and two dose-finding studies have suggested that cilansetron could be effective in the treatment of patients with diarrhea-predominant irritable bowel syndrome. Two large efficacy and safety trials extending over 3 and 6 months revealed a superiority of cilansetron 2 mg orally three-times daily over placebo reflected by numbers needed to treat of 4.8 and 5.6, respectively, for the parameter proportion of patients reporting adequate symptom relief. Dose-ranging studies showed no dose-response relationship. Cilansetron tended to induce constipation but, apart from transient ischemic colitis in four out of 1484 cases, no serious adverse effects were observed. Further trials are underway to fully determine the role of cilansetron in the treatment of diarrhea-predominant irritable bowel syndrome.
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Affiliation(s)
- Georg Stacher
- Professor, Medical University of Vienna, Psychophysiology Unit, Department of Surgery, A-1090 Wien, Austria.
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