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History traces of gastrointestinal motility in Poland

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The objectives of this chapter was to show how motility studies were developed and performed in Poland at the end of century to better understand pathophysiology and improve the clinicians ability to evaluate and treat patients with motility - related disorders. Some of the important historical points along the path to current understanding of the form and function of gastrointestinal motility are presented. Scarce information exists about other than Cracow and Wroc³aw motility centers in Poland in previous century. Lately sophisticated technology became available in Poland and more centers have begun to yield more effective strategies of treatment and enhanced understanding of the pathophysiologic mechanisms underlying GI motility disorders.
The effect of anticholinergic drugs on gastrointestinal motility is complex and incompletely recognized. Accordingly, in 6 adult sheep bipolar electrodes and strain gage force transducers were surgically attached to the antral, small intestinal and gallbladder wall at the serosal side. During chronic experiments the myoelectric and mechanical recordings were performed in fasted and non-fasted animals before and after various doses of hexamethonium, atropine and pirenzepine given intravenously. Hexamethonium administration triggered rebound excitation after an inhibitory period almost in all the recording sites. Administration of atropine and pirenzepine evoked these secondary contractions mostly in the small intestine and gallbladder. No rebounds were observed when the anticholinergic drugs were given during feeding. In fasted animals, rebound excitation arrived later but more frequently than in non-fasted animals. The excitatory changes were dose-dependent. In the gallbladder, these values were lower than in the small intestine. The frequency of the recurrent pattern was dependent upon the dose of the anticholinergic drug used. It is concluded that nicotinic receptors are more important than muscarinic receptors in the initiation of the rebound excitation in pyloric antrum while in the small bowel and gallbladder the role of both cholinergic receptors is similar. The anticholinergic drugs should be used with caution in all these clinical situations, where the enhancement of gastrointestinal motility must be avoided.
Acute changes in diet composition and/or origin alter gastric emptying and gastro-intestinal motility. One of the hypotheses explaining these alterations involves changes in the sensitivity of duodenal vagal sensory neurons. The aim of this study was to evaluate the characteristics of multimodal duodenal vagal sensory neurons in 20 pigs feed either with milk-based or plant-based diets of identical caloric content. Twenty duodenal vagal afferents were recorded in anesthetized animal from the cervical vagus using the single fiber method. 10 pigs were fed with a milk-based diet (MD) for one month while the diet of the 10 other pigs was changed for plant-based diet (PD) the day preceding the recording session. The behavior of the receptors was tested in basal resting conditions and after challenges with duodenal intralipid and close intra-arterial injection of CCK, 5-HT or capsaicin with and without isovolumetric duodenal distensions at 20, 40 and 60 mmHg. All receptors were slowly adapting C type fiber with a receptor field located 6-7 cm distal to the pylorus. The rate of discharge during distension (20, 40 and 60 mmHg) combined with duodenal intralipid was significantly larger for MD compared with PD. Similarly, the rate of discharge observed during distensions performed with CCK and with 5-HT were greater for MD compared with PD while CCK and 5-HT without distension were equally stimulating for MD and PD. No significant difference was found between groups during capsaicin infusion irrespective of the stimulating pressure. In conclusion, a switch to plant-based diet, when compared to a milk-based diet, results in an overall decrease in mechanical sensitivity of duodenal neurons during lipid, 5HT and CCK challenges, but not in basal conditions or after capsaicin. This reduced sensitivity to distension may explain the diet-induced alteration of gastric emptying that is controlled primarily through a vago-vagal reflex.
