Colonic Motility Is Improved by the Activation of 5-HT2B Receptors on Interstitial Cells of Cajal in Diabetic Mice

BACKGROUND & AIMS

Constipation is commonly associated with diabetes. Serotonin (5-HT), produced predominantly by enterochromaffin (EC) cells via tryptophan hydroxylase 1 (TPH1), is a key modulator of gastrointestinal (GI) motility. However, the role of serotonergic signaling in constipation associated with diabetes is unknown.

METHODS

We generated EC cell reporter Tph1-tdTom, EC cell-depleted Tph1-DTA, combined Tph1-tdTom-DTA, and interstitial cell of Cajal (ICC)-specific Kit-GCaMP6 mice. Male mice and surgically ovariectomized female mice were fed a high-fat high-sucrose diet to induce diabetes. The effect of serotonergic signaling on GI motility was studied by examining 5-HT receptor expression in the colon and in vivo GI transit, colonic migrating motor complexes (CMMCs), and calcium imaging in mice treated with either a 5-HT2B receptor (HTR2B) antagonist or agonist.

RESULTS

Colonic transit was delayed in males with diabetes, although colonic Tph1+ cell density and 5-HT levels were increased. Colonic transit was not further reduced in diabetic mice by EC cell depletion. The HTR2B protein, predominantly expressed by colonic ICCs, was markedly decreased in the colonic muscles of males and ovariectomized females with diabetes. Ca2+ activity in colonic ICCs was decreased in diabetic males. Treatment with an HTR2B antagonist impaired CMMCs and colonic motility in healthy males, whereas treatment with an HTR2B agonist improved CMMCs and colonic motility in males with diabetes. Colonic transit in ovariectomized females with diabetes was also improved significantly by the HTR2B agonist treatment.

CONCLUSIONS

Impaired colonic motility in mice with diabetes was improved by enhancing HTR2B signaling. The HTR2B agonist may provide therapeutic benefits for constipation associated with diabetes.

The Impact of Dextran Sodium Sulfate-Induced Gastrointestinal Injury on the Pharmacokinetic Parameters of Donepezil and Its Active Metabolite 6-O-desmethyldonepezil, and Gastric Myoelectric Activity in Experimental Pigs

Gastrointestinal side effects of donepezil, including dyspepsia, nausea, vomiting or diarrhea, occur in 20–30% of patients. The pathogenesis of these dysmotility associated disorders has not been fully clarified yet. Pharmacokinetic parameters of donepezil and its active metabolite 6-O-desmethyldonepezil were investigated in experimental pigs with and without small intestinal injury induced by dextran sodium sulfate (DSS). Morphological features of this injury were evaluated by a video capsule endoscopy. The effect of a single and repeated doses of donepezil on gastric myoelectric activity was assessed. Both DSS-induced small intestinal injury and prolonged small intestinal transit time caused higher plasma concentrations of donepezil in experimental pigs. This has an important implication for clinical practice in humans, with a need to reduce doses of the drug if an underlying gastrointestinal disease is present. Donepezil had an undesirable impact on porcine myoelectric activity. This effect was further aggravated by DSS-induced small intestinal injury. These findings can explain donepezil-associated dyspepsia in humans.

Satiety testing in diabetic gastroparesis: Effects of insulin pump therapy with continuous glucose monitoring on upper gastrointestinal symptoms and gastric myoelectrical activity

BACKGROUND

Symptoms induced by caloric or non-caloric satiety test meals and gastric myoelectrical activity (GMA) have not been studied in patients with diabetic gastroparesis (DGP) before and after intense glucose management.

AIMS

We determined the effects of continuous subcutaneous insulin infusion (CSII) with continuous glucose monitoring (CGM) on GI symptoms, volume consumed, and GMA induced by the caloric meal satiety test (CMST) and water load satiety test (WLST) in DGP.

METHODS

Forty-five patients with DGP underwent CMST and WLST at baseline and 24 weeks after CSII with CGM. Subjects ingested the test meals until they were completely full. Visual analog scales were used to quantify pre- and postmeal symptoms, and GMA was recorded with cutaneous electrodes and analyzed visually and by computer. KEY RESULTS: At baseline and 24-week visits, nausea, bloating, abdominal discomfort, and fullness were immediately increased after CMST and WLST (Ps < 0.01). The meal volumes ingested were significantly less than normal controls at both visits in almost one-third of the subjects. After the CMST, the percentage 3 cycle per minute GMA increased and bradygastria decreased compared with WLST (Ps < 0.05). After treatment for 24 weeks meal volumes ingested, postmeal symptoms and GMA were no different than baseline. CONCLUSIONS AND INFERENCES: (a) Satiety test meals elicited symptoms of nausea, bloating, and abdominal discomfort; (b) CMST stimulated more symptoms and changes in GMA than WLST; and (c) CSII with CGM for 24 weeks did not improve symptoms, volumes ingested, or GMA elicited by the two satiety test meals in these patients with diabetic GP. Satiety tests in diabetic gastropresis are useful to study acute postprandial symptoms and GMA, but these measures were not improved by intensive insulin therapy.

Effect of Tributyrin on Electrical Activity in the Small Intestine during Early Postoperative Period

The effect of enteral administration of tributyrin on electrical activity in the upper segments of the small intestine was examined in rats on the model of postoperative ileus. This postoperative state is characterized with pronounced and long-term disturbances in generation of migrating myoelectric complex of the small intestine. The enteral administration of tributyrin in the early postoperative period aimed to suppress the non-adrenergic non-cholinergic influences and activation of the cholinergic anti-inflammatory pathways is an effective procedure to normalize the migrating myoelectric complex and therefore the coordinated propulsive peristalsis in the small intestine.

Ghrelin Is an Essential Factor for Motilin-Induced Gastric Contraction in Suncus murinus

Motilin was discovered in the 1970s as the most important hormone for stimulating strong gastric contractions; however, the mechanisms by which motilin causes gastric contraction are not clearly understood. Here, we determined the coordinated action of motilin and ghrelin on gastric motility during fasted and postprandial contractions by using house musk shrew (Suncus murinus; order: Insectivora, suncus named as the laboratory strain). Motilin-induced gastric contractions at phases I and II of the migrating motor complex were inhibited by pretreatment with (D-Lys(3))-GHRP-6 (6 mg/kg/h), a ghrelin receptor antagonist. Administration of the motilin receptor antagonist MA-2029 (0.1 mg/kg) and/or (D-Lys(3))-GHRP-6 (0.6 mg/kg) at the peak of phase III abolished the spontaneous gastric phase III contractions in vivo. Motilin did not stimulate gastric contractions in the postprandial state. However, in the presence of a low dose of ghrelin, motilin evoked phase III-like gastric contractions even in the postprandial state, and postprandial gastric emptying was accelerated. In addition, pretreatment with (D-Lys(3))-GHRP-6 blocked the motilin-induced gastric contraction in vitro and in vivo, and a γ-aminobutyric acid (GABA) antagonist reversed this block in gastric contraction. These results indicate that blockade of the GABAergic pathway by ghrelin is essential for motilin-induced gastric contraction.

The Inhibitory Effect of Botulinum Toxin Type A on Rat Pyloric Smooth Muscle Contractile Response to Substance P In Vitro

A decrease in pyloric myoelectrical activity and pyloric substance P (SP) content following intrasphincteric injection of botulinum toxin type A (BTX-A) in free move rats have been demonstrated in our previous studies. The aim of the present study was to investigate the inhibitory effect of BTX-A on rat pyloric muscle contractile response to SP in vitro and the distributions of SP and neurokinin 1 receptor (NK1R) immunoreactive (IR) cells and fibers within pylorus. After treatment with atropine, BTX-A (10 U/mL), similar to [D-Arg¹, D-Phe⁵, D-Trp^7,9, Leu¹¹]-SP (APTL-SP, 1 μmol/L) which is an NK1R antagonist, decreased electric field stimulation (EFS)-induced contractile tension and frequency, whereas, subsequent administration of APTL-SP did not act on contractility. Incubation with BTX-A at 4 and 10 U/mL for 4 h respectively decreased SP (1 μmol/L)-induced contractions by 26.64% ± 5.12% and 74.92% ± 3.62%. SP-IR fibers and NK1R-IR cells both located within pylorus including mucosa and circular muscle layer. However, fewer SP-fibers were observed in pylorus treated with BTX-A (10 U/mL). In conclusion, BTX-A inhibits SP release from enteric terminals in pylorus and EFS-induced contractile responses when muscarinic cholinergic receptors are blocked by atropine. In addition, BTX-A concentration- and time-dependently directly inhibits SP-induced pyloric smooth muscle contractility.

Nitric oxide regulation of migrating motor complex: randomized trial of N(G)-monomethyl-L-arginine effects in relation to muscarinic and serotonergic receptor blockade

AIM

The migrating motor complex (MMC) propels contents through the gastrointestinal tract during fasting. Nitric oxide (NO) is an inhibitory neurotransmitter in the gastrointestinal tract. Little is known about how NO regulates the MMC. In this study, the aim was to examine nitrergic inhibition of the MMC in man using N(G)-monomethyl-L-arginine (L-NMMA) in combination with muscarinic receptor antagonist atropine and 5-HT3 receptor antagonist ondansetron.

