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. 1998 Jun;42(6):830–835. doi: 10.1136/gut.42.6.830

Motilin induces gall bladder emptying and antral contractions in the fasted state in humans

Y Luiking 1, T Peeters 1, M Stolk 1, V Nieuwenhuijs 1, P Portincasa 1, I Depoortere 1, Henegou G P van Berge 1, L Akkermans 1
PMCID: PMC1727155  PMID: 9691922

Abstract

Background—Animal studies have shown that motilin affects gall bladder motility. In humans, no effect has been shown, but erythromycin, a motilin receptor agonist, induces gall bladder emptying. 
Aims—To explore the effect of increasing doses of exogenous motilin on gall bladder volume and antral contractility in the fasted state in humans. 
Methods—After an overnight fast, eight healthy men received increasing intravenous doses of Leu13-motilin (KW-5139) or 0.9% NaCl in a double blind, randomised fashion. Gall bladder volume and antral contraction frequency were determined by ultrasonography. 
Results—Infusion of motilin increased plasma motilin levels. Motilin induced a reduction in gall bladder volume of 8.0 (5.0)%, 17.1 (5.0)%, 18.5 (4.7)%, and 16.1 (4.9)% of baseline volume at the end of infusion of 2, 4, ,8 and 16 pmol/kg/min respectively, compared with mean stable gall bladder volumes during placebo infusion (p<0.05). Antral contraction frequency increased during motilin infusion, but not during placebo infusion (p<0.05). 
Conclusions—Exogenous motilin reducted fasting gall bladder volume and increased antral contractions. After reaching maximal reduction, the gall bladder volume did not decrease further during continuous motilin infusion at higher doses and stayed at the same reduced volume. The degree of gall bladder volume reduction during motilin infusion mimicked gall bladder emptying preceding antral phase III activity of the migrating motor complex in humans. This study indicates that motilin may play a physiological role in the regulation of gall bladder emptying in the fasted state. 



Keywords: motilin; gall bladder; antrum; motility; ultrasonography

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Figure 1 .

Figure 1

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Plasma motilin levels before and during infusion of stepwise increased doses of motilin (means (SEM)). Horizontal bars show the motilin dose. 


Figure 2 .

Figure 2

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Effect of motilin (closed circles) versus placebo (saline; open squares) infusion on gall bladder volume (mean (SEM)). Gall bladder volumes are expressed as percentages of the baseline volume. Horizontal bars show the motilin dosage. p<0.05 for motilin versus placebo. 


Figure 3 .

Figure 3

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Antral contraction frequency (median and interquartile range) during the 20 minute period before infusion, the 80 minute period of infusion, and the 20 minute period after infusion of motilin (shaded column) and of placebo (open column). 


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