Buspirone, a new drug for the management of patients with ineffective esophageal motility?

Scheerens, Charlotte; Tack, Jan; Rommel, Nathalie

doi:10.1177/2050640615585688

Cited by 37 publications

(35 citation statements)

References 47 publications

(45 reference statements)

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“…Recent research analyzing the effectiveness of the serotonin agonist Buspirone in the treatment of esophageal dysfunction associated with systemic sclerosis demonstrated an increase in esophageal motility in 30 patients (Karamanolis et al, ). Other investigations inspired by this study tested greater levels of Buspirone, among other similar compounds, and found that serotonin agonists produce enough effect to warrant greater study and consideration (Scheerens et al, ). A study by Wu et al () presented evidence that serotonin disrupts tight junctions in the esophagus by reducing the expression of their proteins.…”

Section: Neurotransmitters and Diseasesmentioning

confidence: 82%

Neurotransmitters: The Critical Modulators Regulating Gut–Brain Axis

Mittal

Debs

Patel

et al. 2017

Journal Cellular Physiology

384

287

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Neurotransmitters including catecholamines and serotonin play a crucial role in maintaining homeostasis in the human body. Studies on these neurotransmitters mainly revolved around their role in the “fight or flight” response, transmitting signals across a chemical synapse and modulating blood flow throughout the body. However, recent research has demonstrated that neurotransmitters can play a significant role in the gastrointestinal (GI) physiology. Norepinephrine (NE), epinephrine (E), dopamine (DA), and serotonin have recently been a topic of interest because of their roles in the gut physiology and their potential roles in gastrointestinal and central nervous system pathophysiology. These neurotransmitters are able to regulate and control not only blood flow, but also affect gut motility, nutrient absorption, gastrointestinal innate immune system, and the microbiome. Furthermore, in pathological states such as inflammatory bowel disease (IBD) and Parkinson’s disease, the levels of these neurotransmitters are dysregulated, therefore causing a variety of gastrointestinal symptoms. Research in this field has shown that exogenous manipulation of catecholamine serum concentrations can help in decreasing symptomology and/or disease progression. In this review article, we discuss the current state-of-the-art research and literature regarding the role of neurotransmitters in regulation of normal gastrointestinal physiology, their impact on several disease processes, and novel work focused on the use of exogenous hormones and/or psychotropic medications to improve disease symptomology.

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Section: Neurotransmitters and Diseasesmentioning

confidence: 82%

Neurotransmitters: The Critical Modulators Regulating Gut–Brain Axis

Mittal

Debs

Patel

et al. 2017

Journal Cellular Physiology

384

287

View full text Add to dashboard Cite

show abstract

“…Prucalopride may enhance the amplitude of primary esophageal contractions in patients with GERD, while also decreasing esophageal acid exposure and accelerating gastric emptying in healthy controls . Buspirone, a mixed partial 5HT‐1A agonist and dopamine D2 receptor antagonist, increased esophageal contraction amplitudes and decreased reflux symptoms in scleroderma patients, but was not more effective than placebo in patients with IEM and dysphagia . Azithromycin, a motilin receptor agonist, reduces esophageal reflux exposure in GERD and following lung transplant, without altering the total number of reflux episodes.…”

Section: Managementmentioning

confidence: 99%

Ineffective esophageal motility: Concepts, future directions, and conclusions from the Stanford 2018 symposium

Gyawali

Sifrim

Carlson

et al. 2019

Neurogastroenterology Motil

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Background Ineffective esophageal motility (IEM) is a heterogenous minor motility disorder diagnosed when ≥50% ineffective peristaltic sequences (distal contractile integral <450 mm Hg cm s) coexist with normal lower esophageal sphincter relaxation (integrated relaxation pressure < upper limit of normal) on esophageal high‐resolution manometry (HRM). Ineffective esophageal motility is not consistently related to disease states or symptoms and may be seen in asymptomatic healthy individuals. Purpose A 1‐day symposium of esophageal experts reviewed existing literature on IEM, and this review represents the conclusions from the symposium. Severe IEM (>70% ineffective sequences) is associated with higher esophageal reflux burden, particularly while supine, but milder variants do not progress over time or consistently impact quality of life. Ineffective esophageal motility can be further characterized using provocative maneuvers during HRM, especially multiple rapid swallows, where augmentation of smooth muscle contraction defines contraction reserve. The presence of contraction reserve may predict better prognosis, lesser reflux burden and confidence in a standard fundoplication for surgical management of reflux. Other provocative maneuvers (solid swallows, standardized test meal, rapid drink challenge) are useful to characterize bolus transit in IEM. No effective pharmacotherapy exists, and current managements target symptoms and concurrent reflux. Novel testing modalities (baseline and mucosal impedance, functional lumen imaging probe) show promise in elucidating pathophysiology and stratifying IEM phenotypes. Specific prokinetic agents targeting esophageal smooth muscle need to be developed for precision management.

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“…Some of the most important drugs that can in some way alter esophageal motility are included in table I (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23).…”

Section: Current Situationmentioning

confidence: 99%

Practical aspects of high resolution esophageal manometry

Juan¹,

Ríos²,

Bueno³

et al. 2016

Rev Esp Enferm Dig

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High resolution esophageal manometry (HRM) is currently under development as can be seen in the various Chicago classifications. In order to standardize criteria in certain practical aspects with limited scientific evidence, the First National Meeting for Consensus in High Resolution Manometry of the Spanish Digestive Motility Group took place, bringing together a wide group of experts. The proposals were based on a prior survey composed of 47 questions, an exhaustive review of the available literature and the experience of the participants. Methodological aspects relating to the poorly defined analysis criteria of certain new high resolution parameters were discussed, as well as other issues previously overlooked such as spontaneous activity or secondary waves. Final conclusions were drawn with practical applications.

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Buspirone, a new drug for the management of patients with ineffective esophageal motility?

Cited by 37 publications

References 47 publications

Neurotransmitters: The Critical Modulators Regulating Gut–Brain Axis

Neurotransmitters: The Critical Modulators Regulating Gut–Brain Axis

Ineffective esophageal motility: Concepts, future directions, and conclusions from the Stanford 2018 symposium

Practical aspects of high resolution esophageal manometry

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