vofopitant and Vomiting

Cisplatin (4 mg/kg, i.v.) induced both early emesis, which appears within the first 8-h period, and delayed emesis, which appears between 8 and 48 h after its administration to pigeons. GR205171 ([(2S-cis)-N-((2-methoxy-5(5-(trifluoromethyl)-1H-tetrazol-1-yl)-phenyl) methyl)-2-phenyl-3-piperidinamine dihydrochloride]) administered intramuscularly (1-10 mg/kg) reduced significantly the number of emetic response to cisplatin: this reduction was 60-81% (P < 0.05) for early emesis and 48-64% (P < 0.05) for the delayed response. Intracerebroventricularly administered GR205171 (30 microg/kg) also reduced the number of emetic responses: 53% (P < 0.05) in early emesis and 88% (P < 0.05) in the delayed response. However, the latency time to the first emesis was not affected by GR205171. Direct injection of cisplatin (10 microg/kg) into the fourth ventricle produced emesis, which was reduced by GR205171 administered via the peripheral or central route. Substance P-immunoreactive fibres were distributed throughout the dorsal vagal complex. These results suggest that the antiemetic effect of GR205171 on both emetic responses to cisplatin acts on a central site, and that the onset of the emetic response may be mediated partly via GR205171-insensitive mechanisms.

Topics: Animals; Antiemetics; Cisplatin; Columbidae; Female; Immunohistochemistry; Injections, Intramuscular; Injections, Intravenous; Injections, Intraventricular; Male; Neurokinin-1 Receptor Antagonists; Piperidines; Solitary Nucleus; Substance P; Tetrazoles; Vagus Nerve; Vomiting

Tachykinin NK1 receptor antagonists are known to act centrally and to have broad-spectrum antiemetic effects, but their precise site of action has not yet been defined. To identify this site, the effects of the NK1 receptor antagonist GR205171 on the activities of neurons comprising the central pattern generator (CPG) for vomiting were observed in decerebrate paralyzed dogs. A non-respiratory neuron in each of nine dogs was considered to be a CPG neuron based on its response to abdominal vagal stimulation, its location in the CPG area in the reticular formation dorsomedial to the retrofacial nucleus, its firing patterns in prodromal and retching phases and its response to apomorphine. In response to vagal stimulation at 3-10 Hz, the firing of these neurons transiently increased at the onset of stimulation (fast component), gradually increased again (slow component), and finally developed into rhythmic bursts synchronous with retching bursts of the phrenic and abdominal muscle nerves. GR205171 (25-50 microg/kg, i.v.) abolished the slow component and retching bursts in the neurons, and the retching activities of both nerves, but did not change the fast component. The responses of these neurons to repetitive pulse-train vagal stimulation exhibited a vigorous 'wind-up' and finally developed into retching bursts. Both the 'wind-up' phenomenon and retching bursts disappeared after the application of GR205171. These results suggest that the site of the antiemetic action of NK1 receptor antagonists is located in the CPG or in the pathway connecting the solitary nucleus to the CPG.

Topics: Animals; Antiemetics; Apomorphine; Decerebrate State; Dogs; Electric Stimulation; Emetics; Female; Male; Neurokinin-1 Receptor Antagonists; Neurons; Piperidines; Reticular Formation; Tetrazoles; Vagus Nerve; Vomiting

Structural modifications requiring novel synthetic chemistry were made to the morpholine acetal human neurokinin-1 (hNK-1) receptor antagonist 4, and this resulted in the discovery of 2-(R)-(1-(R)-3, 5-bis(trifluoromethyl)phenylethoxy)-3-(S)-(4-fluoro)phenyl-4-(3-ox o-1 ,2,4-triazol-5-yl)methyl morpholine (17). This modified compound is a potent, long-acting hNK-1 receptor antagonist as evidenced by its ability to displace [125I]Substance P from hNK-1 receptors stably expressed in CHO cells (IC50 = 0.09 +/- 0.06 nM) and by the measurement of the rates of association (k1 = 2.8 +/- 1.1 x 10(8) M-1 min-1) and dissociation (k-1 = 0.0054 +/- 0.003 min-1) of 17 from hNK-1 expressed in Sf9 membranes which yields Kd = 19 +/- 12 pM and a t1/2 for receptor occupancy equal to 154 +/- 75 min. Inflammation in the guinea pig induced by a resiniferatoxin challenge (with NK-1 receptor activation mediating the subsequent increase in vascular permeability) is inhibited in a dose-dependent manner by the oral preadmininstration of 17 (IC50 (1 h) = 0.008 mg/kg; IC90 (24 h) = 1.8 mg/kg), indicating that this compound has good oral bioavailbility and peripheral duration of action. Central hNK-1 receptor stimulation is also inhibited by the systemic preadministration of 17 as shown by its ability to block an NK-1 agonist-induced foot tapping response in gerbils (IC50 (4 h) = 0.04 +/- 0.006 mg/kg; IC50 (24 h) = 0.33 +/- 0.017 mg/kg) and by its antiemetic actions in the ferret against cisplatin challenge. The activity of 17 at extended time points in these preclinical animal models sets it apart from earlier morpholine antagonists (such as 4), and the piperidine antagonists 2 and 3 and could prove to be an advantage in the treatment of chronic disorders related to the actions of Substance P. In part on the basis of these data, 17 has been identified as a potential clinical candidate for the treatment of peripheral pain, migraine, chemotherapy-induced emesis, and various psychiatric disorders.

