Interactions amongst factors which influence severity of gastric ulceration in rats

Sensitization and conditioning as contributors to gastrointestinal vulnerability

Electric shocks are stressful and if signalled can result in Pavlovian conditioning of the stress response. Stress arising from such shocks or conditioned psychological "threat" influences vulnerability to gastrointestinal disorders. Reviewed are our studies with rats showing that unconditioned stress experiences sensitize the glandular portion of the stomach to later restraint-in-water induced erosions, as an animal model of ulcer disease. These stress effects are not attributable to corticoids but may be opioid/endorphin dependent. The unconditioned stress-induced sensitization is reduced by allowing the rat either control over or prediction of the shocks even though the direct experience with shocks is identical. Elicitation of the conditioned stress response by a signal during the ulcer induction or even shortly afterwards increases gastric vulnerability to erosions. We are now finding parallel unconditioned stress effects on colonic erosions and increases in intestinal permeability induced by dextran sulphate sodium, as an animal model of inflammatory bowel disease. We conclude that psychological context of past trauma and/or current threat increases vulnerability to gastrointestinal disorders.

Analysis of the cold-water restraint procedure in gastric ulceration and body temperature

Gastric mucosal injury induced by body restraint can be enhanced when combined with cold-water immersion. Based on this fact, the present study had two main purposes: (i) to examine the contribution of each of these two forms of stress on the development of gastric ulceration and regulation of body temperature and (ii) to investigate the importance of the animal's consciousness on gastric ulceration induced by the cold-water restraint. Independent groups of animals were exposed for 3 h to one of the following stressful treatments: body restraint plus cold-water (20+1 degrees C) immersion, body restraint alone or cold-water immersion alone. Control animals were not exposed to any form of stress. Half of the animals submitted to each of the four treatments were anesthetized with thionembutal (35 mg/kg), whereas the other half was injected with saline. Results indicated that body restraint alone was not sufficient to induce gastric ulceration or changes in body temperature. On the other hand, cold-water exposure, either alone or in conjunction with body restraint, induced the same amount of stomach erosions and hypothermia. Therefore, it appears that body restraint does not play an important role on gastric ulceration induced by the cold-water restraint procedure. Present results also indicated that conscious and anesthetized animals immersed in cold water presented robust gastric ulceration and a marked drop in body temperature. However, conscious animals developed more severe gastric damage in comparison to anesthetized animals although both groups presented the same degree of hypothermia. These findings suggest that hypothermia resulting from cold-water exposure has a deleterious effect on gastric ulceration but the animal's conscious activity during the cold-water immersion increases the severity of gastric mucosal damage. It is concluded that cold-water restraint is a useful procedure for the study of the underlying mechanisms involved in stress-induced ulceration.

Anxiety and helplessness in the face of stress predisposes, precipitates, and sustains gastric ulceration

When an organism is subjected to stress, gastric ulcers or ulcerations commonly develop but the vulnerability to and amount of pathology induced varies considerably between individuals. The role of psychological factors in determining the occurrence and severity of these ulcerations is amply demonstrated in the studies reviewed here. The present paper (a) gives a brief history of the search for the causes of gastric ulcer, (b) provides a review of our own research which reveals that vulnerability to gastric ulceration is modulated by psychologically meaningful experiences, and (c) offers a multifactorial perspective on the causes of gastric ulceration and the future of research on it.

Amino Acid Effects on Post-Stress Ulcers: Relationship to Brain Serotonin, 5-HIAA and Norepinephrine

To replicate and extend results of earlier studies on amino acid effects on post-stress ulcers, rats were subjected to i.p. injections of (a) saline, (b) tryptophan, (c) tyrosine + valine or(d) tryptophan + tyrosine + valine, either 30 minutes before or immediately after one hour of water restraint stress. Gastric lesions, brain norepinephrine, serotonin and 5-hydroxyindoleacetic acid (5-HIAA) were examined after one hour of poststress rest. We hypothesised that post-stress lesions could be aggravated by central noradrenergic hypoactivity and serotonergic hyperactivity during the post-stress period. Other studies have indicated that tyrosine + valine reduces central serotonergic activity, while additional tryptophan blocks this effect. We therefore expected post-stress lesions to be reduced in tyrosine + valine but not in tryptophan + tyrosine + valine treated animals. Although these expectations were met tentatively in animals injected prior to stress, thus replicating tyrosine + valine effects we had observed earlier, opposite results were found in animals treated post-stress. The brain analyses indicate that the data cannot be explained by a norepinephrine/serotonin imbalance hypothesis. The time dependency of the effects underlines the need for caution in clinical applications of these amino acid treatments.

