State Key Laboratory of Pharmaceutical Biotechnology and Department of Physiology, School of Life Sciences, Nanjing University, Nanjing, China.
Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China; Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany.
Biomed Pharmacother. 2022 Sep;153:113344. doi: 10.1016/j.biopha.2022.113344. Epub 2022 Jul 1.
Betahistine and gastrodin are the first-line medications for vestibular disorders in clinical practice, nevertheless, their amelioration effects on vestibular dysfunctions still lack direct comparison and their unexpected extra-vestibular effects remain elusive. Recent clinical studies have indicated that both of them may have effects on the gastrointestinal (GI) tract. Therefore, we purposed to systematically compare both vestibular and GI effects induced by betahistine and gastrodin and tried to elucidate the mechanisms underlying their GI effects. Our results showed that betahistine and gastrodin indeed had similar therapeutic effects on vestibular-associated motor dysfunction induced by unilateral labyrinthectomy. However, betahistine reduced total GI motility with gastric hypomotility and colonic hypermotility, whereas gastrodin did not influence total GI motility with only slight colonic hypermotility. In addition, betahistine, at normal dosages, induced a slight injury of gastric mucosa. These GI effects may be due to the different effects of betahistine and gastrodin on substance P and vasoactive intestinal peptide secretion in stomach and/or colon, and agonistic/anatgonistic effects of betahistine on histamine H1 and H3 receptors expressed in GI mucosal cells and H3 receptors distributed on nerves within the myenteric and submucosal plexuses. Furthermore, treatment of betahistine and gastrodin had potential effects on gut microbiota composition, which could lead to changes in host-microbiota homeostasis in turn. These results demonstrate that gastrodin has a consistent improvement effect on vestibular functions compared with betahistine but less effect on GI functions and gut microbiota, suggesting that gastrodin may be more suitable for vestibular disease patients with GI dysfunction.
甲磺酸倍他司汀和天麻素是临床前庭疾病的一线治疗药物,但它们对前庭功能障碍的改善作用仍缺乏直接比较,其意外的前庭外作用仍不清楚。最近的临床研究表明,两者可能对胃肠道(GI)有影响。因此,我们旨在系统比较甲磺酸倍他司汀和天麻素引起的前庭和胃肠道作用,并试图阐明其胃肠道作用的机制。我们的结果表明,甲磺酸倍他司汀和天麻素确实对单侧迷路切除引起的前庭相关运动功能障碍有相似的治疗作用。然而,甲磺酸倍他司汀降低了总胃肠道动力,导致胃动力不足和结肠动力过度,而天麻素不影响总胃肠道动力,仅引起轻微的结肠动力过度。此外,甲磺酸倍他司汀在正常剂量下引起胃黏膜轻微损伤。这些胃肠道作用可能是由于甲磺酸倍他司汀和天麻素对胃和/或结肠中 P 物质和血管活性肠肽分泌的不同影响,以及甲磺酸倍他司汀在胃肠道黏膜细胞中表达的组胺 H1 和 H3 受体以及分布在肌间和黏膜下神经丛中的 H3 受体的激动/拮抗作用。此外,甲磺酸倍他司汀和天麻素的治疗可能对肠道微生物群组成有潜在影响,这反过来又会导致宿主-微生物群平衡的变化。这些结果表明,天麻素与甲磺酸倍他司汀相比对前庭功能有一致的改善作用,但对胃肠道功能和肠道微生物群的影响较小,提示天麻素可能更适合有胃肠道功能障碍的前庭疾病患者。