METHODS

Twenty-six healthy volunteers underwent antroduodenojejunal manometry for 8 h with saline or NO synthase (NOS) inhibitor L-NMMA randomly injected I.V. at 4 h with or without atropine or ondansetron. Plasma ghrelin, motilin and somatostatin were measured by ELISA. Intestinal muscle strip contractions were investigated for NO-dependent mechanisms using L-NMMA and tetrodotoxin. NOS expression was localized by immunohistochemistry.

RESULTS

L-NMMA elicited premature duodenojejunal phase III in all subjects but one, irrespective of atropine or ondansetron. L-NMMA shortened MMC cycle length, suppressed phase I and shifted motility towards phase II. Pre-treatment with atropine extended phase II, while ondansetron had no effect. L-NMMA did not change circulating ghrelin, motilin or somatostatin. Intestinal contractions were stimulated by L-NMMA, insensitive to tetrodotoxin. NOS immunoreactivity was detected in the myenteric plexus but not in smooth muscle cells.

CONCLUSION

Nitric oxide suppresses phase III of MMC independent of muscarinic and 5-HT3 receptors as shown by nitrergic blockade, and acts through a neurocrine disinhibition step resulting in stimulated phase III of MMC independent of cholinergic or 5-HT3 -ergic mechanisms. Furthermore, phase II of MMC is governed by inhibitory nitrergic and excitatory cholinergic, but not 5-HT3 -ergic mechanisms.

[ROLE OF SUBSTRATE ANTIHYPOXANTS IN CORRECTION OF ABNORMALITIES OF MYOELECTRICAL ACTIVITY OF GASTROINTESTINAL TRACT IN VICTIMS WITH SEVERE COMBINED TRAUMA]

The abnormalities of myoelectrical activity of gastrointestinal tract were detected in 80 victims with severe combined trauma. There were observed a decrease of total electrical activity and dyscoordination of electrical activity of sections of gastrointestinal tract. An application of substrate antihypoxants should normalize the indices of myoelectrical activity of gastrointestinal tract. This approach allowed elimination of imbalance of total power between superposed (the stomach, the duodenum) and other sections of gastrointestinal tract. This would remove dyscoordination contraction of the jejunum and the ileum.

[Lymphocyte apoptosis enhancement by the synthetic peptide E in experimental ulcer]

The influence of regulatory peptide type of AFP on the course of experimental ulcer was investigated. It has been shown that activation of apoptosis enhances local necrotic inflammatory reaction, on the one hand, and enables the development of adhesions with on the other.

Effects of 5-HT2B, 5-HT3 and 5-HT4 receptor antagonists on gastrointestinal motor activity in dogs

AIM: To study the effects of 5-hydroxytryptamine (5-HT) receptor antagonists on normal colonic motor activity in conscious dogs.

METHODS: Colonic motor activity was recorded using a strain gauge force transducer in 5 dogs before and after 5-HT2B, 5-HT3 and 5-HT4 receptor antagonist administration. The force transducers were implanted on the serosal surfaces of the gastric antrum, terminal ileum, ileocecal sphincter and colon. Test materials or vehicle alone was administered as an intravenous bolus injection during a quiescent period of the whole colon in the interdigestive state. The effects of these receptor antagonists on normal gastrointestinal motor activity were analyzed.

RESULTS: 5-HT2B, 5-HT3 and 5-HT4 receptor antagonists had no contractile effect on the fasting canine terminal ileum. The 5-HT3 and 5-HT4 receptor antagonists inhibited phase III of the interdigestive motor complex of the antrum and significantly inhibited colonic motor activity. In the proximal colon, the inhibitory effect was dose dependent. Dose dependency, however, was not observed in the distal colon. The 5-HT2B receptor antagonist had no contractile effect on normal colonic motor activity.

CONCLUSION: The 5-HT3 and 5-HT4 receptor antagonists inhibited normal colonic motor activity. The 5-HT2B receptor antagonist had no contractile effect on normal colonic motor activity.

The role of the vagus nerve in the migrating motor complex and ghrelin- and motilin-induced gastric contraction in suncus

The upper gastrointestinal (GI) tract undergoes a temporally coordinated cyclic motor pattern known as the migrating motor complex (MMC) in both dogs and humans during the fasted state. Feeding results in replacement of the MMC by a pattern of noncyclic, intermittent contractile activity termed as postprandial contractions. Although the MMC is known to be stimulated by motilin, recent studies have shown that ghrelin, which is from the same peptide family as motilin, is also involved in the regulation of the MMC. In the present study, we investigated the role of the vagus nerve on gastric motility using conscious suncus—a motilin- and ghrelin-producing small animal. During the fasted state, cyclic MMC comprising phases I, II, and III was observed in both sham-operated and vagotomized suncus; however, the duration and motility index (MI) of phase II was significantly decreased in vagotomized animals. Motilin infusion (50 ng·kg⁻¹·min⁻¹ for 10 min) during phase I had induced phase III–like contractions in both sham-operated and vagotomized animals. Ghrelin infusion (0.1, 0.3, 1, 3, or 10 µg·kg⁻¹·min⁻¹ for 10 min) enhanced the amplitude of phase II MMC in sham-operated animals, but not in vagotomized animals. After feeding, phase I was replaced by postprandial contractions, and motilin infusion (50 ng·kg⁻¹·min⁻¹ for 10 min) did not induce phase III–like contractions in sham-operated suncus. However, in vagotomized suncus, feeding did not evoke postprandial contractions, but exogenous motilin injection strongly induced phase III–like contractions, as noted during the phase I period. Thus, the results indicate that ghrelin stimulates phase II of the MMC via the vagus nerve in suncus. Furthermore, the vagus nerve is essential for initiating postprandial contractions, and inhibition of the phase III–like contractions induced by motilin is highly dependent on the vagus nerve.

Spectral changes in electrical activity of pylorus due to L-NAME induced hypertrophic pyloric stenosis

OBJECTIVES

To investigate the relation between hypertrophic pyloric stenosis (HPS) and the changes in the myoelectrical activity of the pyloric and gastric areas.

METHODS

Three pregnant females, at 14 days of gestation two of which were named as D14n (NOS inhibitor group) and one was named as D14c (control). From the beginning of the study until the end of gestation, rats in D14n group received nitric oxide synthase inhibitor L-NAME for administrating their pups, and the rat in D14c group was drinking water for 21 days. The pups of each group underwent laparotomy at 42 days of their life and myoelectrical signals of their pyloric and gastric regions were recorded via bipolar electrodes and then evaluated through signal processing.

RESULTS

Signal analysis showed that HPS induced pyloric segment reveals a suppressed spectral component that was detected in normal pyloric segment. The HPS induced pyloric segment also revealed higher power/ min and +/- SD compared to that of normal and gastric areas. In the pyloric segment, while the number of interstitial cells of Cajal (ICC) was lesser, the number of smooth muscle cells was higher than in the pyloric segment of controls.

CONCLUSIONS

The spectral differentials depend on the type, population and condition of locally specialized muscular mechanism which can be affected from HPS. The HPS also has a relation to specific cells, such as ICC that generates NO, provoke the spontaneous pacemakers and biological slow waves (Tab. 1, Fig. 1, Ref. 19).

[Effects of neurotrophin 3 on interdigestive migrating motor complex in rats with acute liver injury.]

OBJECTIVE

To observe the effects of neurotrophin 3(NT-3)on interdigestive migrating motor complex (MMC) in rats with D-galactosamine induced acute liver injury.

METHODS

Twenty-four specific pathogen-free purebred rats were equally randomized into control and acute liver injury groups. The control group was injected with equal volume of normal saline via tail vein. Acute liver injury model of the rats was induced by D-galactosamine injection via the tail vein in the acute liver injury group. And the indexes of interdigestive MMC before and after NT-3 injection were recorded by a polygraph and analyzed in model group. The serum NT-3 concentration was assayed in the two groups.

RESULTS

There were no significant changes of gastrointestinal MMC cycle and jejunal phase I MMC after NT-3 injection. Compared with the acute liver injury rats before NT-3 injection , the antral phases I, III and IV MMC were significantly prolonged [(577.44 ± 248.60)s vs (343.58 ± 227.30) s, (80.94 ± 21.15) s vs (24.76 ± 7.41) s, (405.69 ± 131.34) s vs (191.67 ± 128.15) s, P < 0.05] and the phase II MMC was shortened [ (883.94 ± 488.50) s vs (1519.00 ± 831.14) s, P < 0.05] in the acute liver injury group. The duodenal phases I, III and IV MMC were significantly prolonged [ (557.63 ± 335.14) s vs (309.46 ± 220.22) s,(75.91 ± 15.75) s vs (31.15 ± 13.67) s, (423.38 ± 135.22) s vs (209.77 ± 123.83) s, P < 0.05] and MMC II phase was shortened [ (748.81 ± 579.69) s vs (1535.86 ± 930.50) s, P < 0.05] in the acute liver injury rats. In addition, the jejunal MMC III and MMC IV phase was significantly prolonged [ (86.58 ± 23.40) s vs (31.41 ± 16.09) s,(385.18 ± 110.02) s vs (220.59 ± 159.30) s, P < 0.05] and phase II MMC was shortened [ (876.89 ± 652.01) s vs (1870.89 ± 1010.35) s, P < 0.05 ] in the acute liver injury rats. The serum NT-3 level was significantly higher in model group than in control group.

