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. 2017 Oct 5;8(10):e120.
doi: 10.1038/ctg.2017.46.

Influence of GABA-B Agonist Baclofen on Capsaicin-Induced Excitation of Secondary Peristalsis in Humans

Wei-Yi Lei  1 , Jui-Sheng Hung  1 , Tso-Tsai Liu  1 , Chih-Hsun Yi  1 , Chien-Lin Chen  1
Affiliations

Influence of GABA-B Agonist Baclofen on Capsaicin-Induced Excitation of Secondary Peristalsis in Humans

Wei-Yi Lei et al. Clin Transl Gastroenterol. .

Abstract

Objectives: Esophageal instillation of capsaicin enhances secondary peristalsis, but the γ-aminobutyric acid receptor type B (GABA-B) agonist baclofen inhibits secondary peristalsis. This study aimed to investigate whether baclofen could influence heartburn perception and secondary peristalsis subsequent to capsaicin infusion in healthy adults.

Methods: Secondary peristalsis was performed by slow and rapid mid-esophagus air injections in 15 healthy subjects. Two different sessions including esophageal infusion of capsaicin-containing red pepper sauce (0.84 mg) following pre-treatment with placebo or baclofen were randomly performed to test the effects on heartburn perception and secondary peristalsis.

Results: The intensity of heartburn symptom subsequent to capsaicin infusion was significantly greater after pre-treatment of baclofen as compared with the placebo (P=0.03). Baclofen significantly increased the threshold volume of secondary peristalsis to slow air injections subsequent to esophageal capsaicin infusion (P<0.001). Baclofen significantly increased the threshold volume of secondary peristalsis to rapid air injections subsequent to esophageal capsaicin infusion (P<0.01). The frequency of secondary peristalsis subsequent to capsaicin infusion was significantly decreased with baclofen as compared with the placebo (P<0.002). Baclofen had no effect on any of the peristaltic parameters of secondary peristalsis subsequent to capsaicin infusion.

Conclusions: The GABA-B agonist baclofen appears to attenuate the esophagus to capsaicin-induced excitation of secondary peristalsis in healthy adults. Our study suggests the inhibitory modulation for GABA-B receptors on capsaicin-sensitive afferents mediating secondary peristalsis in human esophagus.

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Conflict of interest statement

Guarantor of the article: Chien-Lin Chen, MD, PhD.

Specific author contributions: Data collection, design of the work, and drafting the work: L.W.Y. and C.L.C.; analysis and interpretation of data: J.S.H., L.T.T., C.H.Y.; approved the final version of the submitted work: all the authors.

Financial support: This study was supported by a grant, TCRD 105-08, from Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.

Potential competing interests: None.

Figures

Figure 1
Figure 1
Effects of baclofen on heartburn symptom subsequent to capsaicin infusion. The visual analog scale (VAS) score for heartburn symptom as induced by capsaicin infusion was significantly increased after pre-treatment of baclofen when compared with the placebo (*P=0.03). Values are expressed as mean±s.e.m. Line represents the mean value.
Figure 2
Figure 2
Effects of baclofen on threshold volumes of secondary peristalsis subsequent to capsaicin infusion. (a) The threshold volume of secondary peristalsis subsequent to capsaicin infusion was significantly increased after pre-treatment with baclofen when compared with the placebo during rapid air injection (*P<0.001). (b) The threshold volume of secondary peristalsis subsequent to capsaicin infusion was significantly increased after pre-treatment with baclofen when compared with the placebo during rapid slow injection (**P<0.01). Values are expressed as mean±s.e.m. Line represents the mean value.
Figure 3
Figure 3
Effect of baclofen on the frequency of secondary peristalsis subsequent to capsaicin infusion. Baclofen significantly decreased the frequency of secondary peristalsis subsequent to capsaicin infusion as compared with the placebo (P=0.002). Values are expressed as median with interquartile range.
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