cholecystokinin and Gastric-Dilatation

Duodenal lipid exacerbates gastrointestinal sensations during gastric distension. Using luminal application of the local anesthetic benzocaine, we investigated the role of intestinal receptors in the induction of these sensations. Nine healthy subjects were studied on five occasions, during which isotonic saline or 20% lipid (2 kcal/min), combined with (duodenal or jejunal) 0.75% benzocaine or vehicle at 2.5 ml/min, was infused intraduodenally before and during gastric distension. Intragastric pressures and volumes, gastrointestinal sensations, and plasma CCK levels were determined. Duodenal lipid combined with vehicle increased gastric volume (in ml: saline, -10 +/- 18; lipid/vehicle, 237 +/- 30) and plasma CCK [mean levels (pmol/l): saline, 2.0 +/- 0. 2; lipid/vehicle, 8.0 +/- 1.6] and, during distensions, induced nausea (scores: saline, 3 +/- 2: lipid/vehicle, 58 +/- 19) and decreased pressures at which fullness and discomfort occurred. Duodenal but not jejunal benzocaine attenuated the effect of lipid on gastric volume, plasma CCK, and nausea during distension (135 +/- 38 and 216 +/- 40 ml, 4.6 +/- 0.6 pmol/l and not assessed, and 37 +/- 12 and 64 +/- 21 for lipid + duodenal benzocaine and lipid + jejunal benzocaine, respectively) and on pressures for sensations. In conclusion, intestinal receptors modulate gastrointestinal sensations associated with duodenal lipid and gastric distension. There is also the potential for local neural mechanisms to regulate CCK release and thereby reduce afferent activation indirectly.

Topics: Adult; Anesthetics, Local; Benzocaine; Cholecystokinin; Cross-Over Studies; Duodenum; Female; Gastric Dilatation; Gastric Emptying; Humans; Intestinal Mucosa; Jejunum; Lipids; Male; Middle Aged; Nausea; Neurons, Afferent; Pain Measurement; Pressure; Single-Blind Method; Sodium Chloride; Stomach

Gastric electrical stimulation (GES) has been introduced for treating obesity. The hippocampus is known to be involved in the regulation of gastrointestinal motility. Changes in hypathalumus cholecystokinin (CCK) have been observed in genetically obese rodents. This experiment was to study the effect of GES on the activities of neurons and the expression of CCK in the hippocampus.. We investigated the effect of GES (GES-I: pulse train of standard parameters; GES-2: reduced train-on time; GES-3: increased pulse width; GES-4: reduced pulse frequency) on neurons responsive to gastric distention (GD) by recording extracellular potentials of single neurons and observing the expression of CCK in the rodent hippocampus by immunohistochemistry staining, radioimmunoassay, and real-time PCR.. 92.1% of neurons in the CA2-3 region responded to GD, 53.2% of which showed excitation (GD-E), and 46.8% showed inhibition (GD-I). 64.8% GD-responsive neurons were excited by GES. The response was associated with stimulation strength, pulse width, and frequency; 70.6, 57.1, 94.4, and 66.7% of GD-E and 72.7, 57.1, 86.4, and 50% of GD-I neurons showed excitatory responses to GES-I, -2, -3, and -4, respectively. CCK immunoreactive positive neurons (P<0.001), the content of CCK-like materials (P<0.05) and the amount of CCK mRNA were significantly increased after GES (P<0.05).. These findings suggest the central, neuronal, and hormonal mechanisms of GES. GES may excite the activity of GD-sensitive neurons and increase the expression of CCK in the hippocampus. These excitatory effects of GES seem to be related to the parameters of stimulation.

Topics: Animals; Cholecystokinin; Electric Stimulation; Electrophysiology; Gastric Dilatation; Hippocampus; Male; Neurons; Obesity; Rats; Rats, Wistar; RNA, Messenger; Stomach

The effect of gastric distension on pancreatic secretion of bicarbonate and trypsin was studied in 10 individuals in the basal state or during stimulation with low and high doses of secretin or secretin plus cholecystokinin (CCK). Gastric distension augmented the pancreatic response to secretin but had no consistent effect on the pancreatic response to combination of secretin and CCK. We conclude that gastropancratic reflexes do not have much functional significance in man.

Topics: Cholecystokinin; Gastric Dilatation; Humans; Pancreas; Pancreatic Juice; Reflex; Secretin