title: Differences in the Control of Secondary Peristalsis in the Human Esophagus: Influence of the 5-HT4 Receptor versus the TRPV1 Receptor.
abstract: OBJECTIVE
  Acute administration of 5-hydroxytryptamine4 (5-HT4) receptor agonist, mosapride or esophageal infusion of the transient receptor potential vanilloid receptor-1 (TRPV1) agonist capsaicin promotes secondary peristalsis. We aimed to investigate whether acute esophageal instillation of capsaicin-containing red pepper sauce or administration of mosapride has different effects on the physiological characteristics of secondary peristalsis.
  
  
  METHODS
  Secondary peristalsis was induced with mid-esophageal air injections in 14 healthy subjects. We compared the effects on secondary peristalsis subsequent to capsaicin-containing red pepper sauce (pure capsaicin, 0.84 mg) or 40 mg oral mosapride.
  
  
  RESULTS
  The threshold volume for generating secondary peristalsis during slow air distensions was significantly decreased with capsaicin infusion compared to mosapride (11.6 ± 1.0 vs. 14.1 ± 0.8 mL, P = 0.02). The threshold volume required to produce secondary peristalsis during rapid air distension was also significantly decreased with capsaicin infusion (4.6 ± 0.5 vs. 5.2 ± 0.6 mL, P = 0.02). Secondary peristalsis was noted more frequently in response to rapid air distension after capsaicin infusion than mosapride (80% [60-100%] vs. 65% [5-100%], P = 0.04). Infusion of capsaicin or mosapride administration didn't change any parameters of primary or secondary peristalsis.
  
  
  CONCLUSIONS
  Esophageal infusion with capsaicin-containing red pepper sauce suspension does create greater mechanosensitivity as measured by secondary peristalsis than 5-HT4 receptor agonist mosapride. Capsaicin-sensitive afferents appear to be more involved in the sensory modulation of distension-induced secondary peristalsis.
authors.affiliation: Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
authors.forename: Chih-Hsun
authors.initials: CH
authors.lastname: Yi
authors.affiliation: Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
authors.forename: Wei-Yi
authors.initials: WY
authors.lastname: Lei
authors.affiliation: Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
authors.forename: Jui-Sheng
authors.initials: JS
authors.lastname: Hung
authors.affiliation: Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
authors.forename: Tso-Tsai
authors.initials: TT
authors.lastname: Liu
authors.affiliation: Lynn Institute for Healthcare Research, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States of America.
authors.forename: William C
authors.initials: WC
authors.lastname: Orr
authors.affiliation: Division of Gastroenterology, Department of Clinical Sciences, L. Sacco University Hospital, Milano, Italy.
authors.forename: Pace
authors.initials: P
authors.lastname: Fabio
authors.affiliation: Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
authors.forename: Chien-Lin
authors.initials: CL
authors.lastname: Chen
mesh_terms: D000328:Adult; D001549:Benzamides / Q000008:administration & dosage*; D002211:Capsaicin / Q000008:administration & dosage* / Q000737:chemistry; D002212:Capsicum / Q000737:chemistry; D004947:Esophagus / Q000187:drug effects / Q000503:physiopathology; D005260:Female; D006356:Heartburn / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008365:Manometry; D009025:Morpholines / Q000008:administration & dosage*; D010528:Peristalsis / Q000187:drug effects* / Q000502:physiology; D044422:Receptors, Serotonin, 5-HT4 / Q000187:drug effects; D058828:Serotonin 5-HT4 Receptor Agonists / Q000008:administration & dosage*; D050916:TRPV Cation Channels / Q000819:agonists* / Q000378:metabolism
chemical_list: D001549:Benzamides; D009025:Morpholines; D058828:Serotonin 5-HT4 Receptor Agonists; D050916:TRPV Cation Channels; C494484:TRPV1 receptor; D044422:Receptors, Serotonin, 5-HT4; C062720:mosapride; D002211:Capsaicin