Enkephalinases as a new pharmacological target in the treatment of gastrointestinal tract disorders

Abstract

Enkephalinases, which belong to the family of zinc metalloproteases play a crucial role in modulation of the endogenous opioid system (EOS) activity. Enkephalinase inhibitors (EI) allow obtaining therapeutic concentrations of selected endogenous peptides. One of the first EIs, racecadotril possesses antidiarrheal properties. Moreover, there is evidence that racecadotril presents fewer adverse events compared to other medications used for the treatment of diarrhea, such as loperamide. Lower potency for developing serious adverse events may be the key to choosing EIs as the preferred therapy in patients with chronic diseases. Additionally, EOS is involved in pain modulation, hence EIs might also be used as potential medications in treatment of pain. This review discusses the use of EIs in the treatment of gastrointestinal diseases, including irritable bowel syndrome and inflammatory bowel disease.