Biomedical subjects

S Vanner

Publications and source records attributed to S Vanner.

At least 19 recordsLinked to original sources

PubMed2005

Sensory peptide neurotransmitters mediating mucosal and distension evoked neural vasodilator reflexes in guinea pig ileum.

The aim was to determine the role CGRP and/or tachykinins released from sensory neural mechanisms in enteric neural vasodilator pathways. These pathways project through the myenteric plexus to submucosal vasodilator neurons. Submucosal arterioles were exposed in the distal portion of an in vitro combined submucosal-myenteric guinea pig ileal preparation, and dilation was monitored with videomicroscopy. Vasodilator neural reflexes were activated by gently stroking the mucosa with a fine brush or by distending a balloon placed beneath the flat-sheet preparation in the proximal portion. Dilations evoked by mucosal stroking were inhibited 64% by the CGRP 8-37 and 37% by NK3 (SR 142801) antagonists. When the two antagonists were combined with hexamethonium, only a small vasodilation persisted. Balloon distension-evoked vasodilations were inhibited by NK3 antagonists (66%) but were not altered by CGRP 8-37. In preparations in which myenteric descending interneurons were directly activated by electrical stimulation, combined application of CGRP 8-37 and the NK antagonists had no effect. Stimulation of capsaicin sensitive nerves in the myenteric plexus did not activate these vasodilator reflexes. These findings suggest that mucosal-activated reflexes result from the release of CGRP and tachykinins from enteric sensory neurons. Distension-evoked responses were significantly blocked by NK3 antagonists, suggesting that stretch activation of myenteric sensory neurons release tachykinins that activate NK3 receptors on myenteric vasodilator pathways.

Animals↗

PubMed2005

Inflammation-induced hyperexcitability of nociceptive gastrointestinal DRG neurones: the role of voltage-gated ion channels.

Gastrointestinal (GI) inflammation modulates the intrinsic properties of nociceptive dorsal root ganglia neurones, which innervate the GI tract and these changes are important in the genesis of abdominal pain and visceral hyperalgesia neurones exhibit hyperexcitability characterized by a decreased threshold for activation and increased firing rate, and changes in voltages-gated Na(+) and K(+) channels play a major role in this plasticity. This review highlights emerging evidence that specific subsets of channels and signalling pathways are involved and their potential to provide novel selective therapeutics targets for the treatment of abdominal pain.

Abdominal Pain↗

PubMed2005

Basic and clinical pharmacology of new motility promoting agents.

Recent research has provided new information about drugs that could be used to treat functional motility disorders. Promotility drugs accelerate gastric emptying or colonic transit and these properties may contribute to their efficacy in treating symptoms associated with gastroparesis, functional dyspepsia or constipation. 5-Hydroxytryptamine4 receptors are targets for drugs (tegaserod, renzapride) that treat symptoms in constipated irritable bowel syndrome patients and in gastroparesis. Drugs acting at motilin (erythromycin) and cholecystokinin-1 (dexloxiglumide) receptors accelerate gastric emptying. Dexloxiglumide might be useful in the treatment of functional dyspepsia particularly that associated with lipid intake. Alvimopan is a mu-opioid receptor antagonist that does not cross the blood brain barrier. Alvimopan is effective in treating postsurgical ileus and perhaps opiate-induced bowel dysfunction. Successes and failures of recent efforts to develop promotility agents revealed opportunities and challenges for developing new promotility drugs. The pharmacological properties of partial agonists might be exploited to develop effective promotility drugs. However, opposing actions of promotility agents on motility (increased contraction vs decreased accommodation) limit the clinical efficacy of drugs with these opposing actions. Selection of appropriate patient populations for evaluation of new drugs is also critical.

Animals↗

PubMed2004

Submucosal secretomotor and vasodilator reflexes.

The presence of neuronal reflexes within the intestine that modulate mucosal ion secretion and blood flow have been recognized for many years, but the organization of these reflexes was unclear. This review highlights important findings from recent in vitro guinea-pig studies which have shown that both intrinsic primary afferent neurones (IPANs) and extrinsic primary afferent neurones (EPANs) can respond to chemical and/or mechanical stimuli to activate pathways, the afferent and efferent elements of which are confined to the walls of the intestine. Enteric neuronal pathways involve both myenteric and submucosal plexus neurones whereas capsaicin-sensitive afferent nerves evoke secretion by stimulating submucosal secretomotor neurones and vasodilation by direct actions on the submucosal arterioles. In this review, the cellular mechanisms involved in these pathways are described and the implications of these findings are discussed.

