Characteristics of fasting and fed myoelectric activity in rat small intestine: evaluation by computer analysis

Receptor-mediated inhibition of small bowel migrating complex by GLP-1 analog ROSE-010 delivered via pulmonary and systemic routes in the conscious rat

BACKGROUND

ROSE-010, a Glucagon-Like Peptide-1 (GLP-1) analog, reduces gastrointestinal motility and relieves acute pain in patients with irritable bowel syndrome (IBS). The rat small bowel migrating myoelectric complex (MMC) is a reliable model of pharmacological effects on gastrointestinal motility. Accordingly, we investigated whether ROSE-010 works through GLP-1 receptors in gut musculature and its effectiveness when administered by pulmonary inhalation.

MATERIALS AND METHODS

Rats were implanted with bipolar electrodes at 5, 15 and 25 cm distal to pylorus and myoelectric activity was recorded. First, intravenous or subcutaneous injections of ROSE-010 or GLP-1 (1, 10, 100 μg/kg) with or without the GLP-1 receptor blocker exendin(9-39)amide (300 μg/kg·h), were studied. Second, ROSE-010 (100, 200 μg/kg) Technosphere® powder was studied by inhalation.

RESULTS

The baseline MMC cycle length was 17.5±0.8 min. GLP-1 and ROSE-010, administered intravenously or subcutaneously, significantly inhibited myoelectric activity and prolonged MMC cycling; 100 μg/kg completely inhibited spiking activity for 49.1±4.2 and 73.3±7.7 min, while the MMC cycle length increased to 131.1±11.4 and 149.3±15.5 min, respectively. Effects of both drugs were inhibited by exendin(9-39)amide. Insufflation of ROSE-010 (100, 200 μg/kg) powder formulation totally inhibited myoelectric spiking for 52.6±5.8 and 70.1±5.4 min, and increased MMC cycle length to 102.6±18.3 and 105.9±9.5 min, respectively.

CONCLUSIONS

Pulmonary delivery of ROSE-010 inhibits gut motility through the GLP-1R similar to natural GLP-1. ROSE-010 causes receptor-mediated inhibition of MMC comparable to that of intravenous or subcutaneous administration. This suggests that ROSE-010 administered as a Technosphere® inhalation powder has potential in IBS pain management and treatment.

Fasting and postprandial small intestinal slow waves non-invasively measured in subjects with total gastrectomy

BACKGROUND AND AIM

Slow wave is essential to initiate gastrointestinal tract motility. Subjects with total gastrectomy (TG) provide an opportunity to study small intestinal slow wave in the absence of stomach interference. The aims of this study were to determine the origin of 3 cycles per min (cpm) slow wave recorded via electrogastrogram (EGG) and the characteristics of putative small intestinal slow waves in TG subjects.

METHODS

Thirty-three subjects with TG (25 male, age: 44-83 years) were consecutively enrolled. In each subject, the myoelectricity-like signals of the gastrointestinal tract were recorded using 3-channel EGG. Fourier transform-based spectral analysis was performed to derive the EGG parameters including dominant frequency/power, % normal rhythm (2-4 cpm), and power ratio.

RESULTS

Neither visual nor spectral analysis of the EGG revealed any waves at a frequency of about 3 cpm. The most frequently observed peaks in the power spectra of all subjects were those at approximately 1, approximately 6 and approximately 11 cpm with occurrences of 97%, 6.1% and 90.9%, respectively. Based on visual analysis of all recorded signals, the approximately 11 cpm signal was exactly rhythmically recorded rather than the approximately 1 cpm. The recorded approximately 11 cpm wave had a frequency of 10.9 +/- 1.0 cpm in the fasting state and 10.9 +/- 1.3 cpm in the fed state (NS), and a power of 31.5 +/- 3.2 dB in the fasting state and 35.2 +/- 3.8 dB in the fed state (P < 0.0001). None of other factors, including sex, age, and body mass index, had any impact on this approximately 11 cpm wave.

CONCLUSIONS

Small intestinal slow wave can be recorded non-invasively using EGG via cutaneous electrodes in TG subjects. Sex, age and body mass index have no effect on the intestinal slow waves. The power rather than frequency of intestinal slow wave is increased after a solid meal.

