Effects of pressures on water absorption and secretion in rat jejunum

An investigation into the relationship between small intestinal fluid secretion and systemic arterial blood pressure in the anesthetized rat

The effects of changes in the steady level of diastolic blood pressure on fluid flux across the jejunum has been investigated in the anesthetized rat during perfusion with a nutrient-free and Na⁺-free solution. Diastolic blood pressure was manipulated by intravenous infusions, during the jejunal perfusions, of vasodilators (vasoactive intestinal polypeptide, acetyl-β-methylcholine, and phentolamine) and a vasoconstrictor (arginine vasopressin), each of which acts through a different cellular mechanism. The outcome was that fluid flux was related by a parabolic relationship with diastolic blood pressure in which net secretion occurred over the range 40–100 mmHg, whereas net absorption was recorded at diastolic pressures exceeding 100 mmHg and below 40 mmHg. Against a background of normal absorption promoted by perfusion with 145 mmol L⁻¹ Na⁺/5 mmol L⁻¹ glucose solution, reductions in diastolic blood pressure markedly reduced the mean rate of fluid absorption by 58% overall, whereas the rate of glucose absorption remained unchanged. Our results were explained on the basis that vasodilatation led to increased capillary pressure and then to net filtration of fluid from the mesenteric capillary bed. Experiments in which Escherichia coli heat-stable toxin was added to the jejunal perfusate confirmed the absence of a secretory response, which was consistent with the absence of effect of the toxin on diastolic blood pressure.

Evaluation of a rat model for the study of local regulation of intestinal blood flow: ex vivo asanguineous perfusion of the ileal vascular bed

A new model of ex vivo vascularly perfused, isolated rat ileum was developed and evaluated. Segments of distal ileum (approximately 5 cm) from male Wistar rats were isolated on their vascular pedicles. Perfusion through an aortic cannula with oxygenated (95% O2, 5% CO2) Krebs solution containing 5% bovine albumin, 5.6 mM glucose, and 25 mM mannitol at 37 degrees C was initiated immediately after interruption of blood flow. The bowel preparations, including the abdominal aorta, were then transferred to a perfusion chamber. Perfusion pressure was maintained by gravity at 40 mm Hg. Flow was measured with an electromagnetic flow probe. The portal vein, together with the lymphatics, drained freely into collection tubes. The bowel lumen was perfused at 0.85 ml/min with isotonic modified Krebs solution containing [14C]polyethylene glycol, and the luminal perfusion pressure was monitored. Luminal effluents were collected through a large-bore outlet tubing. As determined by histology, O2 consumption, vascular reactivity, and mucosal permeability, the preparations were viable for at least 60 min of perfusion. With this model, a vasoconstrictor effect of the alpha 2-adrenoceptor agonist clonidine was documented for the first time in isolated rat bowel.

Jejunal permeability to water and electrolytes in patients with chronic intrahepatic hypertension: evidence for a role of aldosterone

Acute prehepatic portal hypertension induces intestinal secretion in animal models. In the course of chronic liver disease, however, these changes are not observed, despite higher portal pressures than those found in experimental studies. Eight patients without diarrhoea and with chronic alcoholic liver disease were examined for evidence of increased jejunal secretion; their suprahepatic wedge pressure was raised from 21 to 45 mmHg (mean 34.6 mmHg). Jejunal perfusion with a triple lumen catheter and a proximal occluding balloon was used to study net flows of water and chloride as well as net and unidirectional flows of sodium and potassium. No statistical difference in intestinal flows of water and electrolytes was noted between cirrhotic patients and control subjects after infusion with a 30 mmol/l glucose solution. Infusion with a 30 mmol/l mannitol solution resulted in a lower absorption of water, Na, K, and Cl than with the glucose solution. A higher rate of Na secretion was observed in cirrhotic patients than control subjects after infusion with 30 mmol/l mannitol (p less than 0.01). In addition, the rate of Na secretion was higher in cirrhotic patients than in control subjects (p less than 0.05). There was no correlation between the net flow of Na and the suprahepatic wedge pressure. A second perfusion with a 30 mmol/l glucose solution was given 75 minutes after a bolus injection of spironolactone (400 mg). Net flows of Na and Cl were lower in cirrhotic patients than in control subjects (p less than 0.05) because of a lower absorption of Na. Patients with gradually developing portal hypertension have moderate jejunal secretions of H2O and electrolytes which we assume are partly masked by increased absorption resulting from hyperaldosteronism. In contrast to animal models, this mechanism may be part of the jejunal adaptation to permeability in acute portal hypertension.

