Abstract

Otilonium bromide (OB) is a spasmolytic drug successfully used for the treatment of irritable bowel syndrome (IBS). Its efficacy has been attributed to the block of L‐ and T‐type Ca2+ channels and muscarinic and tachykinin receptors in the smooth muscle. Furthermore, in healthy rats, repeated OB administration modified neurotransmitter expression and function suggesting other mechanisms of action. On this basis, we investigated whether repeated OB treatment prevented the functional and neurochemical changes observed in the colon of rats underwent to wrap restrain stress (WRS) a psychosocial stressor considered suitable to reproduce the main IBS signs and symptoms. In control, WRS and OB/WRS rats functional parameters were measured in vivo and morphological investigations were done ex vivo in the colon. The results showed that OB counteracts most of the neurotransmitters changes caused by WRS. In particular, the drug prevents the decrease in SP‐, NK1r‐, nNOS‐, VIP‐, and S100β‐immunoreactivity (IR) and the increase in CGRP‐, and CRF1r‐IR. On the contrary, OB does not affect the increase in CRF2r‐IR neurons observed in WRS rats and does not interfere with the mild mucosal inflammation due to WRS. Finally, OB per se increases the Mr2 expression in the muscle wall and decreases the number of the myenteric ChAT‐IR neurons. Functional findings show a significantly reduction in the number of spontaneous abdominal contraction in OB treated rats. The ability of OB to block L‐type Ca2+ channels, also expressed by enteric neurons, might represent a possible mechanism through which OB exerts its actions.

Highlights

  • Otilonium bromide (OB) – known by its IUPAC chemical name N, N-diethyl-N-methyl-2-(4-[2-(octyloxy)benzamido]benzoyloxy)ethanaminium bromide – is prescribed in Europe, Asia and South America as an anti-spasmodic for the treatment of irritable bowel syndrome (IBS) [1]

  • NNOS-IR neurons were significantly decreased either in wrap restrain stress (WRS) or OB/WRS rats compared to controls (Table 1)

  • Mr2-IR in the smooth muscle cells was decreased in WRS rats compared to controls and OB/WRS rats (Fig. 5A–C)

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Summary

Introduction

Otilonium bromide (OB) – known by its IUPAC chemical name N, N-diethyl-N-methyl-2-(4-[2-(octyloxy)benzamido]benzoyloxy)ethanaminium bromide – is prescribed in Europe, Asia and South America as an anti-spasmodic for the treatment of irritable bowel syndrome (IBS) [1]. This drug contains a charged quaternary ammonium that favours its accumulation within the gastrointestinal wall [2]. A recent clinical trial has confirmed the OB efficacy in IBS patients and has shown, for the first time, the long-term beneficial effect of the drug during the follow-up period in a group of patients previously treated with OB as compared to placebo group [5]. The results obtained demonstrated: in the smooth muscle a 2016 The Authors

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