Gastric acid secretion in streptozotocin-diabetic rats--different responses to various secretagogues

Effects of streptozotocin-induced long-term diabetes on parietal cell function and morphology in rats

Gastric pathology is a common complication in diabetes mellitus. The aim of the study was to evaluate the functions and morphological changes of the parietal cells of the rat stomach after streptozotocin-induced diabetes. Diabetes mellitus was induced in Wistar rats by a single intraperitoneal injection of streptozotocin (60 mg/kg body weight). The rats were weighed weekly and sacrificed after 6 months. The glandular portion of the stomach was removed and processed for H(+)-K(+)-ATPase immunohistochemistry and light and electron microscopy studies. Acid secretion was measured in vivo. After 6 months of diabetes, the mean weight of the rats was significantly lower (P < 0.001) compared to control. The mean weight of the stomach to body weight percentage increased significantly (P < 0.001) compared to control. The blood glucose level in diabetic rats was significantly higher (P < 0.001) than in normal control. Diabetic rats showed significant (P < 0.001) decrease in basal and stimulated acid secretion when compared to control. Electron micrographs of the parietal cells of glandular stomach of diabetic rats revealed significant (P < 0.0002) reduction in the number of mitochondria and a small though not significant increase in the number of canaliculi in the parietal cells compared with normal. Immunohistochemistry showed reduced H(+)-K(+)-ATPase (P < 0.00001) compared to control. Long-term diabetes induces morphological as well as functional changes in gastric parietal cells. The decrease in the number of mitochondria accompanied by reduced in H(+)-K(+)-ATPase in parietal cells may explain the reduced acid secretion observed in diabetics.

Differences in intragastric pH in diabetic vs. idiopathic gastroparesis: relation to degree of gastric retention

Evidence suggests that distinct mechanisms underlie diabetic and idiopathic gastroparesis. Differences in gastric acid in gastroparesis of different etiologies and varying degrees of gastric stasis are uninvestigated. We tested the hypotheses that 1) gastric pH profiles show differential alteration in diabetic vs. idiopathic gastroparesis and 2) abnormal pH profiles relate to the severity of gastric stasis. Sixty-four healthy control subjects and 44 gastroparesis patients (20 diabetic, 24 idiopathic) swallowed wireless transmitting capsules and then consumed (99m)Tc-sulfur colloid-labeled meals for gastric scintigraphy. Gastric pH from the capsule was recorded every 5 s. Basal pH was higher in diabetic (3.64 +/- 0.41) vs. control subjects (1.90 +/- 0.18) and idiopathic subjects (2.41 +/- 0.42; P < 0.05). Meals evoked initial pH increases that were greater in diabetic (4.98 +/- 0.32) than idiopathic patients (3.89 +/- 0.39; P = 0.03) but not control subjects (4.48 +/- 0.14). pH nadirs prior to gastric capsule evacuation were higher in diabetic patients (1.50 +/- 0.23) than control subjects (0.58 +/- 0.11; P = 0.003). Four-hour gastric retention was similar in diabetic (18.3 +/- 0.5%) and idiopathic (19.4 +/- 0.5%) patients but higher than control subjects (2.2 +/- 0.5%; P < 0.001). Compared with control subjects, those with moderate-severe stasis (>20% retention at 4 h) had higher basal (3.91 +/- 0.55) and nadir pH (2.23 +/- 0.42) values (P < 0.05). In subgroup analyses, both diabetic and idiopathic patients with moderate-severe gastroparesis exhibited increased pH parameters vs. those with mild gastroparesis. In conclusion, diabetic patients with gastroparesis exhibit reduced gastric acid, an effect more pronounced in those with severely delayed gastric emptying. Idiopathic gastroparetic subjects exhibit nearly normal acid profiles, although those with severely delayed emptying show reduced acid vs. those with mild delays. Thus both etiology and degree of gastric stasis determine gastric acidity in gastroparesis.

Mechanisms of disease: the pathological basis of gastroparesis--a review of experimental and clinical studies

The pathogenesis of gastroparesis is complicated and poorly understood. This lack of understanding remains a major impediment to the development of effective therapies for this condition. Most of the scientific information available on the pathogenesis of gastroparesis has been derived from experimental studies of diabetes in animals. These studies suggest that the disease process can affect nerves (particularly those producing nitric oxide, but also the vagus nerve), interstitial cells of Cajal and smooth muscle. By contrast, human data are sparse, outdated and generally inadequate for the validation of data obtained from experimental models. The available data do, however, suggest that multiple cellular targets are involved. In practice, though, symptoms seldom correlate with objective measures of gastric function and there is still a lot to learn about the pathophysiology of gastroparesis. Future studies should focus on understanding the molecular pathways that lead to gastric dysfunction, in animal models and in humans, and pave the way for the development of rational therapies.

