Metoclopramide does not increase gastric muscle contractility in newborn rats

Prokinetic Agents

Gastrointestinal (GI) prokinetic agents are drugs that increase GI motility and promote the movement of contents in the GI tract by amplifying and controlling the contraction of GI smooth muscle. Currently used prokinetics increase GI motility by acting as a dopamine D₂ receptor antagonist (e.g., metoclopramide, domperidone, levosulpiride) and 5-HT₄ receptor agonist (e.g., mosapride, prucalopride). Some prokinetics also have a cholinesterase inhibitory property (e.g., itopride), and herb-derived prokinetics (e.g., motilitone) affect multiple receptors. Depending on the type and distribution of receptors on which the prokinetics bind, the effect(s) may be regional or throughout the GI tract. Most prokinetics have been used for functional dyspepsia and gastroparesis because they mainly affect upper GI motility. However, prucalopride, a highly selective 5-HT₄ receptor agonist, is used primarily to treat chronic constipation and pseudo-obstruction. Dopamine D₂ receptor antagonists also inhibit the D₂ receptor in the medulla oblongata chemoreceptor trigger zone; therefore, they can treat nausea and vomiting. However, short term use of dopamine D₂ antagonists at an appropriate dose is recommended because of their potential for central nervous system side effects by penetrating the blood-brain barrier. It is necessary to know the mechanism of action, each clinical trial’s characteristics, and the side effects of prokinetics to obtain the best clinical outcomes. This article aims to summarize the results of clinical studies related to the impact of currently available prokinetic agents in Korea on GI motility.

Berberine Depresses Contraction of Smooth Muscle via Inhibiting Myosin Light-chain Kinase

BACKGROUND

Berberine is a natural isoquinoline alkaloid possessing various pharmacological effects, particularly apparent in the treatment of diarrhea, but the underlying mechanism remains unclear. Smooth muscle myosin light-chain kinase (MLCK) plays a crucial role in the smooth muscle relaxation-contraction events, and it is well known that berberine can effectively depress the contraction of smooth muscle. Hence, whether berberine could inhibit MLCK and then depress the smooth muscle contractility might be researched.

OBJECTIVE

The purpose of this study is to investigate the effects of berberine on MLCK. Based on this, the contractility of gastro-intestine, catalysis activity of MLCK, and molecular docking are going to be evaluated.

MATERIALS AND METHODS

The experiment of smooth muscle contraction was directly monitored the contractions of the isolated gastrointestine by frequency and amplitude at different concentration of berberine. The effects of berberine on MLCK were measured in the presence of Ca2+-calmodulin, using the activities of 20 kDa myosin light chain (MLC20) phosphorylation, and myosin Mg2+-ATPase induced by MLCK. The docking study was conducted with expert software in the meantime.

RESULTS

The phosphorylation of myosin and the Mg2+-ATPase activity is reduced in the presence of berberine. Moreover, berberine could inhibit the contractibility of isolated gastric intestine smooth muscle. Berberine could bind to the ATP binding site of MLCK through hydrophobic effect and hydrogen bonding according to the docking study.

CONCLUSION

The present work gives a deep insight into the molecular mechanism for the treatment of diarrhea with berberine, i.e., berberine could suppress the contractility of smooth muscle through binding to MLCK and depressing the catalysis activity of MLCK.

SUMMARY

Berberine significantly reduced the amplitude of contraction in isolated duodenum and gastric strips in ratsBerberine inhibited the phosphorylated extents of MLC20 and Mg2+-ATPase activity of phosphorylated myosin induced by MLCKBerberine binds to the ATP binding site of MLCK by hydrophobic effect and hydrogen bondingBerberine may modulate contraction of smooth muscle by inhibiting MLCK. Abbreviations used: MLCK: Myosin light chain kinase; MLC20: 20 KDa regulating myosin light chain; CaM: Calmodulin.

Postnatal development of the dopaminergic signaling involved in the modulation of intestinal motility in mice

BACKGROUND

Since antidopaminergic drugs are pharmacological agents employed in the management of gastrointestinal motor disorders at all ages, we investigated whether the enteric dopaminergic system may undergo developmental changes after birth.

METHODS

Intestinal mechanical activity was examined in vitro as changes in isometric tension.

RESULTS

In 2-d-old (P2) mice, dopamine induced a contractile effect, decreasing in intensity with age, replaced, at the weaning (day 20), by a relaxant response. Both responses were tetrodotoxin (TTX)-insensitive. In P2, dopaminergic contraction was inhibited by D1-like receptor antagonist and mimicked by D1-like receptor agonist. In 90-d-old (P90) mice, the relaxation was reduced by both D1- and D2-like receptor antagonists, and mimicked by D1- and D2-like receptor agonists. In P2, contraction was antagonized by phospholipase C inhibitor, while in P90 relaxation was antagonized by adenylyl cyclase inhibitor and potentiated by phospholipase C inhibitor. The presence of dopamine receptors was assessed by immunofluorescence. Quantitative real-time polymerase chain reaction (qRT-PCR) revealed a significant increase in D1, D2, and D3 receptor expression in proximal intestine with the age.