Enhanced retrieval of unpleasant memories influenced by shock controllability, shock sequence, and rat strain

The propensity to recall unpleasant events may be related to depression and posttraumatic stress disorder. This study examined the extent to which the recall of a previously unpleasant event (i.e., passive avoidance training) may be influenced by another aversive event. The other aversive event was tail shock. Since the Wistar Kyoto (WKY) rat strain has been proposed as an animal model of depressive behavior, this study was conducted with WKY and Wistar rats. Parameters manipulated included shock controllability, shock sequence (i.e., tail shock before avoidance training versus tail shock after training), and rat strain. Performance of the passive avoidance (PA) response was greater in WKY rats. Exposure to inescapable tail shock was related to greater PA performance compared to exposure to escapable or no-shock treatments. Tail shock prior to PA training led to a greater recall of the PA response. The magnitude of the PA response was influenced by the rat strain, shock controllability, and shock sequence. The applicability of these data to the memory bias phenomenon in depression is discussed.

Differing mechanisms for proactive effects of intermittent and single shock on gastric ulceration

Rats exposed to either 80 5-s shocks on a VT 60-s or to a single 400-s shock plus 80-min rest in the shock apparatus show dramatically increased degree of ulceration induced 72 h later by exposure to 75-min restraint-in-water stress (at 19 degrees C). However, the proactive effect of the 80 shocks on later gastric ulceration was blocked by SC injection of 7 mg/kg naltrexone 20 min prior to the shock session; naltrexone treatment prior to the single shock session had no ameliorating effect. A second experiment confirmed opioid involvement in the proactive augmentation of vulnerability by showing that when a 20 mg/kg injection of morphine replaced the shocks, rats showed a comparable increase in vulnerability. A third experiment replicated the basic findings from the first experiments that 80 intermittent shocks increase vulnerability to the ulcerogenicity of restraint-in-water and that this effect can be mimicked by replacing the shock stress with a 20 mg/kg injection of morphine; however, other groups showed that injection of 40 mg/kg produced a similar effect whereas 10 mg/kg was ineffective as a mimic. This suggests that there are at least two types of proactive effects from shock experiences that can increase later vulnerability to shock-induced gastric ulceration; one is opioid mediated and the other is not. This finding parallels reports made about mediation of prior shock-induced hypoalgesias and expands the spectrum to psychosomatic phenomenon.

Restraint stress in biomedical research: an update

Since the publication of our initial review of restraint stress in 1986, much work has continued with this technique, either as a tool for the investigation of other pharmacological, physiological, or pathologic phenomena or with restraint stress itself serving as the object of the study. As we noted in 1986, the major use of restraint has been for the induction of stress responses in animals and, more specifically, for the investigation of drug effects, particularly as they affect typical stress-related pathology--gastrointestinal, neuroendocrine, and immunological agents have been extensively studied. In compiling this update on restraint stress and its effects, we noted an increasing emphasis on central nervous system mechanisms in peripheral disease, especially gastrointestinal disease. In particular, many CNS-active agents have been tested for their effects on gastric and duodenal lesion formation and gastric secretion, including antidepressants, antipsychotics, anxiolytics, noradrenergic, serotonergic, dopaminergic, and peptidergic compounds. Some of these agents are especially active in the gastrointestinal tract even when administered centrally, further solidifying the concept of a brain-gut axis. The present update includes studies of: methods and procedures, pre-restraint manipulations, post-restraint/healing effects, and drug effects. In addition, a current bibliography of reports that have employed restraint is included.

Some psychosomatic causal factors of restraint-in-water stress ulcers

Rats were stressed by 75 min restraint in a tube suspended vertically while dry (19 degrees C) or partially immersed in tanks of water at different temperatures (19, 27, 35 degrees C), either in a conscious state or while under pentobarbital anesthesia. Restraint was followed by 75 min rest in the home cage and then sacrificed under halothane anesthesia. Assessment of the degree of gastric erosion indicated that restraint alone, whether the animal was rendered unconscious or not, was not sufficient to induce ulceration. However, in conscious animals, the addition of partial immersion did induce ulceration that was inversely related to the temperature of the water bath. This effect was not merely the result of brain stem and spinal reflex processes, because unconscious animals exposed to the most severe conditions (19 degrees C) showed no ulceration.