Tissue fluid pressure, lymph pressure, and fluid transport in rat intestinal villi

Tissue fluid pressure (Pt) and lymph pressure (Pl) as well as fluid transport between initial lymphatics and tissue matrix were determined in the villi of the jejunum in vivo and in vitro. When the intestine was absorbing fluid, free tissue fluid as a micro pool appeared in the villi. Pt and Pl were 2.4 +/- 0.7 and 2.9 +/- 0.8 mm Hg (mean +/- SE), respectively, in the villi in vivo (26 villi of 5 rats) or 0.8 +/- 0.4 and 1.2 +/- 0.5 mm Hg, respectively, in the villi in vitro (30 villi of 5 rats). Pl was significantly (P less than 0.01) higher than Pt. When Evans blue in saline was continuously infused into an initial lymphatic, dye rapidly leaked out into the tissue matrix, but when it was infused into the free tissue fluid, dye did not enter the lymphatics but leaked out of the epithelial layer, apparently due to low hydraulic conductance of the tissue matrix to fluid transport in this direction. Furthermore, in the villi with fat absorption, a retrograde flow of chylous lymph out of the villous tips always occurred, indicating that there are large pores at the villous tips to allow free passage of fluid and chylomicrons. From these findings and other evidences, it is inferred that during fluid absorption a fraction of the lymph may be formed by the transport of the luminal fluid directly into the terminal end of the initial lymphatics via large pores at the villous tips presumably by inhibition of the tissue matrix or by lymphatic suction or both.

Water and electrolyte movement and mucosal morphology in the jejunum of patients with portal hypertension

Intestinal secretion and intercullular space dilatation can be induced in animal models by acute elevation of intravascular volume or portal pressure. We examined whether patients with increased portal venous pressure might represent a clinical counterpart to these animal models. Portal venous pressure, determined by hepatic wedge pressure measurement, was elevated to 10-55 mmHg (mean 29 mmHg) in 8 patients with chronic liver disease without diarrhea. Intestinal transport studies utilizing a steady-state perfusion technique revealed normal absorption of a plasmalike electrolyte solution. A solution dsigned to unmask intestinal secretion demonstrated no difference from control subjects in the movement of water, electrolytes, or protein into the intestional lumen. There was no correlation of absorption of secretion with hepatic wedge pressure. Jejunal biopsy revealed a significant increase in dilatation of intercellular spaces in patients compared to controls; this increase was not correlated with hepatic wedge pressure, but was significantly inversely correlated to plasma renin and aldosterone concentration. We conclude that patients with chronic liver disease and portal hypertension absorb water and electrolytes normally, but have mild morphologic alterations in the intestinal mucosa, possibly related to intravascular volume status.

Intestinal filtration as a consequence of increased mucosal hydraulic permeability. A new concept for laxative action

Two mechanisms have been proposed to explain the secretory action of laxative compounds in the intestine: 1. increase of the intracellular amount of cyclic adenosine monophosphate due to stimulation of the adenylate cyclase system and 2. inhibition of intestinal transfer processes, in particular the Na,K-ATPase activated sodium absorption. In a set of in vivo and in vitro experiments in rat colon it could be demonstrated that dihydroxy bile acids (deoxycholate) and diphenolic laxatives (oxyphenisatin) enhance the hydraulic permeability of the mucosal tissue. The permeability changes take place--and there is good experimental evidence--at the zonulae occludentes which bind the epithelial cells together at their luminal borders. Due to laxative action the hydraulic permeability of the colonic mucosa increases to such an extent that according to the Starling forces the normal subepithelial hydrostatic pressure is a sufficient driving force to reverse net sodium, chloride, and water absorption into net secretion. A new concept of "intestinal filtration as a consequence of increased mucosal hydraulic permeability" is proposed to explain the laxative action of deoxycholate and oxyphenisatin in the colon. The question whether inhibition of Na,K-ATPase activity, cyclic AMP-mediated secretion or increased hydraulic permeability of the colonic mucosa are causatively linked to and quantitatively meaningful in intestinal secretion remains open.

