Miura M, Lawson D C, Clary E M, Mangel A W, Pappas T N
Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Dig Dis Sci. 1999 Jan;44(1):20-4. doi: 10.1023/a:1026633629141.
Irritable bowel syndrome (IBS) represents one of the most common gastrointestinal-related diagnoses. Although the precise etiologic basis of IBS is not known, a common presenting symptom is abdominal pain or discomfort that is thought to develop, at least in part, from a heightened awareness of visceral nociceptive input. Agents capable of reducing this heightened visceral nociception would, therefore, have utility in the treatment of IBS. In this study we evaluated the effects of intravenous and intracerebroventricular administration of a 5-HT3 receptor antagonist, alosetron, on blood pressure changes associated with rectal distension in anesthetized and awake dogs. This vasoactive reflex serves as a model for visceral nociception. For intracerebroventricular studies, the cerebroventricular guides were placed over the lateral ventricle. In anesthetized studies, blood pressure was measured by femoral artery cannulation. In awake studies, blood pressure was monitored by noninvasive measurement. A rectal balloon was placed in the rectum of each dog and maintained throughout the experiments. Each dose of alosetron was given to the dogs as an intravenous or intracerebroventricular bolus, and every 30 min the rectal balloon was inflated and blood pressure responses observed. In both anesthetized and awake dogs alosetron produced a significant inhibition of the vasoactive reflex. In particular, alosetron showed high potency when administered intracerebroventricularly. Alosetron, administered either centrally or peripherally, appears to modulate the visceral nociceptive effect of rectal distension in dogs.
肠易激综合征(IBS)是最常见的胃肠道相关诊断之一。尽管IBS的确切病因尚不清楚,但常见的症状是腹痛或不适,这种症状至少部分被认为是由于内脏伤害性传入的感知增强所致。因此,能够减轻这种增强的内脏痛觉的药物将对IBS的治疗有用。在本研究中,我们评估了静脉内和脑室内给予5-HT3受体拮抗剂阿洛司琼对麻醉和清醒犬直肠扩张相关血压变化的影响。这种血管活性反射可作为内脏痛觉的模型。对于脑室内研究,将脑室导管置于侧脑室上方。在麻醉研究中,通过股动脉插管测量血压。在清醒研究中,通过无创测量监测血压。在每只犬的直肠中放置一个直肠球囊,并在整个实验过程中保持。将每剂阿洛司琼作为静脉内或脑室内推注给予犬,每30分钟将直肠球囊充气并观察血压反应。在麻醉和清醒的犬中,阿洛司琼均对血管活性反射产生了显著抑制作用。特别是,脑室内给予阿洛司琼时显示出高效能。无论是中枢给药还是外周给药,阿洛司琼似乎都能调节犬直肠扩张的内脏痛觉效应。