Effect of luminal ions on the transepithelial electrical potential difference of human rectum

Skin electrodes are the most convenient reference electrodes for clinical measurements of electrical potential differences (pd) across the epithelium of the alimentary tract but the presence of an electrical charge on normal skin introduces an error. In the present study, by comparison with results obtained using subcutaneous and intravenous electrodes, it was shown that an intradermal injection of saline abolished the skin potential differences. This simple method, therefore, allows skin electrodes to be used to measure the true transepithelial potential differences of gut mucosa. The method was applied to investigate the effect on the rectal potential difference of altering the composition of the luminal solutions. Changes in the cations (sodium, potassium, magnesium) showed that sodium was the most important cationic determinant of the potential difference, especially when sodium absorption was stimulated by giving mineralocorticoids. Changes in the anions (chloride, iodide, bromide, nitrate, bicarbonate, sulphate, phosphate, citrate, and acetate) indicated that the molecular size of the anion rather than its chemical nature was the significant factor and suggested that the ions had to cross a barrier relatively impermeable to anions of radius greater than 3.5 to 4 A degrees . Changes in osmolality and glucose concentration were without effect.

Effect of administered mineralocorticoids or ACTH in pregnant women. Attenuation of kaliuretic influence of mineralocorticoids during pregnancy

The role of augmented aldosterone production in pregnancy is poorly understood. Whereas some consider aldosterone secretion in pregnancy excessive, others suggest that this is a compensatory phenomenon. According to yet another view, mechanisms other than the renin-angiotensin-aldosterone system control sodium homeostasis in pregnancy. Metabolic balance studies were performed on 14 3rd trimester women. Mineralocorticoid activity was experimentally increased by administering desoxycorticosterone acetate, 9alpha-fluorocortisol acetate, or ACTH for 4-12 days. Administration of mineralocorticoid or ACTH consistently caused sodium retention. During this mineralocorticoid-induced volume expansion, aldosterone excretion decreased markedly. Natriuresis, which followed discontinuance of the drug, continued while aldosterone excretion, although greatly diminished compared to control values, was greater than that found in normal, nonpregnant individuals. This saline diuresis did not subside until aldosterone excretion returned to its previously high control values. These observations support the concept of the physiological role of increased aldosterone production in pregnancy. Results further revealed a marked dissociation between antinatriuretic and kaliuretic effects of corticoids. Potassium balance was virtually unaltered during continued mineralocorticoid or ACTH administration, despite initially high or abruptly increased sodium intakes. Finally, mineralocorticoid escape was induced by continued desoxycorticosterone acetate therapy in two male volunteers. Kaliuresis occurred which was subsequently abolished when progresterone was administered. Sodium excretion, however, was virtually unaltered. These data, mimicking results observed in gravidas, suggest that progesterone is an important determinant of potassium homeostasis in pregnant women.

Electrical potentials of the sigmoid colon and rectum in irritable bowel syndrome and ulcerative colitis

Using a simple and rapid method, electrical potential differences across rectal and colonic mucosa have been measured at routine sigmoidoscopy in patients with irritable bowel syndrome and ulcerative colitis. In patients with irritable bowel syndrome, all of whom had diarrhoea, the mucosa was charged negatively on the luminal side and potential differences were not significantly different from those of normal subjects. In acute exacerbations of ulcerative colitis, the potential difference was reversed, the luminal side being positive. This characteristic change was seen even in mild attacks. The potential difference was usually restored to normal within a few weeks of commencing treatment. In some cases, however, it was persistently abnormal for months and failed to show the normal response to stimulation by the mineralocorticoid, fludrocortisone. The way in which measurements of potential difference can be useful in diagnosis, prognosis, and as a guide to treatment is discussed.

Renal responses to vena caval and portal venous infusions of sodium chloride in unanaesthetized dogs

1. Recent investigation has shown that sodium excretion is greater following portal venous infusion of 5% sodium chloride (w/v) than after systemic infusion in anaesthetized dogs. It was suggested that a factor of hepatic origin which is capable of depressing renal tubular reabsorption may be involved in this response. The present experiments were undertaken to determine the renal responses of conscious, unanaesthetized dogs to infusions of 5% NaCl administered systemically and by the portal venous routes.

2. No differences were observed in urine flow or sodium excretion rates in normal dogs when responses to the two routes of NaCl infusion were compared; potassium excretion was elevated following systemic as compared to portal NaCl infusion (P < 0·05). Urine flow was significantly greater (P < 0·05) in vasopressin and mineralocorticoid treated dogs following portal infusion of 5% NaCl, but no differences in electrolyte excretion were observed between routes of administration.

3. These findings are not compatible with the concept that a natriuretic factor is released from the liver consequent to elevation of portal venous sodium concentration in the conscious dog.

The influence of corticosteroid pretreatment on anaphylactic bronchoconstriction in the guinea-pig

Previous reports that cortisone and related compounds exerted a small degree of protection against antigen-aerosol-induced anaphylactic reactions, have been confirmed. Optimal effects were obtained 16 to 24 h after corticosteroid pretreatment. Marked effects were obtained from the more potent glucocorticoids, particularly water-soluble compounds. Similar pretreatment decreased the severity and modified the form of anaphylactic bronchoconstrictor responses induced by intravenous administration of antigen. In guinea-pigs pretreated also with mepyramine, the corticosteroids suppressed the residual and presumably non-histamine component of the anaphylactic bronchoconstrictions. Anti-anaphylactic potency was correlated with glucocorticoid and anti-inflammatory activity. A suggested mode of action involves a combination of weak anti-histamine activity and inhibition of release of slow reacting substances of anaphylaxis.