Lymph capillary pressure of rat intestinal villi during fluid absorption

A newly developed intestinal preparation is described for determining lymph capillary pressure (PL) in the villi in vivo and in vitro. Determination of PL provided an estimate of tissue fluid pressure in the villi. PL was related to the fluid absorption rate and increased by lymphatic obstruction. During fluid absorption from isotonic mucosal fluid, PL was 1.4 +/- 0.5 or 1.1 +/- 0.4 cmH2O determined in vivo or in vitro, respectively. Both pressures were essentially in the same range as that (0.7 +/- 0.3--1.3 +/- 0.5 cmH2O) in which the mucosal fluid was isotonic Na2SO4 solution or Na-free solutions from which little fluid absorption occurred. This range of pressures may be taken as the normal tissue fluid pressure in the villi. At a high rate of fluid absorption from hypotonic mucosal fluid, PL increased to 5.2 +/- 1.4 cmH2O and tissue fluid pressure was also similarly increased. It is concluded that the fluid absorptive process by the epithelium could not develop an appreciable hydrostatic pressure in the villus tissue space or in the lymphatics.

Anomalous calcium secretion in rat ileum: role of paracellular pathway

The mechanism of apparent calcium secretion by unstripped rat ileum in vitro has been investigated using mannitol and polyethylene glycol (mol wt 900) as markers for extracellular transepithelial flux. In the absence of electrochemical gradients between the mucosal and serosal bathing media in a modified Ussing chamber, net fluxes of both mannitol and polyethylene glycol were observed from serosa to mucosa in the presence of 11 mM D-glucose. Mucosal-to-serosal calcium flux reveals a significant cellular component, but serosal-to-mucosal calcium permeability is a linear function of mannitol permeability, suggesting an exclusively extracellular route. For the mucosal-to-serosal fluxes, inhibition of calcium flux by 1 mM N-ethylmaleimide results in a calcium-to-mannitol permeability ratio indistinguishable from that measured for serosal-to-mucosal flux. This evidence suggests that the apparent calcium secretion observed at 10 mM medium calcium is not the result of a cellular secretory mechanism. It is proposed that a hydrostatic driving force generated internal to the tissue but external to the cells results in net calcium secretion at calcium conentrations that saturate the cellular absorptive mechanism.

Effects of solute-coupled transport on lymph flow and oncotic pressures in cat ileum

The effects of net volume absorption rate on steady-state lymphatic and capillary volume flows, lymphatic protein flux, and lymph oncotic pressure were analyzed in an isolated vascularly perfused cat ileum preparation. Solute-coupled fluid transport was stimulated by instilling either Tyrode solution, Tyrode + glucose, Tyrode + taurocholic acid (TC), Tyrode + TC + oleic acid, or Tyrode + aspartic acid, into the ileal lumen. Lymph flow increased in a sigmoidal fashion as net volume absorption rate increased. A linear relationship was observed between lymphatic protein flux and net volume absorption rate. The relative contributions of the intestinal capillary and lymphatic systems in removing absorbed volume from the mucosal interstitium was highly dependent on the rate of net volume absorption. Lymph oncotic pressure decreased progressively as net volume absorption rate increased with a maximal reduction in lymph oncotic pressure of 6.0-7.0 mmHg at the higher volume absorption rates. The results of this study indicate that 1) the rate of solute-coupled fluid transport greatly influences the rate of intestinal lympathic and capillary volume flows, lymphatic protein flux, and lymph oncotic pressure, 2) a reduction in tissue oncotic pressure may serve as the major driving force for vascular removal of absorved volume, and 3) the increase in capillary permeability to plasma proteins during fluid transport is related to the rate of volume absorption.