CONCLUSION

NT-3 could enhance the gastrointestinal motility in acute liver injury rats.

Analysis of the excitatory motor response evoked by nicotinic and muscarinic blockade of ovine small bowel

It has been reported that the administration of anticholinergic drugs evokes inhibitory and excitatory responses, but the precise character of the latter has not yet been defined. This study was thus devoted to analyzing its occurrence following various doses of hexamethonium (Hx) and atropine (At) administration in the course of different phases of the small-intestinal migrating motor complex (MMC) in fasted and non-fasted sheep and to further characterize the excitatory responses in comparison with individual phases of the MMC. Two basic types of excitatory response were found. In the course of chronic experiments, various doses of Hx and At evoked rebound excitation (RE, i.e., irregular contractions or spike bursts evoked in response to the anticholinergic drug) alternating with phase 3-like activity (not the organized phase 3 of the MMC or its parts). The intensity of these changes varied and was related to the drug dose. Thus intense and non-intense RE activity were distinguished. In non-fasted sheep, these alterations were slightly less pronounced than in fasted animals. When the drug was given during phase 1 of the MMC, RE did not occur or was greatly reduced and its arrival was delayed. Hx triggered RE mostly in the duodenum, while the action of At was most effective in the jejunum. It is concluded that Hx and At initially hamper small-intestinal motility and just after that evoke a secondary stimulatory response, i.e., phase 3-like activity and RE of different intensity, duration, and repeatability in fasted and non-fasted sheep. These stimulatory effects may resemble unorganized phases of the MMC.

Dose-related effects of cerulein short infusions on proximal small bowel motility in sheep

The effect of cholecystokinin (CCK) upon the intestinal motility has not been entirely explored in ruminants. The aim of this study was to examine the precise effects of CCK amphibian analogue, cerulein, on small-intestinal myoelectric activity in rams in the course of chronic experiments. Five rams underwent implantation of bipolar platinum electrodes to the duodenal bulb, the distal duodenum and jejunum. During continuous myoelectrical and motor recordings, 0.15 M NaCl or the various doses of cerulein were administered intravenously. Short infusions of the smallest dose of cerulein exerted a slight and mostly insignificant effect on the duodenalbulb and the duodenal myoelectric activity index (MAI) values. In the duodenal bulb, the effects of cerulein on myoelectric activity were dose-dependent and closely related to the phase of the MMC. In the duodenum, the higher doses of the hormone evoked short stimulatory response followed by longer inhibitory biphasic effects on MAI. These effects were inversely related to the duration of hormone injection. Infusions of hormones at the higher doses caused a less pronounced biphasic effect. It is concluded that cerulein exerts an inhibitory effect upon the myoelectric activity of the duodenal bulb and a strong stimulatory and inhibitory (biphasic) effect on duodenal motility in sheep.

Characteristics of phase 3-like activity and rebound excitation triggered by hexamethonium and atropine administration in the ovine small bowel

Administration of hexamethonium (Hx) and atropine inhibits myoelectric and motor activity and then evokes a stimulatory effect called rebound excitation (RE) in the ovine small bowel. RE has not been precisely characterized so far and it is possible that it is composed of different types of motility. This study was thus devoted to characterizing these excitatory changes in the myoelectric and motor activity of the small bowel, particularly in the duodenum in conscious sheep. These alterations occurred in response to different intravenous doses of Hx and atropine administered alone or in combinations during various phases of the migrating myoelectric or motor complex (MMC) in the fasted and non-fasted sheep. Initially two basic types of excitatory response to the cholinergic blockade were found. In the course of chronic experiments different doses of Hx and atropine evoked phase 3-like activity (unorganized phase 3 of the MMC or its fragments) alternating with the less regular RE and the duration of these changes was related to the drug dose. In the nonfasted sheep these changes were less pronounced than in the fasted animals. When the drug was given during phase 1 of the MMC, RE did not occur or was greatly reduced. Administration of Hx and atropine in the course of phase 2a and phase 2b of the MMC produced roughly similar effects. Hx triggered stronger phase 3-like activity and RE than atropine. Combinations of Hx and atropine induced an additive effect, more evident in the fasted animals. These actions of Hx and atropine, thus, appear to involve at least partly the same intramural pathways. It is concluded that Hx and atropine evoke phase 3-like activity alternating with RE as the secondary stimulatory response in conscious sheep and both these types of the intestinal motility represent two distinct motility patterns.

Epidural plus general anesthesia vs general anesthesia alone for elective aortic surgery: effects on gastric electrical activity and serum gastrin secretion

BACKGROUND

The aim of this study was to evaluate differences in electrogastrographic activity and serum gastrin secretion in patients subjected to general anesthesia (GA) vs blended anesthesia (BA = GA plus epidural analgesia) for abdominal aortic surgery.

METHODS

Thirty-four patients (all males: 28 with abdominal aorta aneurysm, 6 with obstructive aorto-iliac disease; mean age: 68+/-7 years) were randomly assigned either to GA (N.=17) or to BA (N.=17) for abdominal aortic surgery. Each patient was evaluated for serum gastrin secretion at the time of electrogastrography (EGG) 24 h before and after surgery, using ambulatory equipment. Gastrin levels were tested under fasting conditions and after a standard meal. EGG shows gastric electrical activity that parallels gastric motor activity.

RESULTS

Before surgery, no significant difference was found for any of the EGG parameters or the serum gastrin integrated value (area under the curve [AUC]) between the two groups of patients. After surgery, an increased frequency of electrical waves (tachygastria) was observed in 22% of those undergoing GA and in 5% of patients undergoing BA. The power ratio (postprandial/fasting total power) was exceedingly high (>4) in 53% of the GA patients and in 11% of the BA patients (P<0.05). The gastrin AUC was 263+/-58 pg/mL in the GA group and 179+/-92 pg/mL in the BA group (P<0.01).

CONCLUSIONS

An excess of EGG activity and serum gastrin secretion was observed in patients undergoing GA vs those submitted to BA. Thus, the latter procedure seems to affect gastric function less than GA alone.

[How to raise efficacy of gastroesophageal reflux disease treatment]

AIM

To specify dysfunction of the stomach and duodenum in gastroesophageal reflux disease (GRD) to offer more effective pathogenetic pharmacotherapy of GRD.

MATERIAL AND METHODS

Fibroesophagogastroduodenoscopy with further assessment of esophageal mucosa condition by Savary-Miller, intragastric pH-metry, dynamic gastroscintigraphy and electrogastrography were made in 150 GRD patients.

RESULTS

GRD patients were found to have significant disturbances of a motor-evacuatory function of the gastroduodenal complex. Addition of domperidon and mebeverin to routine combined treatment of GRD raises clinical efficacy of GRD treatment and promotes recovery of gastric and duodenal function though therapeutic efficacy of the above drugs depended on concomitant pathology.

CONCLUSION

Domperidon and mebeverin addition to combined treatment of GRD makes this treatment more effective.

Effect of acid suppression on gastric myoelectrical activity in GERD

BACKGROUND/AIMS

The study aimed to investigate whether acid suppression influences gastric myoelectrical activity in patients with reflux disease.

METHODOLOGY

Twenty-eight patients with erosive esophagitis underwent electrogastrography. All patients were studied before and after esomeprazole. Subjects were divided into mild or moderate esophagitis in order to determine any variation in response related to esophagitis severity.

RESULTS

The reflux symptom improved from 4.2 at baseline to 1.0 at week 8 (P < 0.001). A significant increase in postprandial gastric 3 cycle per minute (normal) activity was observed at week 8 (P < 0.05). There was also significantly increased postprandial gastric 3 cycle per minute (normal) activity in moderate esophagitis (P < 0.05).

CONCLUSIONS

The effect of acid suppression on gastric myoelectrical activity is subtle with an enhancement in normal gastric myoelectrical activity. The myoelectrical response to acid suppression appears to be associated with esophagitis severity.

[Effect of ghrelin on small intestinal transit and interdigestive gastrointestinal migrating myoelectric complex in rats]

OBJECTIVE

To investigate the effects of ghrelin on small intestinal transit and intergigestive gastrointestinal migrating myoelectric complex (MMC) in rats.

METHODS

After a 24-hour fasting, the rats with or without pretreatment with receptor antagonist (D-Lys3)GHRP-6 were given intravenous injections of ghrelin at different doses to observe the changes in small intestinal transit. The MMCs of the fasting rats were recorded using a multilead physiological recording system, and their changes observed in response to intravenous ghrelin injections, or to ghrelin injection following pretreatment with atropine, phentolamine, propranolol, L-arginine or (D-Lys3)GHRP-6, respectively.

RESULTS

Ghrelin enhanced the small intestinal transit dose-dependently, and this effect was inhibited by application of ghrelin receptor antagonist. Ghrelin also showed excitatory effect on the MMCs, which was inhibited by atropine, L-arginine or (D-Lys3)GHRP-6, but not by propranolol and phentolamine.

