Cisapride Prevents Enteric Bacterial Overgrowth and Translocation by Improvement of Intestinal Motility in Rats with Acute Liver Failure

Abstract

Enteric bacterial overgrowth resulting from compromised gastrointestinal motility has been suggested to be important for the development of enteric bacterial translocation. In the present study, the effect of cisapride, a 5-hydroxytryptamine-4-receptor agonist and stimulant of intestinal motility, was evaluated concerning intestinal motility, as measured by intestinal transit time, enteric bacterial overgrowth, and bacterial translocation from the gut in rats with acute liver failure induced by 90% hepatectomy. The results demonstrated that (1) the incidence of bacterial translocation to the systemic and portal circulation as well as to the liver, spleen, kidneys, and lungs was nil, and 17–33% to MLN in hepatectomized animals treated with cisapride, i.e. significantly lower than in hepatectomized rats administered saline; (2) overgrowth of E. coli in the intestine was noted in hepatectomized animals given saline, but not following cisapride treatment; (3) cisapride improved the otherwise delayed intestinal transit time following hepatectomy as shown by an increase in the leading edge of isotopic propulsion and the linear slope of the cumulative percent of radioactivity through each intestinal segment. Thus, we conclude that intravenous administration of cisapride prevents enteric bacterial overgrowth and bacterial translocation by improving intestinal motility in rats with acute liver failure induced by subtotal hepatectomy.

Effect of cisapride on intestinal bacterial overgrowth and bacterial translocation in cirrhosis

“…In fact, cisapride has been reported to prevent IBO and BT by improving intestinal motility in rats with acute liver failure. 39 Moreover, in the pilot intervention study, prolonged OCT significantly decreased in cirrhotic patients after cisapride therapy. This beneficial effect was associated with the abolition of IBO caused by gram-negative organisms in 4 out of the 5 patients treated with cisapride, whereas it persisted positive in the 4 patients who did not receive cisapride administration.…”

Role of intestinal bacterial overgrowth and intestinal motility in bacterial translocation in experimental cirrhosis

“…In addition, selective intestinal decontamination with suppression of aerobic intestinal bacteria prevents BT in cirrhotic rats, and is the current prophylaxis for SBP in humans (17)(18)(19)(20). On the other hand, several studies have shown that impaired intestinal motility is one of the fac-tors contributing to enteric bacterial overgrowth, and also that intestinal transit is delayed in the setting of cirrhosis mainly related to the severity of disease (21)(22)(23)(24).…”

Inhibitory effects of hyperglycemia on neural activity of the vagus in rats

“…Enteric bacterial overgrowth resulting from impaired GI motility has been suggested to be important for the development of enteric bacterial translocation [8]. It has been demonstrated that interdigestive small bowel motility has a regulatory function on the microflora of the upper small bowel [9].…”

“…It has been demonstrated that interdigestive small bowel motility has a regulatory function on the microflora of the upper small bowel [9]. In ICU patients, reduced GI perfusion and motility result in the sequestration of fluids and translocation of bacteria and endotoxins, and the immunological function of the gut is depressed [8]. A delay in intestinal transit appears as an early event in acute pancreatitis, preceding intestinal bacterial overgrowth and translocation.…”