Hung Jui-Sheng, Lei Wei-Yi, Yi Chih-Hsun, Liu Tso-Tsai, Wong Ming-Wun, Liang Shu-Wei, Chen Chien-Lin
Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and School of Medicine, Tzu Chi University, Hualien, Taiwan.
School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan.
J Neurogastroenterol Motil. 2024 Oct 30;30(4):447-452. doi: 10.5056/jnm23098.
BACKGROUND/AIMS: Activation of the cold receptor, transient receptor potential melastatin 8 (TRPM8) by menthol inhibits esophageal secondary peristalsis in healthy adults. Ineffective esophageal motility (IEM) is common. This study is to evaluate the effects of acute infusion of menthol on esophageal peristalsis in patients with IEM.
Twenty patients with IEM (males 11, mean age 36) were studied for esophageal peristalsis using high-resolution manometry. All participant had primary peristalsis performed with 10 water swallows and secondary peristalsis generated with 10 rapid air injections of 20 mL via mid-esophageal infusion port. Two different sessions by randomly performing acute administration of placebo or menthol (3 mM) were used for testing their effects on esophageal peristalsis.
Menthol infusion had no effects on distal contractile integral ( = 0.471), distal latency ( = 0.58), or complete peristalsis ( = 0.251). Menthol infusion did not change basal lower esophageal sphincter pressure ( = 0.321), esophagogastric junction contractile integral ( = 0.758), or integrated relaxation pressure ( = 0.375) of primary peristalsis, but reduced upper esophageal sphincter pressure ( = 0.037). Infusion of menthol significantly reduced the frequency of secondary peristalsis for air injects of 20 mL ( = 0.002), but did not affect distal contractile integral of secondary peristalsis for air injections of 20 mL.
This work has suggested that activation of TRPM8 by menthol can attenuate mechanosensitivity of secondary peristalsis in response to rapid air distension regardless of the presence of IEM.
背景/目的：在健康成年人中，薄荷醇激活冷感受器瞬时受体电位香草酸亚型8（TRPM8）可抑制食管继发性蠕动。无效食管动力（IEM）很常见。本研究旨在评估急性输注薄荷醇对IEM患者食管蠕动的影响。
采用高分辨率测压法对20例IEM患者（男11例，平均年龄36岁）的食管蠕动进行研究。所有参与者通过吞咽10次水来进行原发性蠕动，并通过经食管中段输注端口快速注入10次20 mL空气来产生继发性蠕动。通过随机进行安慰剂或薄荷醇（3 mM）的急性给药的两个不同时段来测试它们对食管蠕动的影响。
输注薄荷醇对远端收缩积分（P = 0.471）、远端潜伏期（P = 0.58）或完全蠕动（P = 0.251）无影响。输注薄荷醇对原发性蠕动的基础下食管括约肌压力（P = 0.321）、食管胃交界收缩积分（P = 0.758）或综合松弛压力（P = 0.375）无改变，但降低了上食管括约肌压力（P = 0.037）。输注薄荷醇显著降低了20 mL空气注入时继发性蠕动的频率（P = 0.002），但不影响20 mL空气注入时继发性蠕动的远端收缩积分。
这项研究表明，无论是否存在IEM，薄荷醇激活TRPM8均可减弱继发性蠕动对快速空气扩张的机械敏感性。
