Effects of different proton pump inhibitors on cardiac contractility in isolated human failing myocardium.

AIM: Proton pump inhibitors (PPI), e.g. pantoprazole (PP), esomeprazole (EP) and omeprazole (OP), work as anti-ulcer/gastrointestinal reflux drugs. Also, they are widely used in postoperative care of patients in cardiac surgery to prevent upper gastrointestinal bleeding. Therefore, in western industrial countries they play a major economic role, representing one of the most important drugs in open heart cardiac surgery. METHODS: Intact muscle strips (n=32) were isolated from the right ventricle wall of failing human hearts. In four different groups (PP, EP, OP, control group, each n=8), force amplitudes were recorded at a frequency of 60 beats per minute (bpm) with increasing PPI concentrations (0 to 320 µm/mL). RESULTS: In isometrically contracting muscle strips, significant negative inotropic effects were observed in the presence of all three PPI-groups (PP, EP and OP) with doses of 2.5 µg/mL and higher compared to the control group (p < 0.05 each). With high doses (320 µm/mL), force amplitudes could be almost completely depressed. The half maximal inhibitory concentration (IC50) for EP was 35.7 (confidence interval: 17.3-73.6) vs. OP 29.3 (6.8-126.6) vs. PP 25.1 (14.6-43.1) µg/mL (n.s.). No significant differences were found between the different proton pump inhibitors (PP, EP, OP) throughout the range of all concentrations. Relaxation was impaired in all PPI subgroups with prolonged time to 90% relaxation (RT90%) and maximum relaxation velocity (­df/dt) was reduced, too. These effects were partially reversible after wash-out of the drugs. CONCLUSION: We conclude that proton pump inhibitors show significant negative inotropic effects on isolated human failing myocardium. There is no apparent difference seen in the magnitude of the effects of each PPI-group. Further, in-vivo investigations are necessary to reveal the clinical evidence of PPI's negative inotropic effects, e.g. in cardio-surgical patients with heart failure.

Exocrine pancreatic function in patients with end-stage renal disease.

AIM: malnutrition is a common problem in patients with end-stage renal disease (ESRD). Several studies showed 30 years ago that more than half of patients with ESRD suffered from exocrine pancreatic insufficiency. However, the studies never investigated whether the functional impairments led to morphological changes of the pancreas or to steatorrhea and thus indicating the need for lifelong pancreatic enzyme substitution. Our goal was therefore not only to establish the frequency but also the severity of exocrine pancreatic insufficiency in hemodialysis patients. METHODS: the study included 50 hemodialysis patients with no history of acute or chronic pancreatitis or upper abdominal symptoms of uncertain origin. All patients with hyperthyroidism, status post-gastrectomy or (partial) small bowel resection, or chronic inflammatory bowel disease were excluded. In all 50 patients, fecal elastase-1 was determined using two different methods (Bioserv Diagnostics and ScheBo Biotech) and fecal fat content and fecal weight were measured. RESULTS: mild to moderate exocrine pancreatic insufficiency (elastase-1 100 - 200 microg/g stool) was found in 10% of patients. It was not correlated with age, sex, and underlying renal disease, duration of hemodialysis, or diarrhea and steatorrhea. In no patient was the enzyme content < 100 microg/g stool, i.e., it never sank to a level at which pancreatic enzyme substitution would have been recommended. Nine patients (18%) had mild diarrhea (200 - 300 g stool/ day), and 10 (20%) had mild steatorrhea (7 - 15 g fat/day in the stool). Five patients had both diarrhea and steatorrhea. CONCLUSIONS: mild to moderate but not severe exocrine pancreatic insufficiency is not infrequent in patients on hemodialysis but unlikely to be responsible for malnutrition in ESRD. Non-pancreas-related steatorrhea is also not uncommon. This finding requires further analysis because steatorrhea might influence nutrition, thus potentially opening the way to new therapeutic approaches.

Spontaneous release of endogenous 5-hydroxytryptamine and 5-hydroxyindoleacetic acid from the isolated vascularly perfused ileum of the guinea-pig.

The spontaneous release of 5-hydroxytryptamine and its metabolite 5-hydroxyindoleacetic acid from the enterochromaffin cells of the small intestine into the portal circulation was investigated in vitro using the vascularly perfused ileum of the guinea-pig. The release of 5-hydroxytryptamine decreased by 70% in a calcium-free medium and by 35% in the presence of tetrodotoxin. Inhibition of monoamine oxidase activity by pargyline (100 microM) had no effect on the spontaneous release of 5-hydroxytryptamine although it caused a 75% reduction in the outflow of 5-hydroxyindoleacetic acid. Imipramine (1 microM), an inhibitor of neuronal uptake of 5-hydroxytryptamine, reduced the 5-hydroxyindoleacetic acid outflow by 57% and increased the release of 5-hydroxytryptamine by 66%. The combination of both drugs showed no additional effect. The tissue content of 5-hydroxytryptamine and its metabolite was not changed after perfusion with the precursor L-tryptophan or monofluoromethyldopa, an inhibitor of the L-aromatic amino acid decarboxylase. The results show that the spontaneous release of 5-hydroxytryptamine and its metabolite reflects largely calcium-dependent exocytotic release of the amine. "Neuronal uptake" (into aminergic and/or enterochromaffin cells) followed by deamination appears to be the main pathway of 5-hydroxytryptamine catabolism in the guinea-pig ileum.

Enhancement of guinea-pig intestinal peristalsis by blockade of muscarinic M1-receptors.

1. The effects of pirenzepine and hyoscine on the peristaltic reflex were investigated in the guinea-pig isolated small intestine. Peristalsis was induced by raising the intraluminal pressure and the volume of fluid propelled was taken as a measure of the efficiency of peristaltic activity. 2. Low concentrations of pirenzepine (0.1-1 nM) and of hyoscine (0.01 nM) significantly enhanced peristalsis, whereas larger concentrations of both drugs caused inhibition. Pirenzepine was about 6 times less potent than hyoscine in increasