Letters To The Editor Open Access
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World J Gastroenterol. Mar 7, 2009; 15(9): 1147-1147
Published online Mar 7, 2009. doi: 10.3748/wjg.15.1147
Lubiprostone: Clinical applications beyond constipation
Shailendra Kapoor, Kristin 24, Schaumburg, IL 60195, United States
Author contributions: Kapoor S contributed all to this work.
Correspondence to: Shailendra Kapoor, MD, Kristin 24, Schaumburg, IL 60195, United States. shailendrakapoor@yahoo.com
Telephone: +1-847-8866789
Fax: +1-847-8979878
Received: October 24, 2008
Revised: November 28, 2008
Accepted: December 5, 2008
Published online: March 7, 2009

Abstract

In comparison to polyethylene glycol, lubiprostone offers other advantages and is increasingly being used as an adjunctive agent in diagnostic as well as management strategies not only in gastroenterology, but in other fields. For instance, lubiprostone exerts beneficial effects in cystic fibrosis tissues. It augmernts the chloride secretion in these cells by activating non-cystic fibrosis transmembrane regulator (CFTR) secretion of chloride by afflicted respiratory epithelia. Lubiprostone also seems to improve visualization of the gastrointestinal tract during procedures such as colonoscopy. This is especially true if the lubiprostone is administered prior to bowel cleansing with agents such as polyethylene glycol electrolyte (PEG-E). Lubiprostone also enhances and stimulates contraction in colonic as well as gastric muscles and may thus further contribute as a prokinetic agent. Besides these effects, lubiprostone also causes hyperpolarization in other tissues such as uterine muscle cells. This may prove to be of significant clinical benefit in the management of uterine pathologies in the near future.

Key Words: Lubiprostone; Cystic fibrosis; Colonoscopy; Uterine muscle; Prokinetic agent



TO THE EDITOR

I read with great interest the recent article by Moeser et al[1]. The authors have provided an interesting comparison of lubiprostone and polyethylene glycol. In comparison with polyethylene glycol, lubiprostone offers other advantages and is increasingly being used as an adjunctive agent in diagnostic as well as management strategies not only in gastroenterology, but in other fields.

For instance, lubiprostone exerts beneficial effects in cystic fibrosis tissues. It augments the chloride secretion in these cells by activating non-cystic fibrosis transmembrane regulator (CFTR) secretion of chloride by afflicted respiratory epithelia[2]. Lubiprostone also seems to improve visualization of the gastrointestinal tract during procedures such as colonoscopy. This is especially true if the lubiprostone is administered prior to bowel cleansing with the agents such as polyethylene glycol electrolyte (PEG-E)[3]. Lubiprostone also enhances and stimulates contraction in colonic as well as gastric muscles and may, thus, further contribute as a prokinetic agent[4]. Besides these effects, lubiprostone also causes hyperpolarization in other tissues such as uterine muscle cells[5]. This may prove to be of significant clinical benefit in the management of uterine pathologies in the near future.

It is clear from the above examples that lubiprostone has an array of clinical features that may enhance its clinical application in gastroenterology. Further studies are needed to evaluate lubiprostone as an effective agent for the management of other diseases besides constipation.

Footnotes

S- Editor Cheng JX L- Editor Ma JY E- Editor Zheng XM

References
1.  Moeser AJ, Nighot PK, Roerig B, Ueno R, Blikslager AT. Comparison of the chloride channel activator lubiprostone and the oral laxative Polyethylene Glycol 3350 on mucosal barrier repair in ischemic-injured porcine intestine. World J Gastroenterol. 2008;14:6012-6017.  [PubMed]  [DOI]  [Cited in This Article: ]
2.  MacDonald KD, McKenzie KR, Henderson MJ, Hawkins CE, Vij N, Zeitlin PL. Lubiprostone activates non-CFTR-dependent respiratory epithelial chloride secretion in cystic fibrosis mice. Am J Physiol Lung Cell Mol Physiol. 2008;295:L933-L940.  [PubMed]  [DOI]  [Cited in This Article: ]
3.  Stengel JZ, Jones DP. Single-dose lubiprostone along with split-dose PEG solution without dietary restrictions for bowel cleansing prior to colonoscopy: a randomized, double-blind, placebo-controlled trial. Am J Gastroenterol. 2008;103:2224-2230.  [PubMed]  [DOI]  [Cited in This Article: ]
4.  Bassil AK, Borman RA, Jarvie EM, McArthur-Wilson RJ, Thangiah R, Sung EZ, Lee K, Sanger GJ. Activation of prostaglandin EP receptors by lubiprostone in rat and human stomach and colon. Br J Pharmacol. 2008;154:126-135.  [PubMed]  [DOI]  [Cited in This Article: ]
5.  Cuppoletti J, Malinowska DH, Chakrabarti J, Ueno R. Effects of lubiprostone on human uterine smooth muscle cells. Prostaglandins Other Lipid Mediat. 2008;86:56-60.  [PubMed]  [DOI]  [Cited in This Article: ]