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.

IMPACT OF FOOD INTAKE ON URODYNAMIC FEATURES OF ORTHOTOPIC URINARY RESERVOIRS

PURPOSE

The inconsistency of urodynamic characteristics among patients with similar, well detubularized urinary reservoirs together with the persistence of nocturnal incontinence in almost a third of such patients has motivated many groups to study in depth the inherent physiological characters of the intestinal segments used. One of the most critical criteria is the effect of food intake on such isolated segments. We determined the effect of food intake on the urodynamic behavior of urinary intestinal reservoirs.

MATERIALS AND METHODS

A total of 50 male patients with well detubularized orthotopic reservoirs (hemiKock or W neobladders) after radical cystectomy underwent medium fill enterocystometry while fasting for 8 hours. Patients were then given a standardized caloric diet and the test was repeated 2 hours after food intake. Comparisons were made in the whole group of patients and subsets according to continence status, reservoir configuration and reservoir duration.

RESULTS

The only significant and consistent finding was the decrease in maximum enterocystometric capacity. This decrease was statistically significant when calculated for the fasting and postprandial states in the whole group (mean +/- SD 539.1 +/- 155.7 and 495.9 +/- 146.2 ml), in continent patients (538 +/- 177 and 505 +/- 168.5 ml) and in patients with enuresis (539 +/- 177 and 481 +/- 106.8 ml, respectively). While the frequency and amplitude of phasic contractions were notably increased postprandially, baseline pressure at mid and maximum capacity were observed to be lowered. However, neither effect achieved statistical significance.

CONCLUSIONS

Definite urodynamic changes occur in intestinal urinary reservoirs in response to food intake, denoting that these detubularized intestinal segments retain at least in part their native behavior in response to eating. The consistent decrease in maximum capacity together with increased phasic motor activity in a subset of these patients may explain their incontinence episodes. Changing food composition and habits may improve the continence state in this subset of patients.

Physiological regulation and NO-dependent inhibition of migrating myoelectric complex in the rat small bowel by OXA

Orexin A (OXA)-positive neurons are found in the lateral hypothalamic area and the enteric nervous system. The aim of this study was to investigate the mechanism of OXA action on small bowel motility. Electrodes were implanted in the serosa of the rat small intestine for recordings of myoelectric activity during infusion of saline or OXA in naive rats, vagotomized rats, rats pretreated with guanethidine (3 mg/kg) or N(omega)-nitro-L-arginine (L-NNA; 1 mg/kg). Naive rats were given a bolus of the orexin receptor-1 (OX1R) antagonist (SB-334867-A; 10 mg/kg), and the effect of both OXA and SB-334867-A on fasting motility was studied. Double-label immunocytochemistry with primary antibodies against OXA, neuronal nitric oxide synthase (nNOS), and OX1R was performed. OXA induced a dose-dependent prolongation of the cycle length of the migrating myoelectric complex (MMC) and, in the higher doses, replaced the activity fronts with an irregular spiking pattern. Vagotomy or pretreatment with guanethidine failed to prevent the response to OXA. The OXA-induced effect on the MMC cycle length was completely inhibited by pretreatment with L-NNA (P < 0.05), as did SB-334867-A. The OX1R antagonist shortened the MMC cycle length from 14.1 (12.0-23.5) to 11.0 (9.5-14.7) min (P < 0.05) during control and treatment periods, respectively. Colocalization of OXA and nNOS was observed in myenteric neurons of the duodenum and nerve fibers in the circular muscle. Our results indicate that OXA inhibition of the MMC involves the OX1R and that activation of a L-arginine/NO pathway possibly originating from OX1R/nNOS-containing neurons in the myenteric plexus may mediate this effect. Endogenous OXA may have a physiological role in regulating the MMC.