Animals↗

PubMed2003

6-mercaptopurine and inflammatory bowel disease: hidden ground for the cytomegalovirus.

6-mercaptopurine (6-MP) and azathioprine are important drugs for the treatment of inflammatory bowel disease (IBD) but their actions suppress host defense against infection. A challenging case of a 19-year-old female patient with quiescent Crohn's disease maintained with 6-MP presenting with dyspnea and a normal chest exam and x-ray is presented. She became ventilator-dependent and only after numerous investigations was diagnosed with cytomegalovirus (CMV) pneumonitis. A systematic literature review of CMV infections in IBD patients was performed. The present case is the first report of a patient with quiescent IBD maintained on 6-MP who developed CMV pneumonitis. Other reports have identified patients with active disease on multiple immunosuppressants who developed CMV pneumonitis and also highlight the risk of CMV colitis in refractory IBD. The authors review the approach to the diagnosis of CMV infections in IBD patients with atypical pneumonia and colitis and highlight the importance of considering CMV infection in these settings.

Adult↗

PubMed2000

Properties of synaptic inputs from myenteric neurons innervating submucosal S neurons in guinea pig ileum.

This study examined synaptic inputs from myenteric neurons innervating submucosal neurons. Intracellular recordings were obtained from submucosal S neurons in guinea pig ileal preparations in vitro, and synaptic inputs were recorded in response to electrical stimulation of exposed myenteric plexus. Most S neurons received synaptic inputs [>80% fast (f) excitatory postsynaptic potentials (EPSP), >30% slow (s) EPSPs] from the myenteric plexus. Synaptic potentials were recorded significant distances aboral (fEPSPs, 25 mm; sEPSPs, 10 mm) but not oral to the stimulating site. When preparations were studied in a double-chamber bath that chemically isolated the stimulating "myenteric chamber" from the recording side "submucosal chamber," all fEPSPs were blocked by hexamethonium in the submucosal chamber, but not by a combination of nicotinic, purinergic, and 5-hydroxytryptamine-3 receptor antagonists in the myenteric chamber. In 15% of cells, a stimulus train elicited prolonged bursts of fEPSPs (>30 s duration) that were blocked by hexamethonium. These findings suggest that most submucosal S neurons receive synaptic inputs from predominantly anally projecting myenteric neurons. These inputs are poised to coordinate intestinal motility and secretion.

Animals↗

PubMed2000

A novel in vitro model of Brunner's gland secretion in the guinea pig duodenum.

A novel in vitro model that combined functional and morphological techniques was employed to directly examine pathways regulating Brunner's gland secretion in isolation from epithelium. In vitro submucosal preparations were dissected from guinea pig duodenum. A videomicroscopy technique was used to measure changes in luminal diameter of glandular acini as an index of activation of secretion. Carbachol elicited concentration-dependent dilations of the lumen (EC(50) = 2 microM) by activating muscarinic receptors on acinar cells. Ultrastructural and histological analyses demonstrated that dilation was accompanied by single and compound exocytosis of mucin-containing granules and the accumulation of mucoid material within the lumen. Inflammatory mediators (histamine, PGE(1), PGE(2)) and intestinal hormones (CCK, gastrin, vasoactive intestinal polypeptide, secretin) also stimulated glandular secretion, whereas activation of submucosal secretomotor neurons by 5-hydroxytryptamine did not. This study directly demonstrates that multiple hormonal, inflammatory, and neurocrine agents activate Brunner's glands, whereas many have dissimilar effects on the epithelium. This suggests that Brunner's glands are regulated by pathways that act both in parallel to and in isolation from those controlling epithelial secretion.

Animals↗

PubMed2000

Myenteric neurons activate submucosal vasodilator neurons in guinea pig ileum.

