Effect of EP1 Receptor Antagonist on Transient Lower Esophageal Sphincter Relaxations in Humans

Digestion. 2020;101(3):270-278. doi: 10.1159/000499333. Epub 2019 Mar 21.

Abstract

Background/aims: Transient lower esophageal sphincter relaxations (TLESRs) are the major cause of gastroesophageal reflux. Recently, an EP1 receptor antagonist, ONO-8539, showed the reduction of TLESRs in monkeys. However, its effect on TLESRs in humans remains unclear. This study investigated the effect of ONO-8539 on postprandial TLESRs in healthy male subjects.

Methods: Twenty-seven subjects participated in this placebo-controlled, cross-over study. The subjects received either placebo or ONO-8539 (450 mg) after a standardized breakfast. A 30-min basal recording was performed 4 h after drug administration. Subsequently, TLESR recordings were performed after a high-fat test meal for 3 h. The examination was repeated at least 7 days from the first evaluation for washout.

Results: Thirteen patients were ultimately analyzed. The basal lower esophageal sphincter pressure was not different between the 2 groups (16.3 and 18.0 mm Hg for placebo and ONO-8539, respectively; p = 0.88). ONO-8539 significantly reduced the number of TLESRs from 15.0 to 12.0 for 3 h (p < 0.05). The proportion of terminating events of TLESRs was significantly different between the 2 groups (p < 0.05). No events and swallowing terminated more TLESRs with ONO-8539 than with placebo.

Conclusions: ONO-8539 suppressed TLESRs mildly. EP1 receptor may be involved with the mechanism of human TLESRs.

Keywords: EP1 receptor; Esophageal motility; Gastroesophageal reflux disease; Lower esophageal sphincter.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Benzoates / administration & dosage*
  • Cross-Over Studies
  • Double-Blind Method
  • Endoscopy, Digestive System / methods
  • Esophageal Sphincter, Lower / diagnostic imaging
  • Esophageal Sphincter, Lower / drug effects*
  • Esophageal Sphincter, Lower / physiopathology
  • Female
  • Gastroesophageal Reflux / physiopathology
  • Gastroesophageal Reflux / prevention & control*
  • Humans
  • Indenes / administration & dosage*
  • Male
  • Manometry / methods
  • Muscle Relaxation / drug effects*
  • Muscle Relaxation / physiology
  • Postprandial Period
  • Receptors, Prostaglandin E, EP1 Subtype / antagonists & inhibitors*
  • Thiazoles / administration & dosage*
  • Treatment Outcome
  • Young Adult

Substances

  • Benzoates
  • Indenes
  • PTGER1 protein, human
  • Receptors, Prostaglandin E, EP1 Subtype
  • Thiazoles
  • ONO-8539