CAPSAICIN AND THE STOMACH - A REVIEW OF EXPERIMENTAL AND CLINICAL-DATA

Capsaicin, the pungent principle of hot pepper, because of its ability to excite and later defunctionalize a subset of primary afferent neur ons, has been extensively used as a probe to elucidate the function of these sensory neurons in a number of physiological processes. In the rat stomach, experimental data provided clear evidence that capsaicin- sensitive (CS) sensory nerves are involved in a local defense mechanis m against gastric ulcer. Stimulation of CS sensory nerves with low int ragastric concentrations of capsaicin protected the rat gastric mucosa against injury produced by different ulcerogenic agents. High local d esensitizing concentrations of capsaicin or systemic neurotoxic doses of the agent markedly enhanced the susceptibility of the rat gastric m ucosa to later noxious challenge. Resiniferatoxin, a potent analogue o f capsaicin possesses an acute gastroprotective effect similar to that of capsaicin in the stomach. The gastroprotective effect of capsaicin -type agents involves an enhancement of the microcirculation effected through the release of mediator peptides from the sensory nerve termin als with calcitonin gene-related peptide being the most likely candida te implicated. They do not depend on vagal efferent or sympathetic neu rons or involve prostanoids. The gastric mucosal protective effect of prostacyclin is retained after systemic or topical capsaicin desensiti zation. Capsaicin-sensitive fibers are involved in the repair mechanis ms of the gastric mucosa. A protective role for CS sensory nerves has also been demonstrated in the colon. In most studies, capsaicin given into the stomach of rats or cats inhibited gastric acid secretion. In humans, although recent studies provide evidence in favor of a benefic ial effect of capsaicin on the gastric mucosa, an exact concentration- related assessment of the effect of the agent is still lacking.