Motilin
Overview
Motilin is a 22-amino acid endogenous peptide hormone secreted by enteroendocrine cells in the duodenum and jejunum. It binds to motilin receptors on gastrointestinal smooth muscle and enteric neurons, stimulating phase III migrating motor complexes and promoting gastric emptying.
Mechanism of Action
The therapeutic rationale for exogenous motilin or receptor agonists includes treatment of gastroparesis and postoperative ileus. Erythromycin acts as a motilin receptor agonist, demonstrating the clinical relevance of this pathway..
Research Summary & Key Findings
Natural motilin itself has not been developed as a therapeutic due to rapid degradation and tachyphylaxis with repeated dosing. Synthetic motilin receptor agonists such as camicinal and mitemcinal have been evaluated in phase II trials for gastroparesis, with mixed results and concerns about receptor desensitization. Current clinical use of motilin pathway stimulation relies primarily on macrolide antibiotics rather than peptide-based agents.
Clinical Status
Motilin is in the research phase with limited clinical data in humans. Current evidence is primarily derived from preclinical (animal or in vitro) studies.
Administration Routes
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