Regulatory role of 5-HT and muscarinic receptor antagonists on the migrating myoelectric complex in rats

The 5-HT(3) and 5-HT(4) receptor antagonists alosetron and piboserod, and the muscarinic receptor antagonists PNU-171990A (2-(diisopropylamino)ethyl 1-phenylcyclopentanecarboxylate, hydrochloride) and PNU-174708A (2-(diisopropylamino)ethyl 1-phenylcyclohexanecarboxylate) were studied by electromyography, defining the migrating myoelectric complex (MMC) after i.v. administration in conscious rats. Alosetron prolonged the MMC cycle length from 16.6 to maximally 30.4 min at the dose 0.5 mg kg(-1). Piboserod promptly abolished MMC pattern and prolonged cycle length from 16.5 to >60 min at 0.5 mg kg(-1). PNU-171990A and PNU-174708A had no effect on basal cycle length up to a dose of 20 mg kg(-1). In controls, saline did not change the MMC pattern, while L-hyoscyamine at the same dose, 20 mg kg(-1), prolonged cycle length from 17.6 to 29.0 min. None of the drugs affected duration or propagation velocity of phase III of MMC. Blockade of 5-HT(4) receptors seems to exert a powerful inhibitory effect on motility, 5-HT(3) receptor blockade is less efficient and muscarinic receptor blockade has low efficacy.

GLP-1 and GLP-2 act in concert to inhibit fasted, but not fed, small bowel motility in the rat

Small bowel motility was studied in rats at increasing (1-20 pmol/kg/min) intravenous doses of either glucagon-like peptide-1 (GLP-1) or glucagon-like peptide-2 (GLP-2) alone, or in combination in the fasted and fed state. There was a dose-dependent inhibitory action of GLP-1 on the migrating myoelectric complex (MMC), where the dose of 5 pmol/kg/min induced an increased MMC cycle length. No effect was seen with GLP-2 alone, but the combination of GLP-1 and GLP-2 induced a more pronounced inhibitory effect, with significant increase of the MMC cycle length from a dose of 2 pmol/kg/min. During fed motility, infusion of GLP-1 resulted in an inhibition of spiking activity compared to control. In contrast, infusion of GLP-2 only numerically increased spiking activity compared to control, while the combination of GLP-1 and GLP-2 resulted in no change compared to control. In summary, this study demonstrates an additive effect of peripheral administration of GLP-1 and GLP-2 on fasted small bowel motility. In the fed state, GLP-1 and GLP-2 seem to display counter-balancing effects on motility of the small intestine.

Localization and effects of orexin on fasting motility in the rat duodenum

The orexins [orexin A (OXA) and orexin B (OXB)] are novel neuropeptides that increase food intake in rodents. The aim of this study was to determine the distribution of orexin and orexin receptors (OX1R and OX2R) in the rat duodenum and examine the effects of intravenous orexin on fasting gut motility. OXA-like immunoreactivity was found in varicose nerve fibers in myenteric and submucosal ganglia, the circular muscle, the mucosa, submucosal and myenteric neurons, and numerous endocrine cells of the mucosa. OXA neurons displayed choline acetyltransferase immunoreactivity, and a subset contained vasoactive intestinal peptide. OXA-containing endocrine cells were identified as enterochromaffin (EC) cells based on the presence of 5-hydroxytryptamine immunoreactivity. OX1R was expressed by neural elements of the gut, and EC cells expressed OX2R. OXA at 100 and 500 pmol x kg(-1) x min(-1) significantly increased the myoelectric motor complex (MMC) cycle length compared with saline. Similarly, OXB increased the MMC cycle length at 100 pmol x kg(-1) x min(-1), but there was no further effect at 500 pmol x kg(-1) x min(-1). We postulate that orexins may affect the MMC through actions on enteric neurotransmission after being released from EC cells and/or enteric neurons.

