Is there an experimental basis for the development of ischaemic colitis as a result of 5-HT3 antagonist treatment?
5-HT(3) antagonists are effective treatments for chemotherapy-induced emesis and diarrhoea and urgency and pain associated with irritable bowel syndrome. Reports of ischaemic colitis led to restricted use of the approved drug, alosetron. This article briefly reviews the controversial information from epidemiology and adverse reaction reports and addresses the experimental basis for the development of ischaemic colitis as a result of 5-HT(3) antagonist treatment. The author reviews the potential factors based involved in the ischaemic colitis and ways in which this class of compound may influence those factors based on experimental evidence, including the literature on any vascular effects of these agents. Finally, the article addresses the theoretical basis for the constipation as a predisposing factor for the development of ischaemic colitis. The evidence reviewed suggests that further studies are needed to explore the principles to prove or disprove the association.
Camilleri
M
M
Clinical Enteric Neuroscience Translational and Epidemiological Research Group, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. camilleri.michael@mayo.edu
D002243:Carbolines / Q000009:adverse effects*; D003092:Colitis / Q000139:chemically induced* / Q000453:epidemiology; D003967:Diarrhea / Q000188:drug therapy*; D006801:Humans; D007511:Ischemia / Q000139:chemically induced* / Q000453:epidemiology; D012307:Risk Factors; D058831:Serotonin 5-HT3 Receptor Antagonists; D012702:Serotonin Antagonists / Q000009:adverse effects*
D002243:Carbolines; D058831:Serotonin 5-HT3 Receptor Antagonists; D012702:Serotonin Antagonists; C090840:alosetron