Effects of saline loading on jejunal absorption of calcium, sodium, and water, and on parathyroid hormone secretion in the rat

To investigate whether intestinal calcium absorption parallels that of sodium following extra-cellular fluid volume expansion, the effects of saline loading on intestinal transport of calcium, sodium and water were studied in rats by perfusing jejunal loops in situ. After calcium-free saline infusion net calcium absorption was reversed similar to that of sodium and water and net secretion occurred. Concurrently, blood-to-lumen (b-l) calcium flux, measured using 45Ca, increased significantly (P less than 0.001). Following expansion with calcium-containing Ringer a similar reversal of net calcium, sodium and water flux was also observed. Again the b-l calicum flux increased but to a significantly lesser extent (P less than 0.05). Plasma ionized calcium remained unchanged after calcium-rich Ringer loading, but decreased significantly (P less than 0.001) when calcium was omitted from the solution. Plasma immunoreactive parathyroid hormone unchanged after expansion with the calcium containing solution but increased following calcum-free infusion. It is concluded that after extracellular fluid volume expansion: 1. net jejunal calcium absorption is decreased; 2. the decrease parallels that of sodium and water; 3. b-l calcium transport is enhanced to a greater degree of calcium-free Rnger infusion than by a calcium-rich solution. This difference could be the result of increased parathyroid hormone secretion.

Renal control of intestinal sodium and water transport in the dog

The influence of an intravenous infusion of saline on the absorption of water and sodium by the jejunum has been investigated in dogs previously submitted to sodium-rich or poor diets. While the net intestinal transport was reduced in sodium-loaded animals, no response was observed in the sodium-deprived dogs, despite identical changes in arterial pressure, intravascular volume and blood dilution indexes. The intestinal response of sodium-deprived dogs became positive after transplanting to their neck vessels the kidneys removed from sodium-loaded animals, thus demonstrating that the presence in the blood of a humoral message of renal origin is required to permit the inhibition of net transport. The difference of the responses depended on the variations of the mucosa-to-serosa unidirectional flux. The net potassium transport did not change significantly. The experimental conditions made unlikely an interference of mineralocorticosteroids, angiotensin or antidiuretic hormone. The present results suggest that the kidney might modulate sodium transport in the jejunum, and perhaps elsewhere in the body, by the way of an additional endocrine function.

Mechanism of production of intestinal secretion by elevated venous pressure

A study was carried out to elucidate the physiological mechanisms responsible for the intestinal secretion produced by venous pressure elevation. In dogs, measurements were made of the rate and composition of small intestinal secretion, rate of flow and composition of intestinal lymph, plasma composition, and mucosal water content, all in response to elevations of intestinal venous pressure. Venous pressure elevations above a threshold value of 30-35 cm H2O produce secretion at a rate of approximately proportional to the value of the pressure minus the threshold value. Above the threshold value, there were large increases in the rates of lymph flow and net sustained transcapillary filtration. These rates were also roughly proportional to the incremental venous pressure. It is concluded that intestinal secretion produced by elevated venous pressure is almost surely secretory filtration, a passive process with the driving force for secretion an increase in mucosal tissue fluid pressures to values of only some 4-6 cm H2O. The increased tissue fluid pressure not only provides the driving force but also produces an increase in the hydraulic permeability of the epithelium without which the driving force would be ineffective. The transepithelial channels are large enough to permit insulin to pass freely and even plasma protein to pass in large amounts, and hence are most probably intercellular. Secretory filtration probably represents a general pathophysiological response of transporting epithelia to elevated tissue fluid pressure. It is proposed that the threshold value for secretion and associated changes is explained by dilution of the tissue fluid protein colloid osmotic pressure in a small subepithelial, juxtacapillary compartment.