title: The effect of levosulpiride on in vitro motor patterns in the human gastric fundus, antrum, and jejunum.
abstract: Levosulpiride is a 5HT4 agonist/D2 antagonist prokinetic agent used to improve gastric emptying in patients with functional dyspepsia or gastroparesis. The aim of this study was to characterize its effect on the main in vitro motility patterns in the human fundus, antrum, and jejunum.
  
  
  
  Circular muscle strips from human stomach (antrum and fundus) and jejunum, obtained from 46 patients undergoing bariatric surgery, were studied using organ baths. Enteric motor neurons (EMNs) were stimulated by electrical field stimulation (EFS).
  
  
  
  Levosulpiride, caused an increase in the EFS-induced cholinergic contractions in the gastric antrum (+37 ± 15.18% at 100 μM, pEC50 = 4.46 ± 0.14; p < 0.05, n = 8) and jejunum (+45.4 ± 22.03% at 100 μM, pEC50 = 3.78 ± 6.81; p < 0.05, n = 5), but not in the gastric fundus. It also caused a slight decrease in tone and frequency of spontaneous contractions in the jejunum, but did not have any major effect on tone or spontaneous contractions in the stomach. It did not have any effect on EFS-induced relaxations mediated by nitric oxide (NO) in the stomach (antrum and fundus) and by NO and ATP in the jejunum.
  
  
  
  Our results suggest that the prokinetic effects of levosulpiride in humans are mainly due to the facilitation of the release of acetylcholine by enteric motor neurons in the gastric antrum and the jejunum.
authors: Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas CIBERehd, Instituto de Salud Carlos III, Barcelona, Spain.
authors: D
authors: D
authors: Gallego
authors: Gastrointestinal Physiology Laboratory, Department of Surgery, Hospital de Mataró, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors: O
authors: O
authors: Ortega
authors: Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas CIBERehd, Instituto de Salud Carlos III, Barcelona, Spain.
authors: C
authors: C
authors: Arenas
authors: Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas CIBERehd, Instituto de Salud Carlos III, Barcelona, Spain.
authors: I
authors: I
authors: López
authors: Gastrointestinal Physiology Laboratory, Department of Surgery, Hospital de Mataró, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors: E
authors: E
authors: Mans
authors: Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas CIBERehd, Instituto de Salud Carlos III, Barcelona, Spain.|Gastrointestinal Physiology Laboratory, Department of Surgery, Hospital de Mataró, Universitat Autònoma de Barcelona, Barcelona, Spain.|Health Sciences Research Institute of the Germans Trias i Pujol Foundation, Barcelona, Spain.
authors: P
authors: P
authors: Clavé
mesh_terms: D000328:Adult; D004305:Dose-Response Relationship, Drug; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects / Q000502:physiology; D005748:Gastric Fundus / Q000187:drug effects* / Q000502:physiology; D005765:Gastrointestinal Agents / Q000494:pharmacology*; D006801:Humans; D007583:Jejunum / Q000187:drug effects* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009924:Organ Culture Techniques; D011706:Pyloric Antrum / Q000187:drug effects* / Q000502:physiology; D058828:Serotonin 5-HT4 Receptor Agonists / Q000494:pharmacology*; D013469:Sulpiride / Q000031:analogs & derivatives* / Q000494:pharmacology
chemical_list: D005765:Gastrointestinal Agents; D058828:Serotonin 5-HT4 Receptor Agonists; D013469:Sulpiride; C078143:levosulpiride
keywords: 5HT4 agonist; D2 antagonists; dyspepsia; gastrokinetic; gastroparesis; motility; motor patterns