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A comparative study on the therapeutic effect of TRPV 1, TRPA 1, and TRPM 8 agonists on swallowing dysfunction associated with aging and neurological diseases
Author(s) -
AlvarezBerdugo D.,
Rofes L.,
Arreola V.,
Martin A.,
Molina L.,
Clavé P.
Publication year - 2018
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.13185
Subject(s) - trpv , medicine , dysphagia , bolus (digestion) , transient receptor potential channel , stimulation , endocrinology , pharmacology , trpv1 , surgery , receptor
Background Oropharyngeal sensory impairment is a potential target to treat swallowing dysfunction in patients with oropharyngeal dysphagia ( OD ). Aim To assess the therapeutic effect of stimulating oropharyngeal sensory afferents with TRPV 1, TRPA 1, or TRPM 8 agonists vs increasing bolus viscosity in older and neurologic patients with OD by comparing four studies of similar experimental design. Methods Swallow function of 142 older patients with impaired safety of swallow at nectar ([50‐350] mPa·s) viscosity was evaluated with videofluoroscopy ( VFS ) while treated with TRPV 1 (150 μmol/L), TRPV 1/A1 (150 μmol/L and 1 mmol/L), or TRPM 8 (1 mmol/L or 10 mmol/L) agonists or modified starch ( MS ) at spoon thick viscosity (>1750 mPa·s). Results TRPV 1 stimulation with capsaicinoids reduced penetrations by 50%, pharyngeal residue by 80%, and LVC time by 24.38% and increased bolus velocity by 36.51%. TRPV 1/A1 stimulation with piperine reduced penetrations by 56.32%, LVC time by 25.55% and increased bolus velocity by 23.63%. TRPM 8 stimulation with menthol 1 mmol/L reduced penetrations by 37.5% while 10 mmol/L reduced LVC time by 18.44%. Thickeners reduced penetrations by 77.11%, but increased pharyngeal residue by 19.89%, delayed LVC by 41.73%, and reduced bolus velocity by 13.44%. Conclusion Natural capsaicinoids have a stronger therapeutic effect on VFS signs and swallow response by stimulating TRPV 1 than TRPV 1/A1 or TRPM 8 agonists. While TRP stimulants increased bolus velocity and reduced swallow response times, thickeners reduced bolus velocity and further delayed the swallow response. This study sets the bases to develop new pharmacologic strategies for older patients with OD , moving away from compensation toward the recovery of swallow function.