Evolving prokinetic therapy: New targets and therapeutic opportunities in gastrointestinal motility disorders

doi:10.4292/wjgpt.v17.i2.118616

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World Journal of Gastrointestinal Pharmacology and Therapeutics

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2150-5349

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Pharmacol Ther. Jun 5, 2026; 17(2): 118616
Published online Jun 5, 2026. doi: 10.4292/wjgpt.v17.i2.118616

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Figure 1 Enteric nervous system targets for prokinetic therapy. Schematic showing key enteric neurotransmitter pathways regulating gastrointestinal motility. Dopamine inhibits acetylcholine release and is blocked by D₂ antagonists (metoclopramide, domperidone), while serotonergic signaling via 5-hydroxytryptamine type 4 receptor agonists (prucalopride, cisapride, velusetrag) enhances cholinergic activity. Cholinergic, motilin, and ghrelin pathways, along with neurokinin-1 receptor antagonists, sodium-hydrogen exchanger 3 inhibitors, and cannabinoid signaling, collectively modulate enteric motor function. 5-HT₃: 5-Hydroxytryptamine type 3 receptor; 5-HT₄: 5-Hydroxytryptamine type 4 receptor; Ach: Acetylcholine; AChE: Acetylcholinesterase; MOA: Mechanism of action; NHE3: Sodium-hydrogen exchanger 3; NK1: Neurokinin-1 receptor; Δ9-THC: Delta-9-tetrahydrocannabinol.

Citation: Goyal O, Chowdhary R, Sehgal T, Joshi T, Bhambri A, Rampurawala IM, Sohi GS, Das A, Arora K, Vuthaluru AR, Goyal MK. Evolving prokinetic therapy: New targets and therapeutic opportunities in gastrointestinal motility disorders. World J Gastrointest Pharmacol Ther 2026; 17(2): 118616
URL: https://www.wjgnet.com/2150-5349/full/v17/i2/118616.htm
DOI: https://dx.doi.org/10.4292/wjgpt.v17.i2.118616

Goyal O, Chowdhary R, Sehgal T, Joshi T, Bhambri A, Rampurawala IM, Sohi GS, Das A, Arora K, Vuthaluru AR, Goyal MK. Evolving prokinetic therapy: New targets and therapeutic opportunities in gastrointestinal motility disorders. World J Gastrointest Pharmacol Ther 2026; 17(2): 118616 [PMID: 42273241 DOI: 10.4292/wjgpt.v17.i2.118616]

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