Automated, quantitative analysis of interdigestive small intestinal myoelectric activity in rats

Quantitative analysis of myoelectric activity (EMG), to investigate small intestinal motility in rats, is normally based on manual classification into sequences of phase I, phase II and phase III. This classification is partly subjective. We aimed to develop a more objective method for the analysis of the migrating myoelectric complex (MMC). From the EMG, a derived signal is calculated as a measure of activity. Depending on the level of this derived signal, the EMG is classified into 'quiescent phase', 'irregular phase' or 'activity front'. The threshold levels for these phases are automatically calculated from the EMG data. A proposal for subdivision into MMCs is automatically generated. To calculate MMC length, the user must manually reject nonpropagated activity fronts. While developing the method, more than 19 derived signals were tested. These included variants of spike frequency, signal power and spike-burst length. The spike frequency signal was chosen because it gave minimal deviation from manual classification. Using the new automated method, recordings from the jejunum of 15 healthy rats were analysed (6 h each). The calculated phase lengths were consistent with the results of manual analysis. The presented method allows objective analysis of the interdigestive EMG signals of the small intestine.

The inhibitory mechanism of GLP-1, but not glucagon, on fasted gut motility is dependent on the L-arginine/nitric oxide pathway

Effects of glucagon-like peptide-1 (GLP-1) and glucagon on fasted gut motility in conscious rats were investigated as regards dependence on nitric oxide (NO). Small bowel motility was studied by electromyography and a jugular vein catheter was implanted for administration of drugs. GLP-1 (5-40 pmol x kg(-1) x min(-1)) prolonged the cycle length and abolished phase III of the migrating myoelectric complex (MMC) (P<0.01). Low doses of GLP-1 did not affect duration, propagation velocity or calculated length of phase III. At 1 mg x kg(-1) N(omega)-nitro-L-arginine (L-NNA) blocked the GLP-1 response up to a dose of 10 pmol x kg(-1) x min(-1) (P<0.05), while higher doses were able to overcome L-NNA-induced disinhibition of the GLP-1 response (P<0.05). Similarly, L-arginine at 300 mg x kg(-1) prevented L-NNA-induced disinhibition of the GLP-1 response (P<0.05). Glucagon (200-1000 pmol x kg(-1) x min(-1)) prolonged the cycle length and abolished phase III of MMC (P<0.01) independent of NO. Again, low doses of glucagon did not affect duration, propagation velocity or calculated length of phase III. In conclusion, inhibition of fasted motility by GLP-1 at low doses is dependent on NO, while high doses of GLP-1 and glucagon exert effects on motility independently from NO.

Vasoactive intestinal peptide suppresses migrating myoelectric complex of rat small intestine independent of nitric oxide

The involvement of nitric oxide (NO) in the biological response to vasoactive intestinal peptide (VIP) on the migrating myoelectric complex (MMC) of small bowel and systemic arterial blood pressure was investigated in the rat. Animals were supplied with bipolar electrodes for electromyography of the small intestine and blood pressure was assessed by a pressure transducer connected to a carotid artery. In the first session, Nomega-nitro-L-arginine (L-NNA) was administered intravenously at 1, 2, 4 and 20 mg kg(-1). Effects of L-NNA at 1 and 20 mg kg(-1) were also studied after L-arginine 300 mg kg(-1). In the second session, intravenous infusion of VIP 500 pmol kg(-1) min(-1) was administered before and after L-NNA at 1 and 20 mg kg(-1). L-NNA at increasing doses stimulated myoelectric spiking of the small bowel until at 4 mg kg(-1) the MMC was disrupted and irregular spiking induced. Neither at 1 nor 20 mg kg(-1) did L-NNA affect the inhibitory motility response or decrease of blood pressure induced by VIP at a dose of 500 pmol kg(-1) min(-1). Our results show that effects of VIP on motility of the small intestine and systemic arterial blood pressure are direct and not dependent on NO as a common final link.

Serotonin stimulates migrating myoelectric complex via 5-HT3-receptors dependent on cholinergic pathways in rat small intestine

