B Coulie1, J Tack, T Peeters, J Janssens. 1. Department of Internal Medicine, University Hospital Gasthuisberg, Catholic University of Leuven, Belgium.
Abstract
BACKGROUND: During the interdigestive state in humans, erythromycin 40 mg induces a premature activity front that starts in the stomach, while erythromycin 200 mg induces a prolonged period of enhanced antral contractile activity. AIMS: To study the involvement of a cholinergic pathway in the motor effects of erythromycin using the muscarinic antagonist atropine and the neural 5-HT1 receptor agonist sumatriptan. METHODS: In 30 healthy volunteers, fasted antroduodenojejunal motor activity was studied by stationary manometry. Placebo (n = 10), atropine (15 micrograms/kg intravenous bolus plus 15 micrograms/kg/h over 30 minutes; n = 10), or sumatriptan (6 mg subcutaneously; n = 10) was administered, followed by infusion of erythromycin 40 mg or 200 mg. RESULTS: After placebo, erythromycin 40 mg induced a premature activity front with gastric onset after 19.1 (1.7) minutes in all volunteers. After atropine, erythromycin 40 mg failed to induce a premature activity front during a 60 minute period in all volunteers (p < 0.001), while sumatriptan prevented the induction of a premature activity front during a 60 minute period in all but one volunteer (p < 0.005). The number of antral contractions and their mean amplitude in the 60 minutes after erythromycin 200 mg did not differ significantly after atropine or sumatriptan versus placebo. CONCLUSIONS: The antral motor effects of erythromycin in humans are mediated via different pathways. The induction of a premature activity front is mediated through activation of an intrinsic cholinergic pathway, while the induction of enhanced antral contractile activity may be mediated via a pathway potentially involving activation of a muscular receptor.
RCT Entities:
BACKGROUND: During the interdigestive state in humans, erythromycin 40 mg induces a premature activity front that starts in the stomach, while erythromycin 200 mg induces a prolonged period of enhanced antral contractile activity. AIMS: To study the involvement of a cholinergic pathway in the motor effects of erythromycin using the muscarinic antagonist atropine and the neural 5-HT1 receptor agonist sumatriptan. METHODS: In 30 healthy volunteers, fasted antroduodenojejunal motor activity was studied by stationary manometry. Placebo (n = 10), atropine (15 micrograms/kg intravenous bolus plus 15 micrograms/kg/h over 30 minutes; n = 10), or sumatriptan (6 mg subcutaneously; n = 10) was administered, followed by infusion of erythromycin 40 mg or 200 mg. RESULTS: After placebo, erythromycin 40 mg induced a premature activity front with gastric onset after 19.1 (1.7) minutes in all volunteers. After atropine, erythromycin 40 mg failed to induce a premature activity front during a 60 minute period in all volunteers (p < 0.001), while sumatriptan prevented the induction of a premature activity front during a 60 minute period in all but one volunteer (p < 0.005). The number of antral contractions and their mean amplitude in the 60 minutes after erythromycin 200 mg did not differ significantly after atropine or sumatriptan versus placebo. CONCLUSIONS: The antral motor effects of erythromycin in humans are mediated via different pathways. The induction of a premature activity front is mediated through activation of an intrinsic cholinergic pathway, while the induction of enhanced antral contractile activity may be mediated via a pathway potentially involving activation of a muscular receptor.
Authors: J Tack; J Janssens; G Vantrappen; T Peeters; V Annese; I Depoortere; E Muls; R Bouillon Journal: Gastroenterology Date: 1992-07 Impact factor: 22.682
Authors: J Janssens; T L Peeters; G Vantrappen; J Tack; J L Urbain; M De Roo; E Muls; R Bouillon Journal: N Engl J Med Date: 1990-04-12 Impact factor: 91.245
Authors: P C Ng; K W So; K S Fung; C H Lee; T F Fok; E Wong; W Wong; K L Cheung; A F Cheng Journal: Arch Dis Child Fetal Neonatal Ed Date: 2001-05 Impact factor: 5.747
Authors: Kate V Everett; Barry A Chioza; Christina Georgoula; Ashley Reece; Francesca Capon; Keith A Parker; Cathy Cord-Udy; Paul McKeigue; Sally Mitton; Agostino Pierro; Prem Puri; Hannah M Mitchison; Eddie M K Chung; R Mark Gardiner Journal: Am J Hum Genet Date: 2008-02-28 Impact factor: 11.025
Authors: G Parthasarathy; K Ravi; M Camilleri; C Andrews; L A Szarka; P A Low; A R Zinsmeister; A E Bharucha Journal: Neurogastroenterol Motil Date: 2015-09-20 Impact factor: 3.598