CONCLUSION

Ghrelin can promote gastrointestinal motilities, and its excitatory effects rely on the cholinergic pathway in close relation to nitric oxide pathway. Ghrelin receptor is involved in its action in promoting the gastrointestinal motilities.

[Effect of ghrelin on duodenal myoelectric activity in conscious rats]

OBJECTIVE

To explore the effect of ghrelin on the duodenal myoelectrical activity during the feeding state and the fasting state in rats.

METHODS

One pair of bipolar silver electrodes were chronically implanted in the duodenal serosa of rats for electromyography. The myoelectrical activity was recorded when ghrelin was injected intravenously into rats during the feeding state or the fasting state. Some rats were pretreated with atropine, phentolamine, propranolol, L-arginine, and (D-Lys3)GHRP-6 respectively to explore the mechanism of ghrelin.

RESULTS

Duodenal migrating myoelectrical complex (MMC) could be induced by ghrelin in the feeding state. Ghrelin could shorten the length of duodenal MMC cycle and increase the amplitude and frequency of phase III during the fasting state. The percentage of phase III in the MMC cycle did not change. These effects were inhibited by atropine and L-arginine (D-Lys3)GHRP-6, but not by propranolol and phentolamine.

CONCLUSION

Ghrelin seems to be closely related to the duodenal motility. The excitatory effect of ghrelin on duodenal MMC might rely on the cholinergic pathway, and have a close relationship with NO. The receptor of ghrelin can regulate its activity.

Effect of ghrelin on gastric myoelectric activity and gastric emptying in rats

Ghrelin is a recently discovered peptide in the endocrine cells of the stomach, which may stimulate gastric motility via the vagal nerve pathway. However, the mechanism of ghrelin-induced changes in gastrointestinal motility has not been clearly defined. The purpose of this study was to investigate the pharmacological effects of ghrelin on gastric myoelectrical activity and gastric emptying in rats, and to investigate whether cholinergic activity is involved in the effects of ghrelin. The study was performed on Sprague-Dawley rats implanted with serosal electrodes for electrogastrographic recording. Gastric slow waves were recorded from fasting rats at baseline and after injection of saline, ghrelin, atropine, or atropine+ghrelin. Gastric emptying of non-caloric liquid was measured by the spectrophotometric method in conscious rats. Intravenous administration of rat ghrelin (20 microg/kg) increased not only dominant frequency, dominant power and regularity of the gastric slow wave but also the gastric emptying rate when compared with the control rats (P<0.01, P<0.05, P<0.05, P<0.001 respectively). These stimulatory actions of ghrelin on both gastric myoelectrical activity and gastric emptying were not fully eliminated by pretreatment with atropine sulphate. These results taken together suggest that ghrelin may play a physiological role in the enteric neurotransmission controlling gastric contractions in rats.

Effects of sibutramine on gastric emptying, intestinal motility and rectal tone in dogs

The aim of this study was to evaluate the effects of sibutramine on gastric emptying, small-bowel contractions, rectal tone and compliance, and gastrointestinal myoelectrical activity. The study was performed in 14 dogs. It was composed of three separate experiments: gastric emptying of liquids and gastrointestinal slow waves; small-bowel contractions; and rectal tone and rectal compliance. Each experiment included two sessions: a control session and a treatment session with sibutramine (5 mg/kg orally) administrated 2 h before the study. Sibutramine significantly accelerated liquid gastric emptying at 75 and 90 min after the meal but did not alter gastrointestinal slow waves. Gastric emptying at 75 and 90 min was 61.42 +/- 7.71 and 66.32 +/- 7.67% in the control session, and increased to 71.27 +/- 5.14 and 75.93 +/- 5.29% in the session with sibutramine (p < 0.05, vs. control). Sibutramine significantly inhibited postprandial small-bowel contractions. Sibutramine did not alter the rectal tone, but significantly increased rectal compliance. Sibutramine accelerates gastric emptying of liquids but inhibits small-bowel contractions. These findings suggest the peripheral mechanisms of sibutramine in reducing food intake and causing weight loss in obesity patients.

The acute effect of oral ethanol intake on gastric myoelectrical activity in healthy volunteers

The acute effect of ethanol intake on the upper gastrointestinal system is not clearly known. Animal studies have shown that ethanol inhibited the antral muscle fiber contractions and slow wave activity.

BACKGROUND/AIMS

To show the acute effect of oral ethanol intake on gastric myoelectrical activity in healthy volunteers.

METHODS

Fourteen healthy male volunteers were included in the study. They were given control solution with test meal and ethanol with test meal on two different days. Electrogastrography recordings were obtained in pre-/postprandial periods.

RESULTS

On the days of ethanol intake, blood alcohol level reached above 80 mg/dl in 10 volunteers. Ethanol intake did not show any significant effect on any of the electrogastrography parameters.

CONCLUSIONS

Though reasonable blood alcohol level was achieved and six volunteers experienced upper gastrointestinal system complaints, ethanol had no effect on gastric myoelectrical activity.

The effect of cholecystokinin peptides on ovine duodeno-jejunal slow waves with and without pretreatment with proglumide

Cholecystokinin exerts a composite influence on gastrointestinal motility but little is known about its effect on small-intestinal slow waves. Thus, six rams were implanted with four bipolar serosal electrodes onto the duodeno-jejunal wall. In the course of chronic experiments the myoelectric activity was continuously recorded in the non-fasted animals. After recording of the full normal migrating myoelectric complex (MMC), 0.15 M NaCl or CCK peptides were injected intravenously during various phases of the next MMC cycle. Five ml of saline was injected over 30 s during phases 1, 2a, or 2b of the MMC. Cerulein was administered at doses of 1 (over 30 s), 10 (over 30 or 60 s), or 100 ng/kg (over 30, 60, 120 or 300 s) and cholecystokinin octapeptide (CCK-OP) at doses 20 times higher. CCK peptides were applied during early or late phase 1 of the MMC and during phases 2a and 2b of the MMC. In the course of additional experiments, saline and hormone administration was directly preceded by infusion of proglumide, an unspecific CCK receptor antagonist, at a dose of 10 mg/kg. The myoelectric recordings were continued until the arrival of a subsequent regular phase 3 of the MMC. In the duodenal bulb, slow waves were occasionally observed. In the duodenum the slow-wave frequency oscillated between 20 and 24 cpm and in the jejunum between 19 and 22 cpm before or after CCK peptides and proglumide. In the duodenum the slow-wave amplitude increased significantly after all doses of cerulein injected during phase 2b of the MMC. After administration of CCK-OP changes in duodenal slow-wave amplitude were not significant but exhibited a tendency similar to those after cerulein. In the jejunum, injection of cerulein and CCK-OP during phase 2 of the MMC increased the slow-wave amplitude significantly and the duration of these changes was longer than in the duodenum. After infusion of proglumide, administration of cerulein at the low dose over 30 s and at the high dose over 300 s in the course of late phase 1 and phases 2a and 2b of the MMC, significantly increased the duodenal slow-wave amplitude. Cerulein injection during phase 2b of the MMC at the high dose over 30 and 60 s, preceded by proglumide infusion, significantly inhibited the duodenal slow-wave amplitude. In the jejunum these changes were even more pronounced and their duration was much longer. It is concluded that CCK peptides affect slow-wave amplitude in the duodeno-jejunum in non-fasted sheep. This effect is stronger in the jejunum and is altered but not abolished by pretreatment with proglumide. Cerulein evokes more pronounced alterations in the slow-wave amplitude than CCK-OP in conscious sheep.

Effects of motilin and mitemcinal (GM-611) on gastrointestinal contractile activity in rhesus monkeys in vivo and in vitro

Neither the presence of motilin receptors nor their action has been investigated in monkeys. The object of this study was to determine the effects of motilin and mitemcinal (GM-611), an erythromycin derivative, on the gastrointestinal tract in rhesus monkeys in vivo and in vitro. In in vivo investigations in conscious monkeys, both motilin and mitemcinal induced migrating motor complex-like contractions in the interdigestive state and also accelerated gastric emptying. In in vitro investigations, the presence of motilin receptors in the gastrointestinal tract was demonstrated by receptor binding assays. Motilin and mitemcinal contracted isolated duodenum strips in a concentration-dependent manner. In conclusion, rhesus monkeys may be useful for studying the physiological and pharmacological roles of the motilin agonistic mechanism because they show reactivity to motilin both in vivo and in vitro.

