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Broad-spectrum antiemetic potential of the L-type calcium channel antagonist nifedipine and evidence for its additive antiemetic interaction with the 5-HT(3) receptor antagonist palonosetron in the least shrew (Cryptotis parva).

Abstract
Cisplatin-like chemotherapeutics cause vomiting via release of multiple neurotransmitters (dopamine, serotonin (5-HT), or substance P (SP)) from the gastrointestinal enterochromaffin cells and/or the brainstem via a calcium dependent process. Diverse channels in the plasma membrane allow extracellular Ca(2+) entry into cells for the transmitter release process. Agonists of 5-HT3 receptors increase calcium influx through both 5-HT3 receptors and L-type Ca(2+) channels. We envisaged that L-type calcium agonists such as FPL 64176 should cause vomiting and corresponding antagonists such as nifedipine would behave as broad-spectrum antiemetics. Administration of FPL 64176 did cause vomiting in the least shrew in a dose-dependent fashion. Nifedipine and the 5-HT3 receptor antagonist palonosetron, potently suppressed FPL 64176-induced vomiting, while a combination of ineffective doses of these antagonists was more efficacious. Subsequently, we investigated the broad-spectrum antiemetic potential of nifedipine against diverse emetogens including agonists of serotonergic 5-HT3- (e.g. 5-HT or 2-Me-5-HT), SP tachykinin NK1- (GR73632), dopamine D2- (apomorphine or quinpirole), and cholinergic M1- (McN-A-343) receptors, as well as the non-specific emetogen, cisplatin. Nifedipine by itself suppressed vomiting in a potent and dose-dependent manner caused by the above emetogens except cisplatin. Moreover, low doses of nifedipine potentiated the antiemetic efficacy of non-effective or semi-effective doses of palonosetron against vomiting caused by either 2-Me-5-HT or cisplatin. Thus, our findings demonstrate that activation of L-type calcium channels causes vomiting, whereas blockade of these ion channels by nifedipine-like antagonists not only provides broad-spectrum antiemetic activity but can also potentiate the antiemetic efficacy of well-established antiemetics such as palonosetron. L-type calcium channel antagonists should also provide antiemetic activity against drug-induced vomiting as well as other emetogens including bacterial and viral proteins.
AuthorsNissar A Darmani, Weixia Zhong, Seetha Chebolu, Mariam Vaezi, Tursun Alkam
JournalEuropean journal of pharmacology (Eur J Pharmacol) Vol. 722 Pg. 2-12 (Jan 05 2014) ISSN: 1879-0712 [Electronic] Netherlands
PMID24513517 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Antiemetics
  • Calcium Channel Blockers
  • Calcium Channels, L-Type
  • Isoquinolines
  • Pyrroles
  • Quinuclidines
  • Receptors, Serotonin, 5-HT3
  • Serotonin 5-HT3 Receptor Antagonists
  • FPL 64176
  • Palonosetron
  • Nifedipine
Topics
  • Animals
  • Antiemetics (pharmacology, therapeutic use)
  • Calcium Channel Blockers (pharmacology, therapeutic use)
  • Calcium Channels, L-Type (metabolism)
  • Drug Synergism
  • Female
  • Isoquinolines (pharmacology)
  • Male
  • Nifedipine (pharmacology, therapeutic use)
  • Palonosetron
  • Pyrroles (adverse effects)
  • Quinuclidines (pharmacology)
  • Receptors, Serotonin, 5-HT3 (metabolism)
  • Serotonin 5-HT3 Receptor Antagonists (pharmacology)
  • Shrews
  • Vomiting (chemically induced, drug therapy)

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