Brain peptides and the modulation of postoperative gastric ileus

Abstract

Postoperative ileus (POI) develops after abdominal surgery irrespective of the site of surgery. When prolonged, POI can lead to longer hospitalization times and higher healthcare costs. Moreover, it is associated with complaints for the patient. In order to develop new strategies to treat this condition, a deeper understanding of the pathophysiology of the POI is necessary. This review will focus on brain peptides (ghrelin, nesfatin-1, somatostatin, corticotropin-releasing factor, thyrotropin-releasing hormone and calcitonin gene-related peptide) involved in the mediation of POI and the possible modulation of these pathways to shorten the time of POI. Lastly, the role of vagal signaling and the possibility of reducing ambient temperature or chewing gum as potential treatment strategies of alleviating symptoms of POI is discussed.

Hesperidin alleviates rat postoperative ileus through anti-inflammation and stimulation of Ca2+-dependent myosin phosphorylation

“…The casual relationship between inflammation and motility disorder in POI needs to be clarified. It was previously reported that the accumulation of pro-inflammatory cytokines and increased expression of NO could be reduced by hesperidin through inhibition of NO related pathways, which was also confirmed in our study [3][4][5][6] . We believe that hesperidin exerts anti-inflammatory effects on POI, ameliorating the digestive motor inactivity in POI rats and accelerating gastrointestinal transit.…”

“…As one of the postoperative dysmotility disorders of the gastrointestinal tract, postoperative ileus remains one of the most perplexing problems in medicine [3,4] . Because prolonged POI is an iatrogenic condition leading to prolonged hospitalization resulting in increased health care costs, the development of effective management strategies to prevent POI is clinically important [5] .…”

“…Hesperidin is the major flavonoid in sweet oranges and lemons [7] and is abundant in certain regularly consumed foods (eg, vegetables and fruits) and some beverages (eg, tea and red wine) [8][9][10] . Hesperidin, like other flavonoids, has been reported to possess a wide range of biological activities, including anti-inflammatory, anti-oxidant, anti-allergic, hepatoprotective, anti-thrombotic, anti-viral, cardiovascular, anti-carcinogenic effects, anti-depressionlike effects and prevention of bone loss [4,7,[10][11][12][13][14][15][16][17] . However, the…”

Calcitonin Gene‐Related Peptide Modulators – The History and Renaissance of a New Migraine Drug Class

“…CGRP signaling has also been implicated as a mediator of the postoperative gastric ileus and inflammation that often occurs with abdominal surgery. Preclinical studies in dogs, rats, and mice have shown that the peptide CGRP receptor antagonist CGRP 8‐37 , the CGRP‐RA olcegepant, and an anti‐CGRP antibody improve postoperative gastric emptying …”

The role of brain somatostatin receptor 2 in the regulation of feeding and drinking behavior

“…Pharmacological activation of brain sst 2 also prevents visceral stress-related inhibition of food intake, e.g. during postoperative gastric ileus known to involve CRF (Stengel and Taché, 2014b) adding to existing evidence that brain somatostatin counteracts several functional responses to acute stressors by interacting with CRF (Stengel et al, 2013). …”