motilin and Intestinal-Obstruction

To verify the efficacy of electroacupuncture (EA) and acupoint injection on early postoperative intestinal obstruction and explore its mechanism.. One hundred and sixteen cases were divided randomly into two groups. In control group (56 cases), the conventional western medicine was applied, including gastrointestinal decompression, parenteral nutrition (PN), anti-inflammation and supporting therapy. In observation group (60 cases), on the basis of the treatment as control group, EA and acupoint injection with Neostigmine were supplemented. Zusanli (ST 36), Shangjuxu (ST 37)/Xiajuxu (ST 39) and Dachangshu (BL 25) were selected as main points. Before treatment and after 3 days treatment, the levels of plasma interleukint (IL-6), tumor necrosis factor-alpha (TNF-alpha) and motilin (MOT) were determined.. In observation group, the mean recovery time of bowel sound and the mean frequency of passing gas were less than those in control group (both P < 0.01). After treatment, in either group, the levels of IL-6 and TNF-alpha were down-regulated as compared with those before treatment (all P < 0.01). After treatment, in observation group, IL-6 level was (15.2 +/- 4.1) pg/mL and TNF-alpha level was (18.3 +/- 6.5) pg/mL. They were (35.5 +/- 7.2) pg/mL and (52.7 +/- 12.3) pg/mL respectively in control group, indicating significant difference in statistics between two groups (both P < 0.01). In either group, MOT level increased after treatment as compared with that before treatment (both P < 0 01). After treatment, in observation group, the increase of MOT level was superior to that in control group [(190.7 +/- 48. 5 ) pg/mL vs (114.6 +/- 36.9) pg/mL, P < 0.01].. Electroacupuncture and acupoint injection are significantly effective in the treatment of early postoperative intestinal obstruction. This therapy may inhibit the release of inflammatory factors to reduce intestinal wall edema and it may promote MOT secretion to increase intestinal peristalsis. As a result, the recovery of gastrointestinal function is promoted.

Topics: Acupuncture Points; Adult; Aged; Cytokines; Electroacupuncture; Female; Humans; Inflammation; Injections; Intestinal Obstruction; Male; Middle Aged; Motilin; Postoperative Complications

In this study, the effect of 13-norleucine motilin (13-Nle-M) on post-cholecystectomy ileus was assessed in 6 female patients. 13-Nle-M given by continuous i.v. infusion (0.4 mug/kg-h) on the second and third day following surgery did not influence the manifestation and duration of intestinal paralysis in comparison to 6 control patients treated with 0.9% saline. Bowel sounds, however, were more pronounced in the 13-Nle-M-group. Blood pressure and pulse rate were not influenced by the polypeptide, and no other side effects were seen, either.

Topics: Adult; Aged; Cholecystectomy; Clinical Trials as Topic; Drug Evaluation; Female; Gastrointestinal Hormones; Humans; Intestinal Obstruction; Intestinal Pseudo-Obstruction; Middle Aged; Motilin; Placebos; Postoperative Complications

The effects of SK-896, a new human motilin analogue ([Leu13]motilin-Hse), on digestive tract motility in postoperative ileus were evaluated in a dog model of ileus after laparotomy. SK-896 was intravenously administered at 0.17, 0.33 and 0.67 microg/kg starting soon after operation and then at 6-h intervals, for a total of 9 times. SK-896 progressively, dose-dependently and significantly increased the duodenal motility from 1 h after operation. The recovery time of the gastrointestinal-interdigestive migrating complex (GI-IMC) activity, which is an indicator of normal gastrointestinal tract activity after laparotomy, was 56.5 +/- 5.0 h in the control group. SK-896 significantly shortened this recovery time. On the other hand, the plasma SK-896 concentrations declined diexponentially after administration, and can be described by a linear pharmacokinetic model within the dose range used. In addition, the pharmacokinetics of SK-896 did not change significantly at any postoperative time. There was no correlation between the plasma SK-896 concentrations and the intensity of duodenal motility, because the activity in the duodenum decreased transiently 13 h after laparotomy and increased with time thereafter. The changes in the activity are considered to reflect the progressive changes in the state of ileus. In conclusion, SK-896 increased the duodenal motility significantly, shortening the recovery time of GI-IMC-like activity in dogs with post-laparotomy ileus. Therefore, it is expected from these results that SK-896 would be useful and effective for the treatment of gastroparalysis after abdominal surgery.

