Motilin and Gastric Inhibitory Polypeptide (GIP)
Craig A. Johnston, Charles D. Barnes in Brain-Gut Peptides and Reproductive Function, 2020
It is possible that either there is interaction between motilin and sex hormone changes during pregnancy or that motilin plays a role during delivery. Basal IRM levels were found to be lower in the mother during late pregnancy than those postpartum, and meal-stimulated release was also reduced (Jenssen et al., 1988). Jenssen et al. (1986b) also observed a transient rise in IRM during delivery. Although this may represent a compensatory mechanism leading to increased gastrointestinal motility following birth (Jenssen et al., 1986b) motilin may have an alternative role, for example, in regulation of uterine motility. The effect of motilin on uterine smooth muscle has not, to my knowledge, been investigated. Breast feeding was not found to influence IRM levels in the mother, so it is unlikely to play a role in this reflex (Holst et al., 1986).
Postulated Physiological and Pathophysiological Roles on Motility
Edwin E. Daniel in Neuropeptide Function in the Gastrointestinal Tract, 2019
Intravenous infusion of 13-Nle-motilin in concentrations mimicking physiological plasma levels682 decreased liquid gastric emptying in three healthy volunteers.683 Subsequent studies, however, demonstrated an acceleration of solid emptying in man653 and of liquid emptying in dogs.684 The increase in gastric emptying can, at least in part, be attributed to the rise of intragastric pressure observed after motilin infusion.227 Besides increasing gastric emptying, motilin also seems to accelerate gastrointestinal transit.685 As mentioned before, erythromycin, which has been shown to act on motilin receptors, normalized gastric emptying in patients with diabetic gastroparesis.632 How motilin affects the pylorus is unknown, and its site(s) of action in accelerating gastric emptying are not entirely clear.
Gastrointestinal Complications of Diabetes Mellitus
Jack L. Leahy, Nathaniel G. Clark, William T. Cefalu in Medical Management of Diabetes Mellitus, 2000
The macrolide antibiotic erythromycin is a potent gastroprokinetic, particularly in diabetic gastroparesis patients. It acts as an agonist at both neural and muscular motilin receptors, which are located throughout the mammalian gastrointestinal tract. Erythromycin was introduced into the clinical motility arena by Janssens et al. (11), who demonstrated that brief administration of this macrolide antibiotic accelerated gastric emptying of solids and increased antral contractions in patients with diabetes, some of whom also had evidence of gastric stasis. Despite its efficacy in the immediate management of symptomatic patients with gastroparesis, there is litde evidence that it improves symptoms over the long term. Erythromycin loses much of its stimulatory effect beyond the first few weeks of treatment, possibly owing to down-regulation of motilin receptor expression.
Motilin Receptor Expression Found in the Human Main and Accessory Lacrimal Glands
Published in Ocular Immunology and Inflammation, 2022
Richard R. Sadig, Alexandra Allende, Geoffrey Hall, Dinh Tran, Michele C Madigan, Stephanie L. Watson, Kenneth G. -J. Ooi
The motilin receptor is an important prokinetic receptor traditionally found in the antrum of the stomach as well as the duodenum.5 Motilin is a 22 amino acid ligand hormone secreted mainly by specialized enterochromaffin mucosal cells of the upper GIT system including the stomach antrum and the duodenum. Its secretion is usually in response to changes in the pH of the stomach, alkalinization of the duodenum and distention of the stomach.6–8 The actions of motilin also affect the cholinergic pathway to stimulate contractions of the gall bladder and the sphincter of Oddi.7 The motilin receptor is a guanine-coupled receptor of class 1 type 1. The motilin receptor has two main bindings site identified, an extracellular portion and a transcellular portion. The extracellular portion involves the docking of peptide-like structures (such as motilin) onto the extramembranous loop portion of the motilin receptor.9 Motilin is released with cholinergic vagal stimulation of local antral nerve plexuses.10 This suggests that motilin can be released both in local response and via central neuronal control – predominantly under cholinergic control.8,10 Motilin receptors have also been found in rabbit brains– with the highest densities found in the hippocampus, hypothalamus and amygdala, as well as in the cerebellum.4,11 Its role in the central nervous system is not entirely clear but it is postulated to be involved with neurotransmission via synaptosomes, as well as stimulating appetite, mood and memory6,11,12,13
Acupoint Massage Can Effectively Promote the Recovery of Gastrointestinal Function after Gynecologic Laparoscopy
Published in Journal of Investigative Surgery, 2021
Di Ruan, Jingjing Li, Junchang Liu, Dandan Li, Ning Ji, Cheng Wang, Yujiang Qu, Yongtao Li
The vagus nerve of the autonomic nervous system regulates gastrointestinal motility by stimulating the release of different gastrointestinal hormones [14]. Motilin is among the one that promotes the motility of gut intestine during digestion [15], and indeed, motilin is one of the indicators that have been clinically used to evaluate postoperative gastrointestinal function [16]. In past few years, the functional relationship between the meridian and autonomic nervous systems has been extensively studied. Acupoint massage was shown to modulate both heart rate variability and meridian electrical conductance [17]. Enhanced qi circulation is believed to promote the stimulating effect of the vagus nerve on gut motility. In accordance to this hypothesis, our data showed that the qi-promoting massage could profoundly elevate not only motilin but also cholecystokinin. Cholecystokinin mediates digestion in the small intestine, and stimulates digestive enzyme releases from the pancreas [18]. Somatostatin suppresses the release of gastrointestinal hormones including motilin and cholecystokinin [19]. Here, we showed that the acupoint massage could reduce somatostatin level in patients, resulting in the up-regulation of digestion-promoting hormones.
Gastroparesis syndromes: emerging drug targets and potential therapeutic opportunities
Published in Expert Opinion on Investigational Drugs, 2023
Le Yu Naing, Matthew Heckroth, Prateek Mathur, Thomas L Abell
There are a few medications that have successfully been used as off-label treatments for GpS. Erythromycin is a macrolide antibiotic that has a prokinetic effect on the GI tract by activating the motilin receptor. Motilin is a peptide synthesized and released in the small intestine, with smaller amounts in the gastric antrum, during fasting and postprandial phases. It acts on motilin receptors to stimulate gastric contractions and increase gastric emptying. Another macrolide, azithromycin, has also demonstrated activity as a motilin receptor agonist, although data is limited. Although not FDA approved for GI motility disorders, erythromycin has been widely used in the acute treatment of Gp. Due to concerns with tachyphylaxis, the risk of antibiotic resistance, poor availability of oral formulation, and its tendency for QT prolongation, long-term use is not widely recommended.
Related Knowledge Centers
- Peptide Hormone
- Gene
- Endocrine System
- Microfold Cell
- Peyer'S Patch
- Intestinal Gland
- Small Intestine
- Duodenum
- Jejunum
- Motilin Receptor