Voltage-gated Ca2+ currents are necessary for slow-wave propagation in the canine gastric antrum

Electrical slow waves determine the timing and force of peristaltic contractions in the stomach. Slow waves originate from a dominant pacemaker in the orad corpus and propagate actively around and down the stomach to the pylorus. The mechanism of slow-wave propagation is controversial. We tested whether Ca(2+) entry via a voltage-dependent, dihydropyridine-resistant Ca(2+) conductance is necessary for active propagation in canine gastric antral muscles. Muscle strips cut parallel to the circular muscle were studied with intracellular electrophysiological techniques using a partitioned-chamber apparatus. Slow-wave upstroke velocity and plateau amplitude decreased from the greater to the lesser curvature, and this corresponded to a decrease in the density of interstitial cells of Cajal in the lesser curvature. Slow-wave propagation velocity between electrodes impaling cells in two regions of muscle and slow-wave upstroke and plateau were measured in response to experimental conditions that reduce the driving force for Ca(2+) entry or block voltage-dependent Ca(2+) currents. Nicardipine (0.1-1 microM) did not affect slow-wave upstroke or propagation velocities. Upstroke velocity, amplitude, and propagation velocity were reduced in a concentration-dependent manner by Ni(2+) (1-100 microM), mibefradil (10-30 microM), and reduced extracellular Ca(2+) (0.5-1.5 mM). Depolarization (by 10-15 mM K(+)) or hyperpolarization (10 microM pinacidil) also reduced upstroke and propagation velocities. The higher concentrations (or lowest Ca(2+)) of these drugs and ionic conditions tested blocked slow-wave propagation. Treatment with cyclopiazonic acid to empty Ca(2+) stores did not affect propagation. These experiments show that voltage-dependent Ca(2+) entry is obligatory for the upstroke phase of slow waves and active propagation.

Cannabinoid type 1 receptor modulates intestinal propulsion by an attenuation of intestinal motor responses within the myenteric part of the peristaltic reflex

Cannabinoid-1 (CB1) receptor activation affects gastrointestinal propulsion in vivo. It was our aim to further characterize the involved myenteric mechanisms in vivo and in vitro. In CB1(-/-) mice and wild-type littermates we performed in vivo transit experiments by charcoal feeding and in vitro electrophysiological recordings in mouse small intestinal smooth muscle. Ascending neuronal contraction (ANC) following electrical field stimulation was studied in rat ileum in a partitioned organ bath separating the aboral stimulation site from the oral recording site. The knockout animals displayed an accelerated upper gastrointestinal transit compared to control animals. The CB1 receptor antagonist AM251 stimulated the force of the ANC in a concentration dependent manner when added in the oral chamber. Anandamide significantly inhibited the ANC when added in the oral chamber. Neither AM251 nor anandamide had an influence on the contraction latency. No effects were observed when drugs were added in the aboral chamber, proving a CB1 mediated action on the neuromuscular junction. Resting membrane potentials and neuronal induced inhibitory junction potentials in CB1(-/-) mice were unchanged as compared to wild type. However, the electrophysiological slow waves were more sensitive to blockade of Ca(2+) channels in CB1(-/-) mice. Our data strongly suggest a physiological involvement of the CB-1 receptor in the regulation of small intestinal motility. Therefore, CB1 receptors are a promising target for the treatment of motility disorders.

Endogenous acyl ghrelin is involved in mediating spontaneous phase III-like contractions of the rat stomach

In humans and dogs, it is known that motilin regulates phase III contractions of migrating motor complex (MMC) in the fasted state. In rats, however, motilin and its receptor have not been found, and administration of motilin failed to induce any phase III-like contractions. Ghrelin was discovered as the endogenous ligand for the growth hormone secretagogue receptor (GHS-R) from the rat stomach. Ghrelin promotes gastric premature phase III (phase III-like contractions) in the fasted state in rats. We hypothesized that endogenous ghrelin regulates spontaneous phase III-like contractions in rats. Strain gauge transducer was sutured on the antrum and a catheter was inserted into the jugular vein. We studied the effects of i.v. administration of ghrelin and a GHS-R antagonist on gastric phase III-like contractions in conscious rats. Plasma level of ghrelin was measured by a radioimmunoassay. Ghrelin augmented spontaneous phase III-like contractions and a GHS-R antagonist significantly attenuated the occurrence of spontaneous phase III-like contractions. During the phase I period, plasma ghrelin level increased to its peak then returned to basal level, subsequently phase III-like contractions were observed. These results suggest that endogenous ghrelin regulates gastric phase III-like contractions in rats.

Rectal distension inhibits postprandial small intestinal motor activity partially via the adrenergic pathway in dogs

OBJECTIVE

Rectal distension is known to induce numerous upper gastrointestinal symptoms. The aim of this study was to investigate the effects and mechanisms of rectal distension on small intestinal myoelectrical and motor activities in 8 dogs using a pair of intestinal electrodes and an intestinal fistula.

MATERIAL AND METHODS

Experiment 1 entailed a 30-min baseline recording and a 30-min recording during rectal balloon distension at various volumes (60, 80, 100 and 120 ml) randomly. Experiment 2 comprised three sessions, each including a 30-min baseline recording, a 20-min recording after intravenous infusion of saline, phentolamine (3 mg/kg) or propranolol (3 mg/kg), respectively, and another 30-min recording during rectal balloon distending.

RESULTS

1) Rectal distension resulted in reduced intestinal motility in a dose-dependent manner (r=0.68, p<0.001). 2) The reduction in intestinal motility was significantly diminished when infusions of phentolamine (2.7+/-1.0 versus 8.4+/-1.5, p<0.01) or propranolol (3.7+/-1.4 versus 8.4+/-1.5, p<0.05) were given, suggesting partial involvement of the alpha- and beta-adrenergic pathways. 3) Rectal distension did not affect the percentage of normal 17-22 cycles/min intestinal slow waves (97.5+/-2.5 versus 93.0+/-5.3, p>0.05), or their dominant frequency (17.2+/-1.2 counts per minute (cpm) versus 17.7+/-1.0 cpm, p>0.05), or dominant power (-4.8+/-2.5 versus -8.2+/-2.9 dB, p>0.05).

CONCLUSIONS

Rectal distension inhibits postprandial small intestinal motor activity in a distension volume-dependent manner in dogs, and this inhibitory effect is at least partially mediated via the alpha and beta adrenergic pathways and does not involve any alterations in intestinal slow waves.

[Effect of Qingre Liqi Granule on clinical therapeutic efficacy, electrogastrogram and gastric emptying in patients with functional dyspepsia]

OBJECTIVE

To evaluate the effects of Qingre Liqi Granule (QLG) on clinical therapeutic efficacy, electrogastrogram (EGG) and gastric emptying in patients with functional dyspepsia (FD).

METHODS

Thirty-two FD patients of dyskinesis type enrolled were treated with QLG by oral taking for 6 days. Scoring on 8 kinds of symptoms, including abdominal distension, abdominal pain, morning gastric fullness, belching, regurgitation, nausea, vomiting, and anorexia, fasting EGG and the gastric emptying determination were performed using single photon emission computed tomography (SPECT) before and after treatment.

RESULTS

The total and individual scores of clinical symptoms, expect that of vomiting, significantly decreased after treatment (P < 0.05), and the percentage of patients with tachygastria and bradygastria significantly decreased (P<0.01) at the same time. EGG after treatment showed significantly elevated rates of normal slow wave dominant power, and nearly normalized dominant frequency. An increased gastric emptying rate at different phases after 75 min (P < 0.05), and significantly shortened gastric emptying half-time (P < 0.01) were shown meanwhile in gastric emptying detection. The improvement of symptom score and gastric emptying half-time showed significant positive linear correlation (r =0.8929, P < 0.01).

CONCLUSION

QLG can improve symptoms of FD patients by regulating the rhythm and power of gastric electro-wave, increasing gastric motility and enhancing gastric emptying function.

Epidural administration of morphine facilitates time of appearance of first gastric interdigestive migrating complex in dogs with paralytic ileus after open abdominal surgery

Morphine is known to delay gastric emptying and intestinal transit, although epidural morphine is believed to decrease postoperative complications. However, these findings are still controversial and based only on clinical observations. We investigated the effects of epidural morphine administration on gut motility by measuring interdigestive migrating complex after open surgery in dogs. Twenty-eight beagles were divided into four groups (n = 7 each) to receive epidural saline (control group), epidural morphine, epidural ropivacaine, or low-dose continuous intravenous morphine. Strain gauge force transducers were sutured under open operation to the serosal surface of the stomach, duodenum, jejunum, and ileum to monitor gut motility. Time of appearance of first interdigestive migrating complex from the stomach propagated to the distal intestine was significantly shorter in the group that received epidural morphine compared with the other three groups. These results suggest that epidural administration of morphine may facilitate recovery from paralytic ileus after open abdominal surgery, perhaps through its effects on the central nervous system.

Effects of ghrelin on feeding regulation and interdigestive migrating complex in rats

OBJECTIVE

Ghrelin is an orexigenic peptide with remarkable prokinetic effects. However, its mechanisms in regulating feeding and gastrointestinal migrating myoelectrical complex (MMC) are not fully understood. The aim of this study was to examine the effects of ghrelin on feeding regulation and duodenal motility in rats.

MATERIAL AND METHODS

Feeding regulation was investigated at different times after intravenous injection of ghrelin and its receptor antagonist (D-Lys3)GHRP-6 in fasted rats. Rats were supplied with a pair of silver bipolar electrodes embedded in the duodenal serosa for electromyography. Ghrelin was injected intravenously into the rats during the fed state or fasted state. Some rats were pretreated with atropine, phentolamine, propranolol, L-arginine, the 5-hydroxytryptamine3 receptor antagonist ondansetron, and (D-Lys3)GHRP-6.