Topics: Acetals; Administration, Oral; Animals; Aprepitant; Behavior, Animal; Binding, Competitive; Capillary Permeability; Cell Line; CHO Cells; Cricetinae; Diterpenes; Esophagus; Female; Ferrets; Gerbillinae; Hindlimb; Humans; Inflammation; Male; Morpholines; Neurokinin-1 Receptor Antagonists; Trachea; Urinary Bladder; Vomiting

Tachykinin NK1 receptor antagonists injected into the medulla oblongata are known to abolish vomiting induced by vagal afferent stimulation. Emetic vagal afferents have been shown to synapse with neurons in the medial solitary nucleus (mNTS), which suggests that substance P is a transmitter in the synapse. To examine this possibility, the effects of GR205171, an NK1 receptor antagonist, on retching and mNTS neuronal responses to the stimulation of abdominal vagal afferents were investigated in decerebrate dogs. GR205171 (0.05-0.7 mg kg-1, i.v.) abolished retching induced by either vagal or mNTS stimulation within 5 min. Firing of mNTS neurons in response to pulse-train and sustained vagal stimulation did not change even after the abolition of retching. Similarly, GR205171 did not have any effects on mNTS evoked potentials induced by pulse-train vagal stimulation. In about 20% of mNTS neurons, the peak firing frequency was facilitated to about 150% with repetitive pulse-train vagal stimulation. This facilitation remained even after the abolition of retching. Administration of GR205171 (1 mg ml-1, 30 microliters) into the 4th ventricle abolished retching, with latencies in excess of 120 min These results suggest that substance P does not participate in synaptic transmission between emetic vagal afferents and mNTS neurons in dogs.

Topics: Animals; Dogs; Electric Stimulation; Evoked Potentials; Female; Injections, Intravenous; Injections, Intraventricular; Male; Neurons; Neurons, Afferent; Piperidines; Receptors, Tachykinin; Solitary Nucleus; Synaptic Transmission; Tetrazoles; Vagus Nerve; Vomiting

The effects of GR205171, a selective tachykinin NK1 receptor antagonist, were investigated on both the acute and delayed phases of cisplatin-induced nausea-like behaviour and vomiting in the conscious piglet. Animals receiving cisplatin (5.5 mg kg(-1), i.v.) were observed for 60 h. Fifteen min prior to cisplatin infusion (T0(-15 min)), eight piglets acting as controls received an intravenous injection of saline solution (1 ml kg(-1)), whereas experimental animals received a single i.v. administration of GR205171 (1 ml kg(-1)) at a dose of 0.01 (n=8), 0.03 (n=8), 0.1 (n = 8), 0.3 (n = 16) or 1.0 (n = 13) mg kg(-1). In eight additional piglets, GR205171 (1 mg kg(-1)) was administered 15 min before the onset of the delayed phase (T16(-15 min)). A further five piglets received GR205171 (1 mg kg(-1)) every 6 h throughout the experiment. The latencies of the first emetic episode (EE) and nausea-like behavioural episode (NE) increased in all experimental groups treated at T0(-15 min), and the total number of both EE and NE during the 60 h was reduced in a dose-dependent manner. In piglets treated at T0(-15 min) with GR205171 1 mg kg(-1), eight out of 13 (62%) did not vomit throughout the experiment. Animals treated with GR205171 (1 mg kg(-1)) at T16(-15 min) exhibited an acute response to cisplatin but did not vomit during the delayed phase. The greatest inhibition of both nausea-like behaviour and vomiting was observed in piglets receiving multiple injections of GR205171. These results demonstrate the long-lasting anti-emetic effects of GR205171, and confirm the key role of substance P within the emetic reflex.

Topics: Animals; Antiemetics; Antineoplastic Agents; Cisplatin; Dose-Response Relationship, Drug; Female; Injections, Intravenous; Male; Nausea; Neurokinin-1 Receptor Antagonists; Piperidines; Swine; Tetrazoles; Vomiting

The roles of tachykinin neurokinin-1 (NK1) receptors in the induction of fictive retching, hypersalivation, and gastric responses associated with emesis induced by abdominal vagal stimulation were studied in paralyzed, decerebrated dogs. Vagal stimulation induced gradual increases in salivary secretion and activity of the parasympathetic postganglionic fibers to the submandibular gland, relaxation of the gastric corpus and antrum, and fictive retching. However, hypersalivation and increased nerve activity were suppressed and antral contractility was enhanced during fictive retching. An NK1 receptor antagonist, GR-205171, abolished the enhancement of antral contractility and fictive retching but had no effect on corpus and antral relaxation. Hypersalivation and increased nerve activity were inhibited by GR-205171 but were not completely abolished. Reflex salivation by lingual nerve stimulation was unaffected. These results suggest that GR-205171 acts on the afferent pathway in the bulb and diminishes hypersalivation and antral contraction related to emesis as well as fictive retching but does not affect gastric relaxation or hypersalivation induced by the vagovagal, vagosalivary, and linguosalivary reflexes.

Topics: Animals; Dogs; Electric Stimulation; Gastrointestinal Motility; Models, Biological; Muscle Contraction; Muscle, Smooth; Neurokinin-1 Receptor Antagonists; Phrenic Nerve; Piperidines; Saliva; Salivation; Stomach; Tetrazoles; Time Factors; Vagus Nerve; Vomiting

The effects of a NK1 antagonist, GR205171, and a 5-HT3 antagonist, ondansetron, in a novel model of post-anaesthesia-induced emesis in Suncus murinus is described. GR205171 (1 and 3 mg k(-1) s.c) and ondansetron (3 mg kg(-1) s.c.) each significantly inhibited emesis. This model may be useful for studying drugs to treat post-operative nausea and vomiting in man.

Topics: Anesthesia; Animals; Halothane; Humans; Male; Nausea; Neurokinin-1 Receptor Antagonists; Ondansetron; Piperidines; Receptors, Serotonin; Receptors, Serotonin, 5-HT3; Serotonin Antagonists; Shrews; Tetrazoles; Vomiting