The effect of insulin-dependent diabetes mellitus on basal and distention-induced acid and pepsin secretion in rat

BACKGROUND

Diabetes mellitus is one of the most common endocrine diseases and affects most body organs. It affects gastric acid secretion, but this effect has not been fully understood. As the effects of diabetes on gastric pepsin secretion has not been proved yet, in this experimental study basal and distension-stimulated acid and pepsin secretions of diabetic and non-diabetic rats have been compared.

MATERIAL AND METHODS

Female N-Mari rats weighing 200-250 g were used. Diabetic state was induced by intraperitoneal injection of 75 mg/kg streptozotocin. Animals were anaesthetized by the interaperitoneal injection of 60 mg/kg thiopental sodium. Then tracheostomy and laparotomy were done and gastric secretions were collected by a cannula entered via duodenum. Gastric distention induce by 1.5 ml normal saline per each 100g of body weight in stomach. Acid and pepsin were measured by titration and Anson's method, respectively.

RESULTS

Basal gastric secretions were similar in diabetic and non-diabetic animals. Distention-stimulated acid secretions in diabetic and non-diabetic rats were 3.24 +/- 0.16 and 8.05 +/- 0.21 micromol/15 min, respectively, which were significantly different (P = 0.00001). Distention-induced pepsin secretion in diabetic and non diabetic rats were 3.16 +/- 0.13 and 5.24 +/- 0.16 microg/15min, respectively, which were significantly different (P = 0.00001).

CONCLUSION

In this study the stomach of diabetic animals showed less reaction to distention, which may be due to the reduction of acid and pepsin secretary cells, reduction of the function of the cells, gastric atrophy or gastric vagus neuropathy. These probabilities need to be examined.

The enhanced spontaneous activity of the diabetic colon is not the consequence of impaired inhibitory control mechanisms

1. Approximately 45% of patients with diabetes mellitus have gastrointestinal complications such as diarrhoea and constipation, but the underlying aetiology is unclear. The present study investigates alterations in spontaneous motility of the colon that may be, in part, responsible for these symptoms using an established animal model of diabetes. 2. Rats were rendered diabetic by a single intraperitoneal injection of streptozotocin and age-matched controls were injected with citrate buffer. Rats were sacrificed after 8-weeks and proximal colonic circular muscle tissue mounted in organ baths. 3. Spontaneous activity was observed in both control and diabetic tissues, but this activity was almost doubled in colonic tissue taken from diabetic rats. It was hypothesized that this increase was due to a deficit in inhibitory control of the colon in the diabetic state. 4. Possible alterations in nitrergic and vasoactive intestinal polypeptide (VIP)ergic control were investigated using a range of pharmacological tools. 5. Sodium nitroprusside, VIP and antioxidants (reduced glutathione, ascorbate and alpha-tocopherol) inhibited the spontaneous activity, but the level of inhibition observed was not different in diabetic tissue compared with control. 6. Arginine, [D-p-Cl-Phe6, Leu17]-VIP and alpha-chymotrypsin had no effect on spontaneous activity in either sets of tissue. 7. N omega-nitro-L-arginine produced a small, but significant, increase in the level of spontaneous activity, but the degree of increase was not different between control and diabetic tissues. 8. Western blots demonstrated that there was no inducible-nitric oxide synthase (iNOS) in control or diabetic tissues and that the levels of endothelial-NOS (eNOS) and neuronal-NOS (nNOS) detected were not statistically significantly different. The [3H]-citrulline assay established that the functionality of the NOS isoforms present were unaltered in the diabetic state. 9. This study demonstrates that there is a marked alteration in motility in the colon taken from diabetic animals. However, the change in motility is unlikely to be due to a change in inhibitory control mechanisms and may be due to an increased excitability.

Enhancement of peptone-induced gastric acid secretion in streptozotocin-induced diabetic rats

We compared the acid secretory response to peptone in normal and streptozotocin-induced diabetic rats. Animals were injected with streptozotocin and used after 5 weeks of diabetes with blood glucose levels of >350 mg/dl. Under urethane anesthesia, 2 ml peptone solution (2-8%) was instilled in the stomach through an acute fistula every 30 min. Peptone increased acid secretion in a concentration-dependent manner in normal rats, the maximal response being obtained at 8%. Likewise, the increased acid response was observed in diabetic rats, yet the maximal response observed at 4% was significantly greater than that in normal rats. In both cases, this response was inhibited potently by famotidine as well as YM-022 (a CCKB antagonist) and partially inhibited by atropine. Peptone increased luminal histamine and plasma gastrin levels in both normal and diabetic rats, and the former response was significantly greater in diabetic animals. The altered acid secretion and histamine output in diabetic rats were reverted by insulin treatment. Pentagastrin- but not histamine-induced acid secretion was also increased in diabetic rats. We conclude that peptone-induced acid secretion is increased in diabetic conditions. This phenomenon is insulin-dependent and associated with an enhanced release of histamine but not with an increased sensitivity of the parietal cells.