RESULTS

Ghrelin had little effect on food intake in the first 30 min after administration, but was found to increase feeding during the subsequent hours. (D-Lys3)GHRP-6 decreased feeding and antagonized the effect of ghrelin. Ghrelin induced duodenal MMC after administration in the fed state, and shortened the duodenal MMC cycle length and the duration of phase III during fasting. The amplitude and frequency of phase III were increased without affecting the percentage of phase III in the MMC cycle. Pretreatment with atropine, L-arginine, ondansetron, and (D-Lys3)GHRP-6 inhibited the effects of ghrelin. Propranolol and phentolamine had little influence on these effects.

CONCLUSIONS

Ghrelin appears to be closely related to feeding and intestinal motility. The excitatory effects of ghrelin are dependent on the cholinergic pathway, and it has a close relationship with the NOS-NO or 5-HT pathway. The ghrelin receptor is involved in its activities.

The Effect of Lidocaine on Postoperative Jejunal Motility in Normal Horses

OBJECTIVE

To measure the effect of lidocaine on the duration of the migrating myoelectric complex (MMC) and Phases I, II, and III of the MMC, spiking activity of the jejunum, and number of Phase III events when administered postoperatively to normal horses.

STUDY DESIGN

Nonrandomized cross-over design.

METHODS

Horses were anesthetized and via flank laparotomy 4 silver-silver chloride bipolar electrodes were sutured to the proximal jejunum. Electrical activity was recorded for 6 hours during 3 recording sessions beginning 24, 48, and 72 hours postoperatively. Saline (0.9% NaCl) solution was administered for 3 hours followed by lidocaine administration for 3 hours (1.3 mg/kg bolus intravenously [IV], 0.05 mg/kg/min IV constant rate infusion).

RESULTS

Duration of MMC was unchanged during lidocaine administration (77 minutes-saline versus 105 minutes-lidocaine, P=.16). Durations of Phase I and II were unchanged during lidocaine administration (P=.19 and .056, respectively). Phase III was shorter during lidocaine administration (P=.002). Spiking activity was unchanged at all time periods during lidocaine administration (24 hours-P=.10; 48 hours-P=.95; and 72 hours-P=.12). The number of Phase III events was unchanged over all time periods during lidocaine administration (P=.053).

CONCLUSIONS

Duration of MMC, spiking activity, and number of Phase III events was unchanged during lidocaine administration.

CLINICAL RELEVANCE

Use of lidocaine as a prokinetic agent cannot be supported by this study in normal horses; however, results may differ in clinically affected horses.

Mechanisms underlying nutrient-induced segmentation in isolated guinea pig small intestine

Mechanisms underlying nutrient-induced segmentation within the gut are not well understood. We have shown that decanoic acid and some amino acids induce neurally dependent segmentation in guinea pig small intestine in vitro. This study examined the neural mechanisms underlying segmentation in the circular muscle and whether the timing of segmentation contractions also depends on slow waves. Decanoic acid (1 mM) was infused into the lumen of guinea pig duodenum and jejunum. Video imaging was used to monitor intestinal diameter as a function of both longitudinal position and time. Circular muscle electrical activity was recorded by using suction electrodes. Recordings from sites of segmenting contractions showed they are always associated with excitatory junction potentials leading to action potentials. Recordings from sites oral and anal to segmenting contractions revealed inhibitory junction potentials that were time locked to those contractions. Slow waves were never observed underlying segmenting contractions. In paralyzed preparations, intracellular recording revealed that slow-wave frequency was highly consistent at 19.5 (SD 1.4) cycles per minute (c/min) in duodenum and 16.6 (SD 1.1) c/min in jejunum. By contrast, the frequencies of segmenting contractions varied widely (duodenum: 3.6-28.8 c/min, median 10.8 c/min; jejunum: 3.0-27.0 c/min, median 7.8 c/min) and sometimes exceeded slow-wave frequencies for that region. Thus nutrient-induced segmentation contractions in guinea pig small intestine do not depend on slow-wave activity. Rather they result from a neural circuit producing rhythmic localized activity in excitatory motor neurons, while simultaneously activating surrounding inhibitory motor neurons.

Inhibitory effects of sildenafil on gastric motility and gastric slow waves in dogs

The aim of this study was to investigate the effects of sildenafil on gastric motility and gastric slow waves in dogs. The study was performed in healthy dogs and composed of three experiments. The first experiment was designed to study the effects of sildenafil on gastric emptying and gastric slow waves. The second experiment was used to investigate the effects of sildenafil on gastric tone. The third experiment was used to study the effects of sildenafil on postprandial antral contractions. (i) Sildenafil did not alter gastric emptying of liquid. (ii) Sildenafil had no effects on dominant frequency and percentage of normal gastric slow waves. The dominant power of gastric slow waves was, however, significantly reduced with sildenafil (P < 0.02). (iii) Fasting gastric volume with sildenafil was significantly higher than that at baseline (P < 0.0005) or in the control session (P < 0.002). However, the postprandial gastric volume was not altered with sildenafil. (iv) Sildenafil inhibited gastric antral motility. The contraction index was 338.5 +/- 39.99 at baseline and 122.5 +/- 20.3 after the injection of sildenafil (P = 0.003). Sildenafil inhibits fundic tone and antral motility but does not seem to delay gastric emptying of liquid in dogs. The amplitude but not the frequency or regularity of the gastric slow wave is inhibited by sildenafil.

Development of colonic motility in the neonatal mouse-studies using spatiotemporal maps

Colonic migrating motor complexes (CMMCs) are spontaneous, anally propagating constrictions, repeating every 3-5 min in mouse colon in vitro. They are regulated by the enteric nervous system and may be equivalent to mass movement contractions. We examined postnatal development of CMMCs and circular muscle innervation to gain insight into mechanisms regulating transit in the maturing colon. Video recordings of mouse colon in vitro were used to construct spatiotemporal maps of spontaneous contractile patterns. Development of nitric oxide synthase (NOS) and cholinergic nerve terminals in the circular muscle was examined immunohistochemically. In adults, CMMCs appeared regularly at 4.6 +/- 0.9-min intervals (n = 5). These intervals were reduced by inhibition of NOS (2.7 +/- 0.2 min; n = 5; P < 0.05). CMMCs were abolished by tetrodotoxin (n = 4). CMMCs at postnatal day (P)10 were indistinguishable from adult. At birth and P4, CMMCs were absent. Instead, small constrictions that propagated both orally and anally, "ripples," were seen. Ripples were unaffected by tetrodotoxin or inhibition of NOS and were present in Ret(-/-) mice (which lack enteric neurons) at embryonic day 18.5. In P6 mice, only ripples were seen in control, but NOS inhibition induced CMMCs (n = 8). NOS terminals were abundant in the circular muscle at birth; cholinergic terminals were sparse but were common by P10. In mouse, myogenic ripples are the only mechanism available to produce colonic transit at birth. At P6, neural circuits that generate CMMCs are present but are inhibited by tonic activity of nitric oxide. Adult patterns appear by P10.

Regional differences in the effects of various doses of cerulein upon the small-intestinal migrating motor complex in fasted and non-fasted sheep

There are no precise data concerning the effect of cerulein on the small-intestinal migrating motor complex (MMC) in sheep. Thus, the effort was directed towards the elucidation of the role of cerulein, a cholecystokinin (CCK) amphibian analogue, in the regulation of MMC cycle in conscious fasted and non-fasted sheep in various regions of the small intestine. In six sheep, equipped with bipolar electrodes in the entire small intestine and with one duodenal strain gauge force transducer in four of these animals, the continuous myoelectric and motor activity recordings were performed. During control period, two normal consecutive MMC cycles were recorded in fasted and non-fasted animals and then cerulein was slowly injected at the dose 1 (during 30 s), 10 (during 30 s or 60 s) or 100 ng/kg (during 30 s, 60 s or 120 s) or infused at the dose 0.5 or 1.5 ng/kg/min during 60 min. After cerulein administration at least two consecutive MMC cycles were also recorded. It was found that cerulein in moderate and higher doses injected in both fasted and non-fasted animals, especially during phase 2a or 2b MMC, inhibited phase 3 in the duodenum in at least one-third of the experiments and significantly increased the MMC cycle duration. The application of 100 ng/kg of cerulein during 120 s in the course of phase 2b MMC prolonged cycle duration from 70 +/- 21 to 113 +/- 19 min (p < 0.05) or from 51 +/- 18 to 113 +/- 19 min (p < 0.01) in fasted and non-fasted sheep respectively. The first phase 3 MMC arriving after cerulein administration at the highest dose was usually abnormal in approximately 60% of the experiments. The second phase 3 observed following the hormone injection was abnormal much less frequently and to the lesser extent. Furthermore, both cerulein doses significantly shortened the duration of phase 3 MMC either in fasted (from approximately 5.5-6.5 cpm to 4-5 cpm) or in non-fasted sheep (from approximately 4.5-5.5 to 3-4.5 cpm). The effects of cerulein exhibited the dose-response character. They were more pronounced when cerulein was injected during phase 2b or 2a MMC when compared with phase 1 MMC. The effects of cerulein on the ileal MMC were less evident, although the inhibition of the ileal phase 3 in response to both higher injected doses was observed occasionally. Infusions of cerulein in non-fasted sheep exerted similar effects as cerulein injections. It was stated that cerulein exerts marked regulatory effect upon the small-intestinal MMC in sheep. Although it remains uncertain whether the efficient doses of cerulein used in the present study correspond to physiological or pharmacological doses of CCK it seems likely that most of these doses were physiological. Thus, it is concluded that cerulein participates in the control of MMC cycles in the digestive and interdigestive states in sheep. It is possible that CCK is a physiological regulator of the ovine small-intestinal MMC.

