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ISSN 1007-9327 CN 14-1219/R  World J Gastroenterol  2009 March 7; 15(9): 1147

LETTERS TO THE EDITOR

Lubiprostone: Clinical applications beyond constipation
 

Shailendra Kapoor


Shailendra Kapoor, Kristin 24, Schaumburg, IL 60195, United States

Author contributions: Kapoor S contributed all to this work.

Correspondence to: Shailendra Kapoor, MD, Kristin 24, Schaumburg, IL 60195, United States. shailendrakapoor@yahoo.com

Telephone: +1-847-8866789  Fax: +1-847-8979878

Received: October 24, 2008   Revised: November 28, 2008

Accepted: December 5, 2008

Published online: March 7, 2009

  

Abstract

In comparison to polyethylene glycol, lubiprostone offers other advantages and is increasingly being used as an adjunctive agent in diagnostic as well as management strategies not only in gastroenterology, but in other fields. For instance, lubiprostone exerts beneficial effects in cystic fibrosis tissues. It augmernts the chloride secretion in these cells by activating non-cystic fibrosis transmembrane regulator (CFTR) secretion of chloride by afflicted respiratory epithelia. Lubiprostone also seems to improve visualization of the gastrointestinal tract during procedures such as colonoscopy. This is especially true if the lubiprostone is administered prior to bowel cleansing with agents such as polyethylene glycol electrolyte (PEG-E). Lubiprostone also enhances and stimulates contraction in colonic as well as gastric muscles and may thus further contribute as a prokinetic agent. Besides these effects, lubiprostone also causes hyperpolarization in other tissues such as uterine muscle cells. This may prove to be of significant clinical benefit in the management of uterine pathologies in the near future.

 

2009 The WJG Press and Baishideng. All rights reserved.

 

Key words: Lubiprostone; Cystic fibrosis; Colonoscopy; Uterine muscle; Prokinetic agent

 

Kapoor S. Lubiprostone: Clinical applications beyond constipation. World J Gastroenterol 2009; 15(9): 1147  Available from: URL: http://www.wjgnet.com/1007-9327/15/1147.asp  DOI: http://dx.doi.org/10.3748/wjg.15.1147

  

TO THE EDITOR

I read with great interest the recent article by Moeser et al[1]. The authors have provided an interesting comparison of lubiprostone and polyethylene glycol. In comparison with polyethylene glycol, lubiprostone offers other advantages and is increasingly being used as an adjunctive agent in diagnostic as well as management strategies not only in gastroenterology, but in other fields.

    For instance, lubiprostone exerts beneficial effects in cystic fibrosis tissues. It augments the chloride secretion in these cells by activating non-cystic fibrosis transmembrane regulator (CFTR) secretion of chloride by afflicted respiratory epithelia[2]. Lubiprostone also seems to improve visualization of the gastrointestinal tract during procedures such as colonoscopy. This is especially true if the lubiprostone is administered prior to bowel cleansing with the agents such as polyethylene glycol electrolyte (PEG-E)[3]. Lubiprostone also enhances and stimulates contraction in colonic as well as gastric muscles and may, thus, further contribute as a prokinetic agent[4]. Besides these effects, lubiprostone also causes hyperpolarization in other tissues such as uterine muscle cells[5]. This may prove to be of significant clinical benefit in the management of uterine pathologies in the near future.

    It is clear from the above examples that lubiprostone has an array of clinical features that may enhance its clinical application in gastroenterology. Further studies are needed to evaluate lubiprostone as an effective agent for the management of other diseases besides constipation.

 

REFERENCES

1      Moeser AJ, Nighot PK, Roerig B, Ueno R, Blikslager AT. Comparison of the chloride channel activator lubiprostone and

        the oral laxative Polyethylene Glycol 3350 on mucosal barrier repair in ischemic-injured porcine intestine. World J

        Gastroenterol 2008; 14: 6012-6017   PubMed    DOI

2      MacDonald KD, McKenzie KR, Henderson MJ, Hawkins CE, Vij N, Zeitlin PL. Lubiprostone activates non-CFTR-dependent

        respiratory epithelial chloride secretion in cystic fibrosis mice. Am J Physiol Lung Cell Mol Physiol 2008; 295: L933-L940  

        PubMed

3.     Stengel JZ, Jones DP. Single-dose lubiprostone along with split-dose PEG solution without dietary restrictions for bowel

        cleansing prior to colonoscopy: a randomized, double-blind, placebo-controlled trial. Am J Gastroenterol 2008; 103:

        2224-2230   PubMed    DOI

4.     Bassil AK, Borman RA, Jarvie EM, McArthur-Wilson RJ, Thangiah R, Sung EZ, Lee K, Sanger GJ. Activation of

        prostaglandin EP receptors by lubiprostone in rat and human stomach and colon. Br J Pharmacol 2008; 154: 126-135  

        PubMed    DOI

5      Cuppoletti J, Malinowska DH, Chakrabarti J, Ueno R. Effects of lubiprostone on human uterine smooth muscle cells.

        Prostaglandins Other Lipid Mediat 2008; 86: 56-60   PubMed    DOI

 S- Editor  Cheng JX    L- Editor  Ma JY    E- Editor  Zheng XM

 

 

 

 

 

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