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. 2002 Jul;51(Suppl 1):i81–i86. doi: 10.1136/gut.51.suppl_1.i81

Serotonergic modulation of visceral sensation: lower gut

M Camilleri
PMCID: PMC1867727  PMID: 12077074

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Figure 1 .

Figure 1

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Evidence of stimulation of 5-HT containing submucosal neurones by stroking the small bowel mucosa. Uptake of FM2-10 was quantified on control and mucosally stimulated sides of preparations in the absence or presence of two concentrations of fluoxetine. Reproduced with permission from Chen and colleagues.2

Figure 2 .

Figure 2

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Effect of alosetron 1 mg twice daily and placebo on adequate relief of pain (A) and stool consistency (B) in female patients with symptoms of diarrhoea. Note the improvement in symptoms and the abrupt change in symptoms with cessation of therapy after 12 weeks. *p<0.05; ***p<0.001. Reproduced with permission from Camilleri and colleagues.35

Figure 3 .

Figure 3

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Model of the effect of 5-HT released from enterochromaffin cells or absorbed tegaserod, a partial 5-HT4 agonist, on activation of intrinsic primary afferent neurones (for example, calcitonin gene related peptide (CGRP)), which in turn stimulate the "peristaltic reflex". This involves orad contraction, mediated through excitatory transmitters such as acetylcholine (ACh) or substance P (SP), and a caudad relaxation, mediated through inhibitory neurotransmitters such as vasoactive intestinal peptide (VIP), pituitary adenylate cyclase associated peptide (PACAP), or nitric oxide synthetase (NOS). MEC, median effective concentration. Adapted from Grider and colleagues.38

Figure 4 .

Figure 4

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Effect of tegaserod on the firing rate of the pelvic afferent fibres stimulated by 50 mm Hg distension of the rectum in cats (mean (SD), n=9); note the dose related reduction in the firing rate, suggesting an effect of tegaserod on visceral afferent function. *p<0.05. Reproduced with permission from Schikowski and colleagues.41

Figure 5 .

Figure 5

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Effect of tegaserod (A) and placebo (B) on orocaecal transit measured as colonic filling at six hours in patients with symptoms of constipation predominant irritable bowel syndrome. Reproduced with permission from Prather and colleagues.43

Figure 6 .

Figure 6

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Effect of tegaserod on monthly assessment of the subjects' global assessment of relief; note the significant increase in the proportion of patients achieving the global relief end point with 2 mg and 6 mg twice daily (bid) tegaserod. *p<0.05; **p<0.01. Reproduced with permission from Mueller-Lissner and colleagues.45

Figure 7 .

Figure 7

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Effect of tegaserod (2 and 6 mg twice daily (bid)) on weekly assessment of pain. *p<0.05; **p<0.01 versus placebo. Significant=at least mild; ≥2 on a six point scale. Reproduced with permission from Mueller-Lissner and colleagues.44

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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