Enteric descending and afferent neural signaling stimulated by giant migrating contractions: essential contributing factors to visceral pain

We investigated whether strong compression of an intestinal segment by giant migrating contractions (GMCs) initiates pseudoaffective signals from the gut, similar to those initiated by its distension with a balloon. The experiments were performed on conscious dogs by using close intra-arterial infusions of test substances that affect the receptors only in the infused segment. The stimulation of GMCs by close intra-arterial infusion of CGRP or distension of an intestinal segment by balloon increased the heart rate; the increase in heart rate was greater when the balloon distension and GMCs occurred concurrently in separate intestinal segments. The suppression of contractility in the distended segment blocked the increase in heart rate. By contrast, the stimulation of rhythmic phasic contractions (RPCs) or their spontaneous occurrence did not increase the heart rate. The occurrence of GMCs as well as intestinal distension also produced descending inhibition. The descending inhibition was blocked by the inhibition of nitric oxide synthase, but it was unaffected by the inhibition of adenylyl cyclase, purinergic receptors P2X and P2Y, and muscarinic receptors M(1) and M(2). The synaptic transmission for descending inhibition was mediated primarily by nicotinic receptors and activation of nitric oxide synthase. It was unaffected by the inhibition of tachykinin receptors NK(1), NK(2), and NK(3); serotonin receptors 5-HT(1A), 5-HT(2)/5-HT(1C), 5-HT(3), and 5-HT(4); and muscarinic receptors. Our findings show that GMCs, but not RPCs, initiate pseudoaffective signals from the gut. In the presence of visceral hypersensitivity or impaired descending inhibition, the GMCs may become a noxious stimulus.

[Periodic motor-secretory activity of the stomach in disbalance of its regulatory mechanisms]

The periodic gastric motor-and-secretor activity in modeling of disbalance of autonomic nervous regulation in chronic fistula canine experiments was studied. It was found that autonomic nervous disbalance at the first stages was accompanied with reorganization of periodic gastric motor and secretor phase lengths which resulted in shortening of gastric basic myoelectrical rhythm period (BMRP), appearing of gastric acid secretion in fasted state and increasing of secretor response to exogenous histamine stimulation. Indeed, the gastric motor rhythms appeared to be more sensitive to changes in activity of regulatory mechanisms than the functional activity of the gastric secretor glands. Long-term disbalance of regulatory mechanisms caused the "regulatory rejection", which was associated with increasing of duodenogastric reflux and increasing of gastric BMRP, as well as with decreasing of gastric mucosal defending properties. We hypothesize that nonadrenergic noncholinergic pathway may play a role in reorganization of the observed gastric motor-and-secretor activity.

Effect of electroacupuncture at Sibai on the gastric myoelectric acitivities of denervated rats

AIM: To explore the mechanism of the exciting effects of electro-acupuncture (EA) at Sibai on the gastric myoelectric activities.

METHODS: A total of 32 rats were randomly divided into four groups. Through intraperitoneal injection with atropine (the anti-cholinergic agent by blockade of muscarinic receptors), hexamethonium (automatic nerve ganglion-blocking agent) and reserpine (anti-adrenergic agent by depleting the adrenergic nerve terminal of its norepinephrine store), effects of EA at Sibai on the gastric myoelectric activities of the denervated rats were observed.

RESULTS: After intraperitoneal injection of atropine and hexamethonium, the average amplitude and ratio of period to time in the phase of high activity of gastric myoelectric slow wave, and the average numbers of the peaks of gastric myoelectric fast wave were significantly decreased (P < 0.01, P < 0.05, P < 0.01), while after intraperitoneal injection of reserpine, the aforementioned three parameters were increased (P < 0.01, P < 0.05, P < 0.01). EA at Sibai point partially relieved the inhibitory effect of atropine and hexamethonium on the gastric myoelectric activities in the rats (P < 0.05 or P > 0.05).

CONCLUSION: Cholinergic and adrenergic nervous systems and autonomic nerve ganglion participate in the peripheral passage of the controlling effects of EA at Foot Yangming Channel on gastrointestinal tract.

[Effects of intra-amygdaloid injection of motilin on the interdigestive migrating myoelectrical complex in rat]

OBJECTIVE

This study is undertaken to explore the effects of motilin in the amygdaloid nucleus on the interdigestive migrating myoelectrical complex (MMC) in rats.

METHODS

Adult SD rats of either sex were used. 0.5 microL motilin (0.74 nmol/microL) was injected into the guide cannula which had been stereotaxically implanted into the amygdaloid nucleus. Then the MMC was recorded by an RM6240B multilead physiological recording system. Some rats also received subdiaphragmatic vagotomy, or intravenous injection of the M-cholinergic receptor antagonist atropine (50 microg/kg), the alpha-adrenergic receptor antagonist phentolamine (200 microg/kg), the beta-adrenergic receptor antagonist propranolol (100 microg/kg), the anti-motilin serum.

RESULTS

After motilin was injected into the amygdaloid nucleus, the duodenal MMC cycle duration was decreased significantly, (586.3 +/- 42.0) vs. (694.0 +/- 36.2)s. However, the amplitude of phase III and the frequency of phase III was increased, (294.7 +/- 43.2) vs (255.1 +/- 23.5) microV and (23.1 +/- 0.6) vs. (18.2 +/- 0.4) bursts/min. But there were no effects on the duration of phase III. The percentage change in frequency of phase III was much greater than the percentage change in amplitude of phase III, (54.3 +/- 5.6) vs. (22.4 +/- 4.3). The effects of motilin in the amygdaloid nucleus on MMC were completely abolished by subdiaphragmatic vagotomy. The effects of motilin in the amygdaloid nucleus on MMC were not affected by intravenously injected atropine, phentolamine or propranolol. The anti-motilin serum partly abolished the effects of motilin in the amygdaloid nucleus on MMC.

CONCLUSION

Motilin in the amygdaloid nucleus has effects on the duodenal MMC cycle duration, the amplitude of phase III and the frequency of phase III, all of which may rely on either the effects of noncholinergic and nonadrenergic neurons on duodenal smooth muscle, or the increase of local motilin via nucleus amygdalae-hypothalamus-brain stem-vagus pathway.

Peripheral mechanisms of intestinal dysmotility in rats with salsolinol induced experimental Parkinson's disease

Gastrointestinal dysmotility in Parkinson's disease (PD) has been attributed in part to peripheral neurotoxine action. Our purpose was the evaluation of the salsolinol effect on intramuscular interstitial cells of Cajal (ICC), duodenal myoelectrical activity (DMA) and vagal afferent activity (VAA) in rats with experimental PD. Twenty rats were divided into 2 equal groups. Experimental PD was produced in one group by 3 weeks of the intraperitoneal salsolinol injections (50 mg/kg/day), whereas the 2-nd group served as control. DMA and VAA were recorded in both groups during fasting and stepwise--gastric distension (GD) of 10 ml. Subsequently fragments of duodenum were removed and intramuscular ICC were assessed as c-Kit antigen percentage in the duodenal muscular zone. Analyses of the fasting DMA and VAA recordings didn't reveal differences between the compared groups. During GD increase of DMA dominant frequency (p=0.04) and VAA frequency (p<0.01) was observed in the controls whereas in the salsolinol group both parameters remained unchanged. Image analysis of duodenum revealed decreased c-Kit expression in the salsolinol-injected animals (p=0.05). The results of our study may suggest the direct effect of salsolinol on both ICC and neuronal pathways of gastro-duodenal reflexes.

[Effect of banxia xiexin decoction and its components on coefficient of variability of slow wave electrogastric rhythm in rats with electrogastric dysrhythmia]

OBJECTIVE

To observe the effect of Banxia Xiexin Decoction (BD) and its components in the rats with electrogastric dysrhythmia, explore the mechanism of BD' s "relieving distension and fullness, and dissolving lumps" and study BD' s compatibility regularity.

METHODS

Rat model of electrogastric dysrhythmia was established, the effects of BD and its components on the coefficient of variability of the model' s slow wave electrogastric rhythm were determined.

RESULTS

Compared with the model group, BD and all the components groups had better effects on all the aspects (P <0. 05 ), Among which the group containing herbs with pungent and bitter flavour (Rhizoma Pinelliae, Rhizoma Zingiberis, Radix Scutellariae, Radix Berberidis julianae) was the best.

CONCLUSION

BD and all the components have the effects of rectifying electrogastric dysrhythmias in various degrees, and the herbs with pungent and bitter flavour are best. This study provides the experimental foundations for further understanding the mechanism of BD' s treating principle-using bitter drugs for purgation and pungent drugs for dispersion, normalizing the functional activities of qi.