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The gastrointestinal research in domestic animals in Poland is briefly discussed in the section. The history starts over seventy years ago with the creation of the Department of Animal Physiology at the Veterinary Faculty of Warsaw University. Professor B. Gutowski, the first head of the Department, and his pupils established the School of Gastrointestinal Physiology; renowned for the achievements in physiology of digestion, gastrointestinal motility, pancreas and liver functions, and comparative physiology of domestic ruminants and wild animals. After the WWII the gastrointestinal research has also been initiated in the newly established faculties of veterinary and animal science of the agricultural universities in Lublin (motility, composition of pepsinogen, biliary and pancreas secretion, vitamin and microelement absorption), Szczecin (lipid absorption, lymph formation), Wroc³aw (gastrointestinal and gall bladder motility, bile secretion) as well as in the Institute of Animal Physiology and Nutrition of the Polish Academy of Science (digestion and absorption, development of the gastrointestinal tract in neonates). The research activity was focused on solving the problems faced by animal production in Poland, but it also resulted in a considerable number of physiological findings of an international dimension, and initiated new research areas.
Alterations in gastrointestinal motility have been reported in response to endotoxin. The effects of lipopolysaccharide (LPS) on motility have been attributed to several substances, including prostaglandins and nitric oxide. The aim of this study was to investigate the expression and the contribution of NOS and COX enzymes to the local effect of LPS on ACh-evoked contractions in rabbit duodenum. The ACh evoked contractions were inhibited by LPS in longitudinal and circular muscles of duodenum. L-NNA, aminoguanidine, ODQ, indomethacin, and NS-398 but not NPLA antagonized the inhibitory effect of LPS. Western blot analysis showed protein bands of 155, 130, 70 and 72 kDa for nNOS, iNOS, COX-1 and COX-2 respectively in rabbit duodenum. All of these isoforms were expressed constitutively and only the nNOS was reduced in the presence of LPS. Expression of nNOS, iNOS, COX-1 and COX-2 was detected by inmunohistochemistry in the smooth muscle layers and in the neurons of the myenteric ganglia of rabbit duodenum. In conclusion, LPS locally administered reduces the contractility of rabbit duodenum and a downregulation of nNOS is associated to this effect. The iNOS, COX-1 and COX-2 were expressed constitutively but their expression was not modified by LPS.
Delayed gastric emptying in patients with both type 1 and type 2 diabetes mellitus (DM) occurs in approximately 50% of these patients. However, the role and the action mechanism of insulin on gastrointestinal (GI) motility are still unclear. The purpose of the present study was to investigate the involvement of cyclooxygenase-2 (COX-2) and prostaglandin E2 in the effects of insulin on gastric emptying in male rats. The normal and streptozotocin (STZ)-pretreated rats were injected intraperitoneally with or without insulin, atropine and specific muscarinic receptor antagonists before examination of measurement of gastric emptying, spontaneous contractile activity of smooth muscle strips, plasma cholecystokinin (CCK), and prostaglandin E2 (PGE2) analysis. Protein expression of COX-2 and insulin receptors (IRs) were analyzed by the technique of western blot. Acute different doses of insulin accelerated gastric emptying. Atropine interrupted the insulin effect on gastric emptying, and muscarnic M1/M3 receptor antagonists interrupted the insulin-reversed gastric emptying in normal and DM rats. Besides, we observed the expression of (IRs) in GI and found that IR was changed under the insulin and DM treatment, and was also different between STZ-pretreated rats and hyperglycemic rats. Expression of COX-2 in stomach was decreased in DM rats but restored by insulin. The COX inhibitor, indomethacin, decreased the gastric emptying which was induced or reversed by insulin in normal and DM rats, respectively. PGE2 production in stomach corresponded to the COX-2 expression. The contraction of GI smooth muscle stimulated by PGE2 was increased in insulin-pretreated normal and DM rats. We conclude that insulin changed the expression of IRs in stomach in DM rats. The delayed GI motility in diabetes was at least in part due to the COX-2 and PGE2 pathway which associated with decreasing COX-2 and diminishing PGE2 production in stomach. The attenuation of PGE2 production was employed for the index of the reduction of smooth muscle contraction in stomach in diabetes. Insulin stimulated the smooth muscle contraction through the IRs and COX-2 expression plus PGE2 production in rat stomach as well as reversed the delayed gastric emptying via the nervous actions of muscarinic M1 and M3 receptors in DM rats.
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