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Esophagoprotective Potential of Cisapride (An Additional Benefit for Gastroesophageal Reflux Disease)

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Abstract

Cisapride is a novel prokinetic agent thatreleases acetylcholine at the level of the myentericplexus. Acetylcholine also plays a role in the secretoryfunction of salivary glands evoked by intraesophagal mechanical and chemical stimulation, mediatedthrough the esophagosalivary reflex. The impact,however, of cisapride on salivary protective componentsmediated by esophagosalivary reflex remains unknown. Therefore, we have studied salivary pH,bicarbonate, nonbicarbonate, glycoconjugate, protein,EGF, TGF-α, and PGE2 before and afterthe administration of cisapride. The study was conductedin 20 asymptomatic volunteers (9 women and 11 men, mean age 36,range 26-52). Salivary secretions were collected underbasal conditions and during masticatory, mechanical, andchemical stimulation before and after four days of cisapride administration (10 or 20 mg fourtimes a day). Cisapride administration resulted in a 45%increase in salivary volume during the basal condition(P < 0.01), a 32% increase during mastication (P < 0.05), a 53% increase during mechanical(P < 0.05), and a 51% increase during chemical (P< 0.01) stimulation. Cisapride administrationresulted also in a significant increase in salivaryprotein output (P < 0.05), salivary bicarbonate (P <0.05), and nonbicarbonate buffers (P < 0.05), andsalivary EGF (P < 0.05). Salivary glycoconjugatesignificantly increased only during mechanicalstimulation with the catheter and at the end of the esophageal perfusionprocedure (P < 0.05). Although a similar trend wasalso recorded during the analysis of salivaryPGE2, this difference did not reachstatistical significance. Salivary pH and TGF-α before and after cisaprideadministration remained unchanged. The stimulatoryimpact of cisapride on salivary volume and inorganic(bicarbonate and nonbicarbonate buffers) and organic(protein, glycoconjugate, and EGF) protective componentswould benefit patients with GERD and would also bepotential therapy for xerostomia.

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Authors
  1. George F. Goldin
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  2. Marek Marcinkiewicz
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  3. Tomasz Zbroch
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  4. Leonid P. Bityutskiy
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  5. R.W. Mccallum
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  6. J. Sarosiek
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Goldin, G.F., Marcinkiewicz, M., Zbroch, T. et al. Esophagoprotective Potential of Cisapride (An Additional Benefit for Gastroesophageal Reflux Disease). Dig Dis Sci 42, 1362–1369 (1997). https://doi.org/10.1023/A:1018825618043

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