title: Effects of mosapride on esophageal secondary peristalsis in humans.
abstract: BACKGROUND
  Secondary peristalsis is important for the clearance of refluxate or retained food bolus from the esophagus. Mosapride is a prokinetic agent that enhances GI motility by stimulating 5-hydroxytrypatamine(4) (5-HT(4) ) receptors, but its effects on secondary peristalsis are yet unclear in humans. We aimed to investigate the effect of a 5-HT(4) agonist mosapride on esophageal distension-induced secondary peristalsis in normal subjects.
  
  
  METHODS
  After a baseline recording esophageal motility, secondary peristalsis was generated by slow and rapid mid-esophageal injections of air in 15 healthy subjects. Two separate sessions with 40mg oral mosapride or placebo were randomly performed to test their effects on esophageal secondary peristalsis.
  
  
  RESULTS
  Mosapride decreased the threshold volume for triggering secondary peristalsis during rapid air distension (4.5±0.3 vs 5.3±0.4mL; P=0.04) but not slow air distension (14.3±1.2 vs 13.3±1.3mL; P=0.41). Secondary peristalsis was triggered more frequently in response to rapid air distension after application of mosapride [100% (90-100%) vs 90% (80-100%); P=0.02]. Mosapride significantly increased pressure wave amplitudes of secondary peristalsis during slow (135.4±13.8 vs 105.0±12.9mmHg; P=0.001) and rapid air distensions (124.0±11.6 vs 95.9±14.0mmHg; P=0.002).
  
  
  CONCLUSIONS
  Mosapride enhances sensitivity to distension-induced secondary peristalsis and facilitates secondary peristaltic contractility. These data provide an evidence for modulation of esophageal secondary peristalsis by the 5-HT(4) agonist mosapride, as well support for its clinical utility.
authors.affiliation: Department of Medicine, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan. harry.clchen@msa.hinet.net
authors.forename: C L
authors.initials: CL
authors.lastname: Chen
authors.forename: T T
authors.initials: TT
authors.lastname: Liu
authors.forename: C H
authors.initials: CH
authors.lastname: Yi
authors.forename: W C
authors.initials: WC
authors.lastname: Orr
mesh_terms: D000284:Administration, Oral; D000328:Adult; D001549:Benzamides / Q000008:administration & dosage / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D004947:Esophagus / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D009025:Morpholines / Q000008:administration & dosage / Q000494:pharmacology*; D009119:Muscle Contraction / Q000187:drug effects / Q000502:physiology; D010528:Peristalsis / Q000187:drug effects* / Q000502:physiology; D044422:Receptors, Serotonin, 5-HT4 / Q000187:drug effects / Q000502:physiology; D017366:Serotonin Receptor Agonists / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D001549:Benzamides; D009025:Morpholines; D017366:Serotonin Receptor Agonists; D044422:Receptors, Serotonin, 5-HT4; C062720:mosapride