Komoto Shunsuke, Miura Soichiro
Second Department of Internal Medicine, National Defense Medical College.
Nihon Rinsho. 2006 Aug;64(8):1487-90.
Irritable bowel syndrome (IBS) is a common chronic gastrointestinal (GI) disorder, but its pathophysiology remains unknown. 5-hydroxytryptamine (5-HT, serotonin) is an important neurotransmitter involved in the brain-gut connection. Alosetron, a 5-HT3 receptor antagonist, has been demonstrated in randomized, placebo-controlled trials (RCT) to be effective in diarrhea-predominant IBS(IBS-D). Constipation is the most common adverse event. Alosetron improved abdominal pain and discomfort and stool consistency in both female and male patients, but it did not improve other symptoms (sense of urgency, stool frequency and bloating) in male patients. Although less is known about the gender differences in therapeutic benefit, a new 5-HT3 antagonist, cilansetron, has demonstrated effectiveness in male and female IBS-D patients and is currently under clinical trials.
肠易激综合征(IBS)是一种常见的慢性胃肠道疾病,但其病理生理学仍不清楚。5-羟色胺(5-HT,血清素)是一种参与脑-肠联系的重要神经递质。阿洛司琼,一种5-HT3受体拮抗剂,已在随机、安慰剂对照试验(RCT)中被证明对腹泻型肠易激综合征(IBS-D)有效。便秘是最常见的不良事件。阿洛司琼改善了女性和男性患者的腹痛和不适以及大便性状,但对男性患者的其他症状(急迫感、大便频率和腹胀)没有改善。尽管关于治疗益处的性别差异了解较少,但一种新的5-HT3拮抗剂西兰司琼已在男性和女性IBS-D患者中显示出有效性,目前正在进行临床试验。