[Mechanism of hypothalamic effect in small intestine electro-activity of rats regulated by fructus aurantii immaturus]

OBJECTIVE

To observe the effect of Fructus Aurantii Immaturus (FAI) on the electro-activity of small intestines in rats, and evaluate the interrelations between the FAI regulating effect and choecystokinin (CCK) and somatostatin (SS).

METHODS

Migrating myoelectric complex (MMC) cyclic period, the ratio of the active time to the cyclic period, and the number of the fast wave within the active time per minute were observed between FAI and the normal saline group by external alimentary canal electrodes; the CCK contents in dorsomedial hypothalamic nucleus (DMH), ventromedia hypothalamic nucleus (VMH), lateral hypothalamus area (LHA) and SS in VMH, LHA, paraventricular nucleus (PVN) by using immuno-chemistry technique and micro-image pattern quantitative analysis and scanning system.

RESULTS

The MMC cyclic period shortened, the ratio of the active time to the cyclic period increased and the number of the fast wave within the active time per minute increased in the FAI group, which showed significant difference from the normal saline group; CCK positive neurons were reduced in the areas of DMH, VMH and LHA, SS positive neurons were increased in the areas of VMH, LHA and PVN in the FAI gioup,which showed significant difference compared with the normal saline and the blank control group.

CONCLUSION

FAI can stimulate the electro-reactivity of small intestines. The stimulative effect of FAI might be related to CCK and SS in hypothamus.

Inhibitory effects of sildenafil on small intestinal motility and myoelectrical activity in dogs

Previous studies have shown that sildenafil inhibits the esophageal motility in both humans and animals. The aim of this study was to investigate the effects of sildenafil on intestinal myoelectrical activity and motility. The study was composed of 2 experiments and performed in 7 healthy female dogs with a duodenal cannula 20 cm beyond pylorus (19-26 kg). The first experiment was designed to study the effects of sildenafil on intestinal myoelectrical activity and it included 2 sessions each consisting of 30-minute baseline, 15-minute posttreatment (placebo or 100 mg sildenafil) and 90 minutes after a liquid meal. Intestinal myoelectrical activity was recorded during the entire experiment period. The second experiment was aimed to investigate the effect of sildenafil on intestinal motility and was performed immediately after a solid meal. Intestinal motility was measured by a manometric catheter inserted into the small intestine via the duodenum cannula for 30 minutes at baseline and 60 minutes after sildenafil. Sildenafil significantly reduced the amplitude but had no effect on the frequency and regularity of the intestinal myoelectrical activity. Sildenafil significantly inhibited postprandial intestinal contractions. Although the frequency of the contractions was not altered, the mean area under the curve was significantly reduced during the first 30 minutes (P < .03) and second 30 minutes after sildenafil (P < .03); the power of intestinal contractile activities was also significantly reduced during the first 30 minutes (P < .0004) and second 30 minutes after sildenafil (P < .0003) in comparison with baseline. In conclusion, sildenafil inhibits the amplitude of both intestinal contractile activity and intestinal slow waves.

Relationship between dietary-induced changes in intestinal commensal microflora and duodenojejunal myoelectric activity monitored by radiotelemetry in the rat in vivo

Interdigestive intestinal motility, and especially phase III of the migrating myoelectric/motor complex (MMC), is responsible for intestinal clearance and plays an important role in prevention of bacterial overgrowth and translocation in the gut. Yet previous results from gnotobiotic rats have shown that intestinal microflora can themselves affect the characteristics of the myoelectric activity of the gut during the interdigestive state. Given that the composition of the intestinal microflora can be altered by dietary manipulations, we investigated the effect of supplementation of the diet with synbiotics on intestinal microflora structure and the duodenojejunal myoelectric activity in the rat. To reduce animal distress caused by restraint and handling, which can itself affect GI motility, we applied radiotelemetry for duodenojejunal EMG recordings in conscious, freely moving rats. Thirty 16-month-old Spraque-Dawley rats were used. The diet for 15 rats (E group) was supplemented with chicory inulin, Lactobacillus rhamnosus and Bifidobacterium lactis. The remaining 15 rats were fed control diet without supplements (C group). Three rats from each group were implanted with three bipolar electrodes positioned at 2, 14 and 28 cm distal to the pylorus. After recovery, two 6 h recordings of duodenojejunal EMG were carried out on each operated rat. Subsequently, group C rats received feed supplements and group E rats received only control diet for 1 week, and an additional two 6 h recordings were carried out on each of these rats. Non-operated C and E rats were killed and samples of GI tract were collected for microbiological analyses. Supplementation of the diet with the pro- and prebiotics mixture increased the number of bifidobacteria, whereas it decreased the number of enterobacteria in jejunum, ileum, caecum and colon. In both caecum and colon, the dietary supplementation increased the number of total anaerobes and lactobacilli. Treatment with synbiotics increased occurrence of phase III of the MMC at all three levels of the small intestine. The propagation velocity of phase III in the whole recording segment was also increased from 3.7 +/- 0.2 to 4.4 +/- 0.2 cm min(-1) by dietary treatment. Treatment with synbiotics increased the frequency of response potentials of the propagated phase III of the MMC at both levels of the jejunum, but not in the duodenum. In both parts of the jejunum, the supplementation of the diet significantly decreased the duration of phase II of the MMC, while it did not change the duration of phase I and phase III. Using the telemetry technique it was demonstrated that changes in the gastrointestinal microflora exhibited an intestinal motility response and, more importantly, that such changes can be initiated by the addition of synbiotics to the diet.

[Influence of scald and lipopolysaccharide on gastrointestinal motility]

OBJECTIVE

To investigate the pathogenesis of gastrointestinal motility dysfunction as a result of scald and lipopolysaccharide (LPS) challenge in guinea pigs.

METHODS

Thirty guinea pigs were enrolled in the study and were randomly divided into 3 groups:i. e. control (n = 10, with intraperitoneal injection of isotonic saline), scald (n = 10, with 30% TBSA deep partial thickness burn) and LPS (n = 10, with intraperitoneal injection of LPS) groups. Thirty minutes after treatment, all animals were gavaged with carbolic ink. The propelled distance of the ink within the gastrointestinal tract was measured. The intestinal tissue was harvested and homogenized, and the contents of CGRP, Na+-K+-ATP enzyme, Mg2+-ATP enzyme, Ca2+-ATP enzyme, Ca2+-Mg2+-ATP enzyme were determined, and the delta phim of haustra coli smooth muscular cell mitochondria was assessed.

RESULTS

The propelled distance of the ink in the gastrointestinal tract in scald (53 +/- 9 cm) and LPS (91 +/- 10 cm) groups was obviously shorter than that in control group (142 +/- 11 cm, P < 0.01). Furthermore, the distance in scald group was shorter than that in LPS group (P < 0.01). The CGRP content in scald and LPS groups [52.0 +/- 39.0 microg/L and 20.0 +/- 23.0 microg/L] was obviously higher than that in control group (0.8 +/-2.0 microg/L, P <0.05 or 0.01), especially in scald group ( P < 0.05). The Na+-K+-ATP enzyme, Mg2+-ATP enzyme, Ca2+-ATP enzyme, Ca2+-Mg2+-ATP enzyme and the delta phim in scald and LPS groups were remarkably lower than those in control group (P <0.005), but there was no difference between scald and LPS groups (P > 0.05).

CONCLUSION

The gastrointestinal motility of guinea pigs could obviously be inhibited by scald and LPS, especially by scald. LPS might be the key factor to produce change in the membrane potential of mitochondria of intestinal smooth muscle after severe scald.

Effect of SC-435 on the gastrointestinal migrating myoelectric complex in guinea pigs

OBJECTIVE

To determine whether SC-435, a new ileal apical sodium-codependent bile acid transporter (IBAT) inhibitor, can alter the gastrointestinal motility in guinea pigs.

METHODS

Sixty guinea pigs received regular diet or IBAT inhibitor (SC-435) diet for 2, 4, and 8 weeks, respectively. At the end of the feeding period, the gallbladder motility was assessed and then four bipolar silver electrodes were implanted on the antrum, duodenum, jejunum, and ileum. Seven days later, migrating motor complex (MMC) was recorded and the total bile acid pool size was measured according to the isotope dilution principle in the meantime.

RESULTS

After feeding SC435, the gallbladder motility was declined in the 4-week group and the 8-week group. The bile acid pool size decreased by 17.11% (P <0.05) in the 4-week group and 48.35% (P < 0.05) in the 8-week group. The places of origin of MMC were changed where antral origins (37%) and duodenal origins (46%) decreased whereas jejunal origins (17%) increased. The MMC cycle period was prolonged in the duodenum (1.16 times in the 4-week group, P < 0.05; 1.38 times in the 8-week group, P < 0.05) whereas MMC amplitude fell in the duodenum (10.58% in the 4-week group, P <0.05; 49.17% in the 8-week group, P <0.05). There were not significant differences in all parameters of MMC between the control group and the 2-week group in guinea pigs.

CONCLUSION

The IBAT inhibitor (SC-435) reduces the bile acid pool size and inhibits the MMC cycle activity. MMC is related to the enterohepatic circulation of bile acids, which is consistent with the changes of the bile acid pool size in guinea pigs.