Motilin induces gall bladder emptying and antral contractions in the fasted state in humans.
BACKGROUND
Animal studies have shown that motilin affects gall bladder motility. In humans, no effect has been shown, but erythromycin, a motilin receptor agonist, induces gall bladder emptying.


OBJECTIVE
To explore the effect of increasing doses of exogenous motilin on gall bladder volume and antral contractility in the fasted state in humans.


METHODS
After an overnight fast, eight healthy men received increasing intravenous doses of Leu13-motilin (KW-5139) or 0.9% NaCl in a double blind, randomised fashion. Gall bladder volume and antral contraction frequency were determined by ultrasonography.


RESULTS
Infusion of motilin increased plasma motilin levels. Motilin induced a reduction in gall bladder volume of 8.0 (5.0)%, 17.1 (5.0)%, 18.5 (4.7)%, and 16.1 (4.9)% of baseline volume at the end of infusion of 2, 4, 8, and 16 pmol/kg/min respectively, compared with mean stable gall bladder volumes during placebo infusion (p < 0.05). Antral contraction frequency increased during motilin infusion, but not during placebo infusion (p < 0.05).


CONCLUSIONS
Exogenous motilin reducted fasting gall bladder volume and increased antral contractions. After reaching maximal reduction, the gall bladder volume did not decrease further during continuous motilin infusion at higher doses and stayed at the same reduced volume. The degree of gall bladder volume reduction during motilin infusion mimicked gall bladder emptying preceding antral phase III activity of the migrating motor complex in humans. This study indicates that motilin may play a physiological role in the regulation of gall bladder emptying in the fasted state.
Department of Surgery, University Hospital Utrecht, The Netherlands.
Y C
YC
Luiking
T L
TL
Peeters
M F
MF
Stolk
V B
VB
Nieuwenhuijs
P
P
Portincasa
I
I
Depoortere
G P
GP
van Berge Henegouwen
L M
LM
Akkermans
D000328:Adult; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005215:Fasting; D005704:Gallbladder / Q000000981:diagnostic imaging; D016473:Gallbladder Emptying / Q000187:drug effects*; D005746:Gastric Emptying / Q000187:drug effects*; D006801:Humans; D008297:Male; D009037:Motilin / Q000494:pharmacology*; D011706:Pyloric Antrum / Q000000981:diagnostic imaging; D014463:Ultrasonography
D009037:Motilin