This study examined whether myenteric neurons activate submucosal vasodilator pathways in in vitro combined submucosal-myenteric plexus preparations from guinea pig ileum. Exposed myenteric ganglia were electrically stimulated, and changes in the outside diameter of submucosal arterioles were monitored in adjoining tissue by videomicroscopy. Stimulation up to 18 mm from the recording site evoked large TTX-sensitive vasodilations in both orad and aborad directions. In double-chamber baths, which isolated the stimulating myenteric chamber from the recording submucosal chamber, hexamethonium or the muscarinic antagonist 4-diphenylacetoxy-N-(2-chloroethyl)-piperdine hydrochloride (4-DAMP) almost completely blocked dilations when superfused in the submucosal chamber. When hexamethonium was placed in the myenteric chamber approximately 50% of responses were hexamethonium sensitive in both orad and aboard orientations. The addition of 4-DAMP or substitution of Ca(2+)-free, 12 mM Mg(2+) solution did not cause further inhibition. These results demonstrate that polysynaptic pathways in the myenteric plexus projecting orad and aborad can activate submucosal vasodilator neurons. These pathways could coordinate intestinal blood flow and motility.

Animals↗

PubMed2000

Neural pathways regulating Brunner's gland secretion in guinea pig duodenum in vitro.

This study examined the neural pathways innervating Brunner's glands using a novel in vitro model of acinar secretion from Brunner's glands in submucosal preparations from the guinea pig duodenum. Neural pathways were activated by focal electrical stimulation and excitatory agonists, and videomicroscopy was used to monitor dilation of acinar lumen. Electrical stimulation of perivascular nerves evoked large dilations that were blocked by TTX (1 microM) or the muscarinic receptor antagonist 4-diphenylacetoxy-N-(2-chloroethyl)-piperidine hydrochloride (1 microM). The nicotinic agonist 1,1-dimethyl-4-phenylpiperazinium iodide (100 microM) had no effect, and the nerve-evoked responses were not inhibited by hexamethonium (200 microM). Dilations were abolished in preparations from chronically vagotomized animals. Activation of submucosal ganglia significantly dilated submucosal arterioles but not Brunner's glands. Effects of electrical stimulation of perivascular and submucosal nerves were not altered by guanethidine. Capsaicin and substance P also dilated arterioles but had no effect on Brunner's glands. Cholinergic (choline acetyltransferase-immunoreactive) nerve fibers were found in Brunner's glands. These findings demonstrate that Brunner's glands are innervated by cholinergic vagal fibers but not by capsaicin-sensitive or intrinsic enteric nerves.

Animals↗

PubMed1998

Organization of intrinsic cholinergic neurons projecting within submucosal plexus of guinea pig ileum.

Electrophysiological techniques were employed to examine the organization of the projections of submucosal neurons in the submucosal plexus of guinea pig ileum. These neurons were activated by focal pressure-pulse application of 5-hydroxytryptamine (5-HT) to single ganglia in submucosal preparations in vitro, and resulting fast excitatory postsynaptic potentials (EPSPs) were recorded intracellularly in S-type neurons. 5-HT-evoked fast EPSPs were blocked by TTX, hexamethonium, and ICS-205-930 (tropisetron). 5-HT was applied either directly to the ganglion containing the neuron recorded intracellularly or to adjacent ganglia positioned at increasing distances on either side of the impaled cell in circumferential or longitudinal orientations. All S-type neurons recorded in this study (n = 103) received nicotinic fast EPSPs from cholinergic neurons when 5-HT was applied directly to the ganglion containing the impaled neuron. Stimulation of adjacent ganglia also evoked nicotinic fast EPSPs, but the number of neurons that received this input decreased as the distance between the stimulus and the impaled cell increased. Maximal projections were 3 mm in the circumferential and orad-to-aborad orientations. There were no significant projections in the aborad-to-orad direction. These findings suggest that S-type neurons in the submucosal plexus are innervated by intrinsic cholinergic neurons that project over relatively short distances and have a distinct orad-to-aborad polarity.

Animals↗

PubMed1998

Cellular pathways of mast cell- and capsaicin-sensitive nerve-evoked ileal submucosal arteriolar dilations.

