Related Experiment Video
Updated: Jun 20, 2026
05:56
Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting
Published on: June 21, 2024
Concordance between substance P levels and antiemetic guidelines
Gerald M Higa1, Miklos L Auber, Ramin Altaha
1Health Sciences Center, West Virginia University, Morgantown, WV 26506-9520, USA. ghiga@hsc.wvu.edu
The Journal of Supportive Oncology
|September 8, 2009
Summary
Antagonists of the substance P/neurokinin 1 (NK1) receptor pathway are now standard antiemetics. This study found substance P levels correlate with chemotherapy-induced vomiting, supporting NK1 antagonist use.
Area of Science:
- Oncology
- Pharmacology
- Neuroscience
Background:
- Antiemetic guidelines include substance P/neurokinin 1 (NK1) receptor antagonists for chemotherapy.
- The correlation between substance P levels and emetic response requires further investigation.
Purpose of the Study:
- To determine the concordance between substance P levels and current antiemetic practice guidelines.
- To provide biochemical justification for NK1 receptor antagonist use and cisplatin dosage criteria.
Main Methods:
- Collected 5 blood samples over 72 hours from 22 adult patients receiving cisplatin chemotherapy.
- Measured substance P levels and analyzed data based on cisplatin dosage and vomiting phase.
Main Results:
- Mean baseline substance P level was 318 pg/mL.
- Substance P levels increased during both phases of the emetic response.
- Analysis showed significant differences in substance P levels (P<0.0001) based on cisplatin dosage and vomiting phase.
Conclusions:
- Preliminary analysis supports including NK1 receptor antagonists in antiemetic guidelines.
- Data provide biochemical rationale for current cisplatin dosage criteria in clinical trials.
Related Concept Videos
01:28Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates these...
01:27Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
01:29Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists
Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
Phenothiazines, such as prochlorperazine...
Phenothiazines, such as prochlorperazine...
01:21Chemotherapy-Induced Nausea and Vomiting: Cannabinoids
Tetrahydrocannabinol (THC) is a phytocannabinoid that primarily interacts with the CB1 receptor, a type of G protein-coupled receptor (GPCR) predominantly in and around the chemoreceptor trigger zone (CTZ) and emetic center. THC also blocks the serotonin receptor activity in the dorsal vagal complex (DVC) by inhibiting serotonin release. THC exerts its anti-emetic effects through these interactions, which are beneficial for patients undergoing chemotherapy.
Two synthetic agonists of THC,...
Two synthetic agonists of THC,...
01:22Pathophysiology of Vomiting
Vomiting is a complex physiological response to expel harmful or irritating substances from the body. It's a defensive mechanism triggered by stimuli like poisons, microbial toxins, cytotoxic drugs, and mechanical abdominal distension. The process is centrally coordinated by the vomiting (or emetic) center located in the medulla of the brainstem. This area, rich in muscarinic M1, histamine H1, neurokinin 1 (NK1), and serotonin 5-HT3 receptors, coordinates the act of vomiting through interaction...
01:23Drugs Affecting GI Tract Motility: Serotonin Receptor Agonists
Serotonin, a crucial neurotransmitter synthesized by enterochromaffin cells, plays a cardinal role in regulating gastrointestinal (GI) motility. With over 90% of the body's total serotonin in the GI tract, its influence on digestive processes is profound. Serotonin is swiftly released upon various stimuli, such as food boluses or certain drugs, triggering intrinsic sensory neurons in the myenteric plexus and extrinsic vagal and spinal sensory neurons. This leads to the activation of the...