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New Pharmaceutical Approaches to the Treatment of IBS:Future Development & Research

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Ελληνική Γαστροεντερολογική Εταιρία   

Αποθετήριο :
Annals of Gastroenterology   

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New Pharmaceutical Approaches to the Treatment of IBS:Future Development & Research (EN)
R. Spiller, N. Coleman,
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
2007-03-19
SUMMARY Current approaches to treatment of Irritable Bowel Syndrome (IBS) aim to normalise disturbed intestinal physiology. The most effective centrally acting drugs are tricyclic antidepressants. Alosetron, a 5-HT3 receptor antagonist is effective in women with diarrhea-predominant IBS whilst tegaserod and prucalopride are 5-HT4 agonists enhancing bowel motility in constipation-predominant IBS. Serotonergic receptor modulation has been the first targeted pharmacological intervention. The development of new drugs constitutes a major challenge as there are many targets along the brain-gut axis and the enteric nervous system (ENS). Newer tricyclic antidepressants with fewer side effects and corticotrophin releasing factor-1 (CRF-1) antagonists are examples of future centrally acting drugs. Agents that alter visceral sensitivity include kappa-opioid agonists (fedotozine, trimebutine, asimadoline), alpha-2 adrenoreceptor agonists (clonidine, lidamidine), tachykinin receptor antagonists (neurokinin A, substance P) and other experimental anti-nociceptive drugs (GABA-B receptor agonists). COX-2 inhibitors may be effective for postinfectious IBS. Drugs potentially useful in controlling intestinal motility and secretion other than serotonergic receptors modulators, include muscarinic receptors antagonists (derifenacin, zamenifenacin), octreotide and CCK-1 receptor antagonists (dexloglumide). Neurotrophins (NT- 3 and brain derived neurotrophic factor) are promising factors for the treatment of IBS patients with constipation. The development of new and effective drugs for IBS requires a more detailed understanding of pathophysiologic mechanisms, a fact that will allow us a more targeted intervention. Key words: Irritable bavel syndrome, visceral sensitivity tricyclic antidepressants, muscarinic receptors (EN)
Αγγλική γλώσσα
Hellenic Society of Gastroenterology (EN)
1792-7463
1108-7471
Annals of Gastroenterology; Volume 15, No 3 (2002) (EN)
Ελληνική Γαστροεντερολογική Εταιρία
Annals of Gastroenterology
Special Topics



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