Topics: Animals; Disease Models, Animal; Dogs; Gastrointestinal Motility; Humans; Injections, Intravenous; Intestinal Obstruction; Laparotomy; Male; Motilin; Postoperative Complications

A novel peptide called ghrelin or motilin-related-peptide (MTLRP) was found in the stomach of various mammals. We studied its effect on the motor function of the rat gastrointestinal tract. In normal, conscious unoperated animals, ghrelin/MTLRP (5 or 20 microg/kg iv) significantly accelerated the gastric emptying of a methylcellulose liquid solution (gastric residue after 15 min: 57 +/- 7, 42 +/- 11, 17 +/- 4, and 9 +/- 3% of the ingested meal with doses of 0, 1, 5, and 20 microg/kg iv, respectively) Transit of the methylcellulose liquid solution was also accelerated by ghrelin/MTLRP in the small intestine but not in the colon. Des-[Gln(14)]ghrelin, also found in the mammalian stomach, was as potent as ghrelin in emptying the stomach (gastric residue after 15 min: 12 +/- 3% at a dose of 20 microg/kg iv). In rats in which postoperative gastrointestinal ileus had been experimentally induced, ghrelin/MTLRP (20 microg/kg iv) reversed the delayed gastric evacuation (gastric residue after 15 min: 28 +/- 7% of the ingested meal vs. 82 +/- 9% with saline). In comparison, the gastric ileus was not modified by high doses of motilin (77 +/- 7%) or erythromycin (82 +/- 6%) and was only partially improved by calcitonin gene-related peptide (CGRP) 8-37 antagonist (59 +/- 7%). Ghrelin/MTLRP, therefore, accelerates the gastric emptying and small intestinal transit of a liquid meal and is a strong prokinetic agent capable of reversing the postoperative gastric ileus in rat.

Topics: Animals; Colon; Disease Models, Animal; Dose-Response Relationship, Drug; Gastric Emptying; Gastrointestinal Motility; Ghrelin; Intestinal Obstruction; Intestine, Small; Male; Motilin; Peptide Hormones; Peptides; Postoperative Complications; Rats; Rats, Sprague-Dawley

The aim of this study was to investigate the effect of SK-896 (Phe-Val-Pro-Ile-Phe-Thr-Try-Gly-Glu-Leu-Gln-Arg-Leu-Gln-Glu-Lys-Glu- Arg-Asn-Lys-Gly-Gln-Hse), a new motilin analogue, on gastrointestinal motility and transit in dogs with post-operative ileus, and to compare the effects of this agent on these parameters with the effects of prostaglandin F(2alpha), a well-known gastroprokinetic agent. We used chronically implanted force transducers to measure motility and radiography of radio-opaque markers to measure transit. Infusion of SK-896 1 microgram/kg/h, for 20 min twice a day induced interdigestive migrating contractions-like motility. Infusion of prostaglandin F(2alpha), 20 microgram/kg/h, for 1 h twice a day induced continuous contractions in the distal part of the small intestine. The time of first appearance of interdigestive migrating contractions in the stomach (gastric-interdigestive migrating contractions) and the gastric emptying time of the solid marker with the administration of SK-896 were significantly less than those noted with the administration of prostaglandin F(2alpha). It appears that gastric-interdigestive migrating contractions play an important role in the transit of substances, especially solid substances, in the gastrointestinal tract. We conclude that SK-896, which induced gastric-interdigestive migrating contractions, is effective to induce early recovery from post-operative ileus.

Topics: Amino Acid Sequence; Animals; Digestive System; Digestive System Surgical Procedures; Dogs; Gastrointestinal Motility; Gastrointestinal Transit; Intestinal Obstruction; Male; Molecular Sequence Data; Motilin; Myoelectric Complex, Migrating; Postoperative Complications; Time Factors

Cyclical motor activity of the gastrointestinal tract, normally occurring during the interdigestive period in several mammals, is disrupted in the post-operative ileus. We determined the recovery from the disappearance of cyclical motor activity, from the stomach to the colon, in dogs after laparotomy with the force transducers. Moreover, we examined the effects of Leu13-motilin (KW-5139) and prostaglandin F2 alpha (PGF2 alpha), administered in the early post-operative period, on the gastrointestinal motility. Following laparotomy, the cyclical motor activity reappeared firstly in the ileum and the colon, then in the jejunum and the duodenum, and finally in the stomach. The reappearance time of the phase III contractions in the stomach was 105.8 +/- 10.6 h (n = 4). In the early post-operative period, KW-5139 (0.5 microgram kg-1, i.v.) induced phase-III-like contractions, whereas PGF2 alpha (50 micrograms kg-1, i.v.) induced simultaneously occurring contractions over the whole gastrointestine. The treatment with KW-5139 (0.5 microgram kg-1, i.v.) four times (twice daily on the first and the second post-operative day) significantly (P < 0.05) shortened the time required to recover the phase III contractions in the stomach (64.2 +/- 2.2 h, n = 4), whereas that with PGF2 alpha (50 micrograms kg-1, i.v.) four times did not (111.3 +/- 17.2 h, n = 4). The present results indicate that, after laparotomy, the cyclical motor activity recovers faster in the distal intestine than in the proximal intestine and the stomach, and that KW-5139, but not PGF2 alpha, shortens the reappearance time of the phase III activity in the stomach.