This study characterized mast cell- and capsaicin-sensitive sensory nerve vasodilator mechanisms regulating submucosal arterioles in the guinea pig ileum. The outside diameter of arterioles in in vitro submucosal preparations from milk-sensitized guinea pigs was monitored using videomicroscopy. Superfusion of the cow's milk protein, beta-lactoglobulin (beta-Lg; 5 microM), evoked large dilations, which became completely desensitized. beta-Lg-evoked dilations were blocked by pyrilamine or NG-monomethyl-L-arginine plus indomethacin but not by TTX. Electron microscopic studies revealed that mast cells, in preparations receiving beta-Lg, demonstrated significant reductions of the dispersed and intact granule areas compared with preparations not exposed to beta-Lg. Paired experiments were conducted to determine if capsaicin-sensitive, nerve-evoked responses involved mast cell degranulation. One preparation received capsaicin (200 nM) followed by beta-Lg (5 microM); the other preparation received the drugs in reverse order. Prior treatment with capsaicin or beta-Lg had no effect on subsequent dilations evoked by the alternate treatment. Electron microscopy showed that nerve-arteriole associations were 10 times closer than nerve-mast cell associations. Mast cell numbers were not increased by milk sensitization. These findings suggest that mast cell- and capsaicin-sensitive nerve-evoked vasodilator mechanisms act independently in a model in which mast cell numbers are not increased.

Alprostadil↗

PubMed1997

Characterization of neurokinin-1 receptors in the submucosal plexus of guinea pig ileum.

This study combined immunohistochemical double-labeling techniques with functional studies to characterize the neurokinin-1 (NK1) receptors mediating neuronal and vasodilator responses in submucosal guinea pig ileum. NK1 receptor distribution in whole mount preparations of the submucosa was examined using a rabbit polyclonal antibody directed against the COOH terminus of the rat NK1 receptor. Results showed that 97% of neuropeptide Y immunoreactive submucosal neurons colocalized NK1 receptor immunoreactivity, whereas vasoactive intestinal polypeptide immunoreactive neurons were not NK1 immunoreactive. Intracellular recordings were made using neurobiotin-filled electrodes to enable reidentification of recorded neurons for immunohistochemical study. The selective NK1 agonists [Sar9,Met(O2)11]substance P (SP) and septide depolarized S-type submucosal neurons. Of these neurons, 36% were NK1 immunoreactive and 64% were not. NK1 immunoreactivity was not observed on submucosal arterioles, but superfusion of [Sar9,Met(O2)11]SP and septide dilated preconstricted submucosal arterioles. Agonist-evoked responses in both neurons and blood vessels were blocked by the selective NK1 antagonist CP-99994. These findings suggest that NK1 receptors are found on submucosal neurons and arterioles and that electrophysiological and immunohistochemical techniques may identify conformational variants of the receptor.

Animals↗

PubMed1997

Cellular pathways mediating tachykinin-evoked secretomotor responses in guinea pig ileum.

This study characterized tachykinin-evoked secretomotor responses in in vitro submucosal and mucosal-submucosal preparations of the guinea pig ileum using combined intracellular and Ussing chamber recording techniques. Superfusion of endogenous tachykinins substance P (SP), neurokinin A (NKA), and neurokinin B depolarized single submucosal neurons and evoked increased short-circuit current (Isc) responses in Ussing chamber preparations. The NK1-receptor agonist [Sar9,Met(O2)11]SP [50% effective concentration (EC50) = 2 nM] depolarized all submucosal neurons examined. The NK3-receptor agonist senktide (EC50 = 20 nM) depolarized approximately 50% of neurons examined, whereas the NK2-receptor agonist [Ala5,beta-Ala8]NKA-(4-10) had no effect on membrane potential. [Sar9,Met(O2)11]SP and senktide evoked similar increases in Isc that were tetrodotoxin sensitive (91 and 100%, respectively) and were selectively blocked by the NK1 antagonist CP-99,994 and the NK3 antagonist SR-142,801, respectively. Capsaicin-evoked increases in Isc were significantly inhibited (54%, P < 0.05) by CP-99,994 but not by SR-142,801. Neither antagonist inhibited slow excitatory postsynaptic potentials. These findings suggest that tachykinin-evoked secretion in guinea pig ileum is mediated by NK1 and NK3 receptors on submucosal secretomotor neurons and that capsaicin-sensitive nerves release tachykinin(s) that activate the NK1 receptors.