CONCLUSION

In mouse small intestine, the response to dopamine undergoes developmental changes shifting from contraction to relaxation at weaning, as the consequence of D2-like receptor recruitment and increased expression of D1 receptors.

Gastric and pyloric sphincter muscle function and the developmental-dependent regulation of gastric content emptying in the rat

Feeding intolerance is a common issue in the care of preterm neonates. The condition manifests as delayed emptying of gastric contents and represents a therapeutic challenge, since the factors accounting for its manifestations are unknown. The main goal of this study was to comparatively investigate the age-related function of rat gastric and pyloric smooth muscle and their putative regulators. We hypothesized that a reduced gastric muscle contraction potential early in life contributes to the delayed gastric emptying of the newborn. Newborn and adult rat gastric (fundus) and pyloric sphincter tissues were comparatively studied in vitro. Shortening of the tissue-specific dissociated smooth muscle cell was evaluated, and expression of the key regulatory proteins Rho-associated kinase 2 and myosin light chain kinase was determined. Gastric and pyloric smooth muscle cell shortening was significantly greater in the adult than the respective newborn counterpart. Expression of myosin light chain kinase and Rho-associated kinase 2 was developmentally regulated and increased with age. Pyloric sphincter muscle expresses a higher neuronal nitric oxide synthase and phosphorylated vasodilator-stimulated phosphoprotein content in newborn than adult tissue. Compared with later in life, the newborn rat gastropyloric muscle has a Ca(2+)-related reduced potential for contraction and the pyloric sphincter relaxation-dependent modulators are overexpressed. To the extent that these rodent data can be extrapolated to humans, the delayed gastric emptying in the newborn reflects reduced stomach muscle contraction potential, as opposed to increased pyloric sphincter tone.

Pharmacologic Treatment for Pediatric Gastroparesis: A Review of the Literature

There have been a number of agents that have been tried for treatment of gastroparesis over the past 3 decades, with varying levels of success. Guidelines exist for the management of gastroparesis in adults; however, even though the cause of gastroparesis in children is similar to that in adults, no guidelines exist for treating pediatric gastroparesis as studies on the topic are limited. With what little information we have on pediatric gastroparesis, medications used in children's studies do not seem to demonstrate the same results as in adult patients with gastroparesis; thus, future studies of whether certain medications are effective for treating pediatric gastroparesis and at what dose still need to be conducted. Pharmacological treatment options for pediatric gastroparesis do not show a clear correlation of resolving or even maintaining gastroparesis-associated symptoms or disease state. This article reviews the available studies of drugs that have shown some efficacy, with an emphasis on pediatric studies.

In situ nasal gel drug delivery: A novel approach for brain targeting through the mucosal membrane

Recently, sustained and controlled drug delivery has become the demand, and research has been undertaken in achieving much better drug product effectiveness, reliability and safety. The in situ polymeric system has gained much attention, to develop a controlled release system. It has been used as a vehicle for local and systemic drug delivery. Nowadays, it has created much interest, because of its characteristics of high vascularization, high permeability, rapid onset of action, low enzymatic degradation, and avoidance of hepatic first pass metabolism. The main aim of this review is to provide knowledge of different mechanisms of nasal absorption and approaches for nasal drug delivery.

In vivo ultrasound assessment of gastric emptying in newborn mice

OBJECTIVES

The aim of the present study was to develop an ultrasonographic approach to comparatively assess gastric emptying in newborn wild-type and guanosine triphosphate cyclohydrolase knockout hph-1 mice, because we previously reported gastroparesis early in life in this strain.

METHODS

Stomach transverse, anteroposterior, and longitudinal ultrasonographic measurements were obtained with a 40-MHz transducer in pups immediately after maternal separation and 4 hours later. A conventional equation was used and the predicted values validated by obtaining postmortem gastric content volume measurements. Wild-type and hph-1 mice gastric emptying rates were comparatively evaluated at 1 to 3 and 5 to 8 days of age, respectively.

RESULTS

The ultrasound equation closely predicted the newborn stomach content volumes with a correlation coefficient (R) of 0.93 and 0.81 (P < 0.01) for measurements obtained on full stomach and after 4 hours of fasting, respectively. In wild-type mice, gastric emptying was age dependent and associated with a greater residual volume at 1 to 3 days (65% ± 7%), as compared with 5- to 8-day-old pups (33% ± 4%; P  < 0.01), after fasting. In contrast, an equal duration of fasting resulted in a significantly greater residual gastric content volume in 5- to 8-day-old hph-1 mice (68%  ± 7%; P < 0.01), as compared with same-age wild-type mice.

CONCLUSIONS

Ultrasonography offers a sensitive and accurate estimate of gastric content volume in newborn mice. In wild-type newborn mice, gastric emptying rate is age dependent and significantly reduced in the immediate postnatal period. The newborn hph-1 mice have a significantly higher gastric residual volume, as compared with wild-type same-age animals.