Topics: Analysis of Variance; Animals; Biomechanical Phenomena; Dinoprost; Dogs; Dose-Response Relationship, Drug; Drug Evaluation, Preclinical; Gastrointestinal Motility; Hormones; Intestinal Obstruction; Male; Motilin; Postoperative Complications; Random Allocation; Stimulation, Chemical

The hypothesis was that postoperative ileus might be caused by a disturbed balance between the motor-stimulating hormones, motilin and substance P, and the motor-inhibitory hormone, vasoactive intestinal polypeptide, and that octreotide might prevent this disturbance and so ameliorate the ileus. In 15 conscious dogs with chronic gastrointestinal electrodes, electrical activity was recorded and blood was drawn for radioimmunoassay of motilin, substance P, and vasoactive intestinal peptide (VIP) during fasting and after a liquid meal. Ileus was then induced by celiotomy and intestinal abrasion. During and after operation, five dogs received 154 mM NaCl only, five dogs octreotide, 0.19 micrograms/kg/hr, and five octreotide, 0.83 micrograms/kg/hr. Plasma levels of motilin, substance P, and VIP were changed little by operation, but cyclical increases in plasma motilin, which occurred preoperatively during phase III of the interdigestive myoelectric complex, were completely abolished postoperatively during ileus, as was the complex itself. Octreotide ameliorated the ileus and restored the cyclic increases in motilin found in health, nor did it alter plasma substance P and VIP. In conclusion, octreotide ameliorates postoperative ileus, but it does not do so by increasing plasma motilin or substance P or decreasing plasma VIP.

Topics: Animals; Dogs; Eating; Female; Intestinal Obstruction; Motilin; Octreotide; Postoperative Complications; Substance P; Vasoactive Intestinal Peptide

Cyclic pattern of interdigestive motility and of plasma levels of motilin, somatostatin and pancreatic peptide (PP) show close relationship. During interdigestive state gastric and lower esophageal motility seems to be mediated by pulsatile release of motilin, whereas the motor activity of duodenum seems to be controlled by somatostatin. Disturbed interdigestive motility could be demonstrated in gastrointestinal diseases like bacterial overgrowth, sclerodermia, post-vagotomy diarrhea and reflux esophagitis.

Topics: Diarrhea; Female; Gastroesophageal Reflux; Gastrointestinal Motility; Humans; Intestinal Obstruction; Intestinal Secretions; Male; Motilin; Peptides; Scleroderma, Systemic; Somatostatin; Vagotomy

Plasma immunoreactive motilin (IRM) concentrations were strikingly higher in patients with chronic renal failure (CRF) than in normal subjects. IRM in azotemic plasma was heterogeneous in gel-filtration profile. The first peak eluted in the void volume of the column and the second and the third one, comprising a major portion of IRM content, came out coincidentally with insulin and authentic motilin, respectively. By contrast, no discernible amount of IRM was found in the region corresponding with the second peak in gel-filtration of the plasma from normals and very little in a patient with ileus whole plasma IRM level was elevated. The hypermotilinemia and the accumulation of this high molecular weight motilin in patients with CRF suggest that the kidney plays some role in the elimination of motilin, and further, that the clearance of the high molecular motilin is more dependent on renal function than that of authentic motilin. The present paper emphasizes the necessity for clarifying the significance of the heterogeneity of IRM in CRF.

Topics: Chromatography, Gel; Gastrointestinal Hormones; Humans; Intestinal Obstruction; Kidney Failure, Chronic; Molecular Weight; Motilin

Two inhibitory mechanisms in the human colon which may contribute to postoperative ileus have been studied. Dopamine, a possible peripheral neurotransmitter, inhibited isolated colonic smooth muscle strips by a direct effect in longitudinal muscle any by a nerve-mediated mechanism as circular muscle. Plasma motilin levels were suppressed pre- and per- operatively and elevation of levels postoperatively correlated with the return of normal motility and the severity of the operation.

Topics: Cholecystectomy; Colon; Dopamine; Electromyography; Herniorrhaphy; Humans; In Vitro Techniques; Intestinal Obstruction; Motilin; Muscle Contraction; Postoperative Complications; Pressure