Animals↗

PubMed1996

An evidence-based approach to prescribing NSAIDs in musculoskeletal disease: a Canadian consensus. Canadian NSAID Consensus Participants.

OBJECTIVE: To make recommendations for the long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) in primary care practice, particularly for patients at high risk for NSAID-induced complications. OPTIONS: The use of misoprostol to prevent gastrointestinal ulceration and other unwanted NSAIDs effects was considered. The role of cyclooxygenase-2 (COX-2) versus COX-1 inhibiting agents was also examined. OUTCOMES: Reduction of complications associated with long-term use of NSAIDs. EVIDENCE: Evidence was gathered in late 1995 from published research studies and reviews. Position papers were prepared by faculty and advisory board members and discussed at the Canadian NSAID Consensus Symposium in Cambridge, Ont., Jan. 26 and 27, 1996. VALUES: Recommendations were based on randomized, placebo-controlled clinical trials (level I evidence) and case-control studies (level II evidence) involving NSAID use when such evidence was available. When the scientific literature was incomplete or inconsistent in a particular area, recommendations reflect the consensus of the participants at the symposium (level III evidence). Physicians were recruited from across Canada for their expertise in rheumatology, gastroenterology, epidemiology, gerontology, family practice, and clinical and basic scientific research. BENEFITS, HARMS AND COSTS: Although a reduction in complications due to inappropriate NSAID use should reduce costs of additional investigations, admissions to hospital and time lost from work, definitive cost analysis studies are not yet available. RECOMMENDATIONS: Currently, no NSAID is available that lacks potential for serious toxicity; therefore, long-term use of NSAIDs should be avoided whenever possible, particularly in high-risk patients (e.g., those who are elderly, suffer from hypertension, congestive heart failure, renal or hepatic impairment or volume depletion, take certain concomitant medications or have a history of peptic ulcer disease) (level I evidence). If NSAIDs are to be used in patients with gastric or nephrotoxic risk factors, the lowest effective dose of NSAID should be used (level III evidence); NSAIDs that are weak COX-1 inhibitors may be preferred (level II evidence). In addition, concomitant administration of misoprostol is recommended in patients at increased risk for upper gastrointestinal complications (level I evidence). However, the clinical judgement of the practising clinician must always be part of any therapeutic decision. VALIDATION: These recommendations are based on the consensus of Canadian experts in rheumatology, gastroenterology and epidemiology, and have been subjected to external peer review.

Anti-Inflammatory Agents, Non-Steroidal↗

PubMed1996

Neural circuitry of capsaicin-sensitive afferents innervating submucosal arterioles in guinea pig ileum.

The circuitry of capsaicin-sensitive nerves innervating submucosal arterioles in the guinea pig ileum was examined. The orientation of in vitro submucosal preparations in a double-chamber bath was varied so that nerves on differing segments of arterioles could be stimulated with capsaicin. Capsaicin-evoked dilation of preconstricted arterioles was recorded using videomicroscopy. Superfusion of capsaicin onto either proximal or distal segments of a parent arteriole divided between the chambers evoked a dilation in the opposite chamber (63 and 58%, respectively) but had no effect on extrinsically denervated preparations. When the divider separated the vascular arcades joining the two parent arterioles on the opposite or same side of the intestine, capsaicin evoked little or no response (8 and 11%, respectively). Capsaicin stimulation confined to one branch of a single vessel dilated the opposite branch (42%). In preparations with adjacently attached mucosa, application of capsaicin to the mucosa dilated arterioles in the opposite chamber. These findings suggest that capsaicin stimulation of the mucosa evokes dilation of arterioles through a submucosal reflex and that both afferent and efferent elements are confined to the submucosa and mucosa.

Animals↗

PubMed1996

Neural reflexes controlling intestinal microcirculation.

