Liraglutide improves symptoms in irritable bowel patients through brain-gut signaling

Linaclotide, a coronate cyclase C agonist, can significantly improve abdominal pain, constipation and abdominal distension in constipated patients, namely irritable bowel syndrome, but how it improves abdominal pain in humans is unclear.

Background

Linaclotide, a coronate cyclase C (GC+C) agonist, has been found in large randomized controlled trials to significantly improve abdominal pain, constipation, and abdominal distension in constipated patients, i.e., irritable bowel syndrome, but how it improves abdominal pain in humans remains unclear.In this randomized clinical trial, researchers sought to explore the effects of liraglutide and placebo on afferent and efferent gut-to-gut signaling in IBS+C patients.

research method

Patients with IBS+C (Rome III) and rectal hypersensitivity (2:1) were randomly assigned to treatment with liraglutide (290 g) or placebo for 10 weeks and evaluated for anorectal and brain axis by bi-directional magnetic stimulation via anorectal electrical stimulation and transcranial stimulation via the vertebral approach.Rectal sensory examination balloon dilatation.Assessments included abdominal pain, bowel symptoms, and quality of life (QOL) scores.The main indicators were cortical and cortical rectal evoked potential latency.

Research findings

There were 39 patients in this trial, 26 of whom were treated with liraglutide and 13 with placebo.

The latency of rectal cortical evoked potential was significantly prolonged by liraglutide (P1: 19 + 6, P < 0.005; N1: 20 + 7, P < 0.02) (P1: 3 + 5; N1: 4.7 + 5, P = 0.3).There was no change in cortical-anorectal and spinal-anorectal latencies.Compared with baseline, liraglutide increased significantly (P < 0.001) in the allowable maximum rectal volume (cc).Abdominal pain was reduced after liraglutide administration (P<0.001).

Compared with baseline and placebo, liraglutide with complete spontaneous defecation improved the IBS-QOL score (P=0.01).The overall remission rate did not differ between liraglutide and placebo (54% vs 23%, P=0.13).

research conclusion

Liraglutide prolonged intestinal-brain signaling from baseline, but neither in nor out signaling was affected compared with placebo.Liraglutide significantly improved rectal anaphylaxis, IBS+C symptoms, and QOL compared with placebo.This may be the reason for the analgesic effect of liraglutide in IBS+C patients.

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