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. 1998 Jan;42(1):36–41. doi: 10.1136/gut.42.1.36

Actions of the 5-hydroxytryptamine 1 receptor agonist sumatriptan on interdigestive gastrointestinal motility in man

J Tack 1, B Coulie 1, A Wilmer 1, T Peeters 1, J Janssens 1
PMCID: PMC1726962  PMID: 9505883

Abstract

Background—Pharmacological studies of the enteric nervous system have shown the presence of several subtypes of 5-hydroxytryptamine (5HT) receptor, which might be involved in control of the migrating motor complex. 
Aims—To study the effect of sumatriptan, an agonist of enteric neuronal 5HT1P receptors, on interdigestive motility in man. 
Subjects and methods—In 12 healthy subjects, interdigestive motility was recorded manometrically in the upper gastrointestinal tract. In seven subjects blood samples were drawn every 15 minutes for radioimmunoassay of motilin and somatostatin. After two phase 3s of the migrating motor complex, 6 mg of sumatriptan was administered subcutaneously. Recording continued until two more phase 3s had occurred. 
Results—Sumatriptan induced a premature phase 3 in the jejunum after a median of 10 (8) minutes. The duration of the migrating motor complex cycle was shortened at the expense of phase 2. After sumatriptan, plasma somatostatin concentrations were reduced and gastric phase 3s were suppressed, although median motilin concentrations and the occurrence of plasma motilin peaks were not affected. Phase 3s of the migrating motor complex preceding sumatriptan were associated with motilin peaks, while phase 3s after sumatriptan were not. Furthermore, pretreatment with sumatriptan prevented the induction of a gastric phase 3 by the motilin agonist erythromycin. 
Conclusions—Administration of the 5HT1P receptor agonist sumatriptan induces a premature intestinal phase 3, suppresses gastric phase 3s, prevents induct- ion of a gastric phase 3 by erythromycin, and reduces plasma somatostatin concentrations. 



Keywords: migrating motor complex; motilin; somatostatin; erythromycin; enteric nervous system

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Figure 1 .

Figure 1

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Effect of sumatriptan on upper gastrointestinal motility in a healthy volunteer. A1, A2, A3, antral recording sites; D, duodenal recording site; J1, J2, jejunal recording sites. 


Figure 2 .

Figure 2

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Typical changes of interdigestive motility and its relation to motilin plasma concentrations in a healthy volunteer. The seven lower traces depict schematic representations (flat line = phase 1; tinted bars = phase 2; black bars = phase 3) of the different phases of the MMC in the stomach and the upper small intestine. A1, A2, A3, A4, antral recording sites; D1, duodenal recording site; J1, J2, jejunal recording sites. Two spontaneous activity fronts occur, the first of gastric origin and the second of duodenal origin. Administration of sumatriptan induces a premature jejunal activity front. The upper trace depicts motilin plasma concentrations throughout the study. The spontaneously occurring activity front is accompanied by a plasma motilin peak (x). The sumatriptan induced premature jejunal activity front is not accompanied by a plasma motilin peak. After administration of sumatriptan, a plasma motilin peak (xx) is not accompanied by phase 3 activity. 


Figure 3 .

Figure 3

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Plasma somatostatin concentrations in seven healthy volunteers at 15 minute intervals before and after sumatriptan 6 mg subcutaneously. The activity front preceding the administration of sumatriptan (at time 15 minutes) is accompanied by a plasma somatostatin peak. After its administration, low plasma somatostatin concentrations are observed, and the sumatriptan induced premature activity front (on average at time 10 minutes) is not accompanied by a plasma peak. 


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