It has long been established that neural reflexes are involved in the regulation of gastrointestinal vascular function, in particular the mucosal hyperemia that follows food ingestion. However, more precise identification of reflex pathways involved in the control of mucosal blood flow had not previously been forthcoming because of a lack of adequate methods to examine resistance arterioles within the intestinal wall. Recent advances have employed novel in vitro preparations and videomicroscopic techniques to investigate the neural control of the gastrointestinal microvasculature and involvement of intrinsic and extrinsic vasodilatory neurons in mucosal reflexes. Vasoconstrictor innervation to submucosal arterioles is mediated solely by extrinsic sympathetic nerves that release ATP onto arteriolar P2n-purinoceptors. Neurogenic vasodilation of submucosal arterioles occurs by release of acetylcholine and/or neuropeptides from intrinsic submucosal neurons as well as by release of substance P and calcitonin gene-related peptide from extrinsic sensory nerves. Both vasodilator pathways can be activated independently by mucosal stimulation, and both have afferent and efferent components confined to the mucosa and submucosal neuronal plexus. We speculate that the intrinsic enteric cholinergic reflex pathways are involved in local physiological control of mucosal blood flow, whereas extrinsic sensory reflex pathways are preferentially activated during inflammatory states.

Animals↗

PubMed1995

Histamine H1 and H3 vasodilator mechanisms in the guinea pig ileum.

BACKGROUND/AIMS: Histamine dilates gastrointestinal blood vessels. Whether this is caused by direct activation of vascular histamine receptors or by activation of enteric neurons is not known. The aim of this study was to determine which of these pathways is activated by histamine and to examine the cellular mechanisms involved. METHODS: The effects of histamine were studied in in vitro submucosal preparations from the guinea pig ileum using videomicroscopy to monitor changes in submucosal arteriolar diameter. RESULTS: Histamine caused a tetrodotoxin-insensitive dose-dependent dilation (median effective concentration [EC50], 1 mumol/L), showing direct activation of vascular histamine receptors. The H1 antagonist pyrilamine, but not the H2 blocker ranitidine, competitively inhibited the histamine dilatation. The nitric oxide synthase inhibitor NG-monomethyl-L-arginine (L-NMMA) inhibited histamine vasodilations by 66%. Indomethacin alone did not alter histamine vasodilations but, when combined with L-NMMA, caused a significantly greater inhibition of the histamine response compared with L-NMMA alone. L-Arginine prevented the actions of L-NMMA. In the presence of both H1 and H2 antagonists, periarteriolar stimulation of sympathetic nerves evoked a tetrodotoxin-sensitive vasoconstriction, which was inhibited by histamine (EC50, 0.8 mumol/L). This histamine action was blocked by the H3 antagonist thioperamide. CONCLUSIONS: Histamine can produce vasodilation of submucosal arterioles by two distinct mechanisms: activation of vascular H1 receptors resulting in release of nitric oxide from endothelium and activation of H3 receptors on sympathetic nerve terminals resulting in presynaptic inhibition of vasoconstrictor tone.

Animals↗

PubMed1995

Capsaicin-sensitive afferent nerves activate submucosal secretomotor neurons in guinea pig ileum.

This study examined whether capsaicin-sensitive sensory nerves regulate intestinal ion transport using both Ussing chamber and intracellular recording techniques in in vitro submucosal preparations from the guinea pig ileum. In Ussing chamber studies, serosal application of capsaicin (20 nM-20 microM) evoked a biphasic dose-dependent increase in short-circuit current (Isc) (maximal effective concentration 200 nM and 2 microM, respectively). In chloride-free buffer, capsaicin responses were significantly reduced. Capsaicin evoked little or no response when extrinsic sensory nerve fibers had been surgically removed and tetrodotoxin and low-calcium and high-magnesium solutions blocked responses to capsaicin. In epithelial preparations devoid of submucosal neurons, capsaicin had virtually no effect, suggesting that responses evoked by capsaicin-sensitive nerves result from activation of submucosal secretomotor neurons. Intracellular recordings from single submucosal neurons demonstrated that superfusion with capsaicin (2 microM) depolarized neurons with an associated decreased conductance. Depolarizations were completely desensitized when capsaicin was reapplied, but synaptic inputs were unaffected. This study suggests that capsaicin-sensitive nerves can regulate ion transport in the gastrointestinal tract by release of neurotransmitter(s) that activate submucosal secretomotor neurons.

Animals↗