We have investigated the effect of 5-hydroxytryptamine (5-HT) and different 5-HT-receptor antagonists and atropine on the migrating myoelectric complex in the rat small intestine. Infusion of 5-HT dose-dependently shortened the interval between phase III of the migrating myoelectric complex (MMC). In untreated animals the interval in upper jejunum was 19.1 (16.0-22.1) min. At doses of 10 and 20 nmol kg-1 min-1, the interval decreased to 15.2 (12.0-18.4) and 10.2 (9.4-11.0) min, respectively. The 5-HT3-receptor antagonist ondansetron (0.5 mg kg-1) alone increased the MMC interval from 20.8 (15.1-26.5) to 33.9 (19.4-48.4) min. Neither methiothepin (0.5 mg kg-1) nor ketanserin (0.5 mg kg-1), selective for 5-HT1/5-HT2- and 5-HT2-receptors, respectively, changed the MMC interval. The 5-HT4-receptor antagonist GR 113808 (0.5 mg kg-1) disrupted the MMC and induced irregular spiking activity. Ondansetron and atropine antagonized the 5-HT-induced shortening of the MMC interval. Neither methiothepin nor ketanserin affected the response to 5-HT. GR 113808 did not block the response to 5-HT in half of the animals; however, in the remaining ones MMC was disrupted and irregular spiking induced. In conclusion, these results show that 5-HT dose-dependently stimulates the cycling of the MMC in the small intestine via 5-HT3-receptors and a cholinergic final pathway. Our findings encourage further studies on the role of the 5-HT3-receptor in the control of gastrointestinal motility.

Inhibitory effect of glucagon-like peptide-1 on small bowel motility. Fasting but not fed motility inhibited via nitric oxide independently of insulin and somatostatin

Effects of glucagon-like peptide-1 (GLP-1)(7-36)amide on fasted and fed motility in the rat small intestine were investigated in relation to its dependence on nitric oxide (NO), insulin, and somatostatin. Small bowel electromyography was performed using bipolar electrodes implanted 15, 25, and 35 cm distal to pylorus, and transit was studied with a radioactive marker. In the fasted state, GLP-1 (5-20 pmol kg-1min-1), reaching physiological plasma levels, prolonged the migrating myoelectric complex (MMC) cycle length along with slowed transit. This effect was antagonized by exendin(9-39)amide. The NO synthase inhibitor Nomega-nitro- L-arginine (L-NNA) also blocked the response to GLP-1, whereas L-arginine restored the response. Insulin (80-200 pmol kg-1min-1) induced irregular spiking, whereas somatostatin (100-500 pmol kg-1min-1) increased the MMC cycle length, independently of NO. In the fed state, GLP-1 (20-40 pmol kg-1min-1) reduced motility, an inhibition unaffected by L-NNA, whereas motility was stimulated by exendin(9-39)amide. Infusion of GLP-1 (20-100 pmol kg-1min-1) did not affect plasma insulin, but somatostatin was increased. In conclusion, GLP-1 seems to inhibit small bowel motility directly via the GLP-1 receptor. Inhibition of fasting motility is dependent of NO and not mediated via insulin or somatostatin, whereas inhibition of fed motility is independent of NO.

Mediation of irregular spiking activity by multiple neurokinin-receptors in the small intestine of the rat

1. We have studied the small intestinal myoelectric response to the natural tachykinins substance P (SP), neurokinin A (NKA), neurokinin B (NKB), and the neurokinin-receptor selective agonists substance P methyl esther (SPME), [beta-Ala8]neurokinin A 4-10, and senktide in conscious rats. 2. The effects of the agonists were studied before and after administration of the selective neurokinin2 (NK2)-receptor antagonist MEN 10,627. 3. Under basal conditions SP, NKA, NKB, as well as the selective NK1-receptor agonist SPME, the NK2-receptor agonist [beta-Ala8]NKA 4-10, and the NK3-receptor agonist senktide, disrupted the interdigestive rhythm with regularly recycling migrating myoelectric complexes and induced a phase II-like irregular spiking activity. 4. MEN 10,627 given alone did not affect the interdigestive rhythm. 5. MEN 10,627 inhibited the response to [beta-Ala8]NKA 4-10 but not to SP, SPME, NKA, NKB or senktide. 6. It is concluded that not only NK2 receptors, but also other receptors, such as NK1 and NK3 receptors, may mediate the motility-stimulating action of different tachykinins in vivo. 7. It is further concluded that MEN 10,627 exerts a selective NK2-receptor antagonism, and may be a valuable tool for assessing the functional role of NK2-receptors in gastrointestinal physiology.