Diarrhea-predominant irritable bowel syndrome (IBS-D) is a frequent functional disorder of the gastrointestinal (GI) tract affecting nearly one fifth of the worldwide population. IBS-D is associated with numerous symptoms including diarrhea, bloating, abdominal pain and discomfort, which significantly reduce patients' quality of life. Due to a complex and unclear pathogenesis, effective therapy against IBS-D has not been developed yet. Nowadays, treatment is focused on non-pharmacological (e.g. changes in diet and life style) and pharmacological (e.g. loperamide, ramosetron, rifaximin) approaches. The endogenous opioid system is responsible for the maintenance of homeostasis in the GI tract. Activation of the intestinal opioid receptors (ORs), in particular μ (MOP) and δ (DOP) results in reduction of epithelial secretion and increase of water/electrolyte absorption; moreover, opioids are strong analgesic agents. Thus, ligands of ORs are a promising target in IBS-D treatment. In this review, we discuss the role of ORs in the pathogenesis of IBS-D and the use of "classical" and novel, such as P-317, eluxadoline and biphalin MOP and DOP receptor ligands in preclinical and clinical trials.

Holter assessment of sleep-disordered breathing in pulmonary arterial hypertension and in pulmonary hypertension due to left ventricular dysfunction Ocena zaburzeń oddychania w czasie snu z wykorzystaniem rejestracji holterowskiej u pacjentów z tętniczym nadciśnieniem płucnym oraz nadciśnieniem płucnym wtórnym do dysfunkcji lewej komory serca AbstractIntroduction. Sleep-disordered breathing (SDB) affects approximately 2-12% of the general population and the prevalence among patients with heart failure due to left ventricular dysfunction (LV-HF) is even higher. SDB is an important determinant of worse clinical outcomes in such patients. In contrast, the prevalence of SDB in pulmonary arterial hypertension (PAH) and its implications remain unclear. The purpose of this study was to compare relations between estimated apnea-hypopnoea index (eAHI) and clinical parameters in patients with LV-HF and PAH, with particular attention to the consequences of SDB.