Depressive behavior and stress ulcer in Wistar Kyoto rats

Wistar Kyoto (WKY) rats, as compared to several other rat strains, are hypoactive in the open field test and in the defensive burying test. WKY rats readily acquire a learned helplessness task as well as a passive avoidance tasks. WKY rats also reveal a greater susceptibility to restraint-induced stress ulcer. The behavioral tests suggest the presence of depressive behavior in WKY rats. When exposed to the Porsolt forced-swim test of 'behavioral despair', WKY rats are judged as exhibiting more depressive behavior. Desipramine not only reduced immobility in the forced-swim test, but also diminished the severity of restraint-induced stress ulcer. These data suggested a heightened activity of the hypothalamic-pituitary axis. Basal plasma ACTH levels did not differ between WKY rats and Wistar rats, but serial plasma ACTH response to restraint stress was significantly greater for WKY rats. These data suggest that depressive behavior is a characteristic of WKY rats and this strain is a valuable model for studying depression which may be induced by an exaggerated stress response.

Parallelism among stress effects on ulcer, immunosuppression and analgesia: commonality of mechanisms?

Some general principles and mechanisms have been discovered that govern proactive effects of one stress on animals' later stress or challenge induced behavior, nociception, immune function, and stomach ulcerations. As described below, these principles demonstrate a considerable degree of parallelism across the domains represented by measures of learning deficits and fear-related behaviors, hypoalgesia, immunological status and stress gastric ulcerations. At a minimum, these parallels suggest that operational factors found important in one domain are likely factors of importance in the other domains. Beyond this, these parallels are permissive of an inference of commonality in underlying processes. Nonetheless, results reviewed below suggest that the specific response of the organism to stress is highly dependent on specific characteristics of the stressor.

Stress ulceration in rats: impact of prior stress experience

The role of prior stress experience on the response of the organism to a later stressor has been studied in terms of the extent of gastric ulceration induced by the second stressor. These studies have focused largely on effects of prior stress (shock, restraint, activity) on the ulceration developing under later restraint and activity stress. The studies indicate that prior exposure to restraint stress provides some protection against later restraint ulcer development. Using shock as the prior stressor, the effects on later restraint stress are determined by the particular characteristics of the shock (controllability and predictability), and by contextual factors. Studies are lacking on the significance of these characteristics of shock for later activity stress ulcers. Further studies are required therefore on the significance of psychological characteristics of the prestress, and on the effects of these prestressors at different stages of the life cycle. The identification of these factors, and a clearer picture of the protective and exacerbating effect of prior stress will allow us to explore the physiological (central and peripheral) mechanisms underlying ulcer development and ulcer susceptibility.

The neurobiology of stress ulcers

We have reviewed the neurobiology of stress ulcers from animal models to potential pharmacotherapeutic mechanisms. The evidence strongly supports the hypothesis that certain stress-related gastric lesions are 'brain-driven' events which may be more effectively managed through central manipulations than by altering local, gastric factors. Recent advances in the use of anxiolytic and antidepressant drugs in the management of stress-related gastric mucosal injury further supports the contention that a brain-gut axis, which may have nervous, peptidergic and classic monoaminergic components, modulates the intricate and complicated pattern of communication between the brain and the stomach. Delineation of the precise pathways which make up this communication as well as their manipulation by various pharmacological agents will be the focus of future research endeavour.

Strain, age, but not gender, influence ulcer severity induced by water-restraint stress

Two ulcerogenic procedures, supine restraint (SR) and water restraint (WR) were compared. In Experiment 1, Fischer-344 (F344), Sprague-Dawley (S-D), Wistar, Long-Evans (L-E), Spontaneously Hypertensive rats (SHR) and Wistar Kyoto normotensive (WKY) rats were exposed to SR and WR. WR produced more ulcers than SR. There was no difference in ulcer scores between WKY, F344 and L-E but these rats had significantly more ulcers as compared to SHR, Wistar and S-D rats. In Experiment 2, 4- and 16-month-old SHR, WKY and F344 rats were exposed to SR and WR. The older WKY rats had more ulcers than all other treatment groups. Experiment 3 revealed no significant differences between male and female rats exposed to either SR or WR. Body temperature (BT) scores obtained after restraint and after 2-hr postrestraint rest were only marginally related to ulcer severity. Rats exposed to WR had lower BT scores but the strain and age ulcer differences did not have corresponding BT differences. These studies revealed the following: the ulcer susceptibility of WKY rats; the WR technique is a useful ulcerogenic procedure; and hypothermia is a weak covariant to restraint-induced stress ulcer.

A comparison of two ulcerogenic techniques

Long Evans rats 45, 130, or 280 days old were exposed either to a supine restraint or a water restraint treatment for two hr. This was followed by a 2-hr rest period. Core body temperature was recorded every 30 min. Stress-induced hypothermia was greatest in the water restraint treatment and in younger rats irrespective in both restraint conditions. The water restraint procedure as compared to the supine restraint produced significantly more ulcers in 130- and 280-day-old rats.