Effect of rimonabant on oesophageal motor function in man

Scarpellini, Emidio; Blondeau, Kathleen; Boecxstaens, Veerle; Vos, Rita De; Gasbarrini, Antonio; Farré, Ricard; Tack, Jan

doi:10.1111/j.1365-2036.2011.04576.x

Cited by 28 publications

(18 citation statements)

References 46 publications

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“…Delta9‐tetrahydrocannabinol, a mixed CB1/CB2 receptor agonist, reduced the occurrence of meal‐induced TLESRs in healthy subjects but was associated with central side effects including nausea and vomiting 41 . Rimonabant, a CB1 receptor antagonist, was also shown to increase LES basal pressure and to decrease TLESRs and postprandial reflux events in healthy volunteers; however, the drug is also associated with central side effects 42 …”

Section: Medications That Alter Les Function (Table 1)mentioning

confidence: 99%

The lower esophageal sphincter

Hershcovici

Mashimo

Fass

2011

Neurogastroenterology Motil

101

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Correspondence 823 Pethidine, metoclopramide and the gnstro-oesophageal sphincter Gastro-oesophageal reflux after pethidine? We were interested to read the paper by Hey ef al. (Anaesthesia 1981; 3 6. 173-6) but feel that they have failed to provide direct support for their suggestion that pethidine increases the possibility of gastro-oesopha-geal reflux, and that metoclopramide is a useful adjunct in the prevention of reflux in patients receiving pethi-dine. Their study would have been much more valuable if they had actually demonstrated acid reflux which can be easily done with an intra-oesophageal pH probe at the same time as manometric measurements. They have demonstrated lowering of lower oesophageal sphincter (LOS) pressure with pethidine and conclude that this must lead to the increased possibility of reflux because a study of Hall et a1.l quoted by them suggested that this was so. However, in contrast, atropine is also known to lower LOS pressure in man2 but it does not increase epidsodes of acid reflux.) It is true that Hall et aZ.I did find some correlation between gastro-oesophageal re-flux and lowering of the LOS pressure, this has not been the finding of other workers and there is a considerable overlap between the LOS pressure in those who reflux and the pressure in those who do not."7 Indeed Bennett6 showed that individuals with a LOS pressure as low as 8 cmH2O may not reflux whereas those with a LOS pressure as high as 32 cmHzO do. There is, therefore, a lack of precise correlation between LOS pressure and the presence or absence of reflux. This is probably related, in part, to the problem of determining a pressure reading from what is not a single pressure but a group of varying pressures which depend on the position of the manometric probe in the moreover the LOS does not have a static of fixed pressure, and it varies considerably with mechanical stress, hormonal factors, and even emotional fac-It is unwise to imply that lowering the LOS pressure with pethidine is likely to lead to reflux without demonstrating acid reflux into the oesophagus, and it is even more unwise to assume that, because metoclopra-mide appears to oppose the effect of pethidine on LOS pressure, it actually would prevent any gastro-oesopha-geal reflux that might occur. DB. The effects of premedication drugs on the lower oesophageal high pressure zone acid and reflux status of Rhesus monkeys and man. Gut 1975; 1 6 347-52. 2. LIND JS, CRISPIN JS, MCIWR DK. The effect ofatropine on the gastroesophageal sphincter. Canadian Journal of Physiology and Pharmacology 1968; 46.233-8. 3. SKINNER DB, CAMP TF. Relation of esophageal reflux to lower esophageal sphincter pressures decreased by atro-pine. Gastroenterology 1968; 54: 543-51. 4. POPE CE. A dynamic test of sphincter strength: its application to the lower esophageal sphincter. Gastroenterology 1967; 5 2 779-86. 5. HADDAD JK. Relation of gastroesophageal reflux to yield sphincter pressures. Gastroenterology 1970; 58: 175-84. 6. BENNETT JR. The physician's problem. Gut 1973; 14: 24...

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Section: Medications That Alter Les Function (Table 1)mentioning

confidence: 99%

The lower esophageal sphincter

Hershcovici

Mashimo

Fass

2011

Neurogastroenterology Motil

101

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“…Consistent with animal studies, THC (10 and 20 mg) inhibited the increase in transient LES relaxations evoked by meal ingestion and reduced spontaneous swallowing as well as basal LES pressure in healthy volunteers (Beaumont et al 2009). Intriguingly, the data indicating suppression of transient LES relaxation following CB 1 receptor activation were not confirmed in a subsequent clinical study, in which the CB 1 receptor antagonist rimonabant inhibited the meal-induced increase in transient LES relaxation and increased postprandial LES pressure leading to a lower number of acid reflux events (Scarpellini et al 2011). It should be noted, however, that rimonabant may exert potent CB 1 -receptor-independent pharmacological effects ).…”

Section: Lower Esophageal Sphincter Relaxationmentioning

confidence: 91%

Endocannabinoids

2015

Handbook of Experimental Pharmacology

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“…Throughout the study, 10 saline swallows of 5 mL of water were administered at 30‐minute intervals. Throughout the study, the sensations of fullness, nausea, heartburn, belching, satiety, hunger, anxiety, dizziness, sleepiness, and fatigue were measured every 15 minute using validated 100‐mm visual analogue scales (Fig. ).…”

Section: Methodsmentioning

confidence: 99%

“…Pharmacological agents inhibiting TLESRs, such as the gamma‐amino butyric acid B (GABA‐B) agonist baclofen, has been evaluated in GERD but the high incidence of central side‐effects with baclofen, and the low gain with newer GABA‐B agonists, have hampered their successful use or drug development in GERD . More recently, we demonstrated that itopride, an antidopaminergic and cholinesterase inhibitor, and rimonabant, a cannabinoid‐1 receptor inhibitor, are also able to inhibit TLESRs . Itopride pilot studies in GERD patients are encouraging, but more extensive evaluation of its potential in GERD is lacking .…”

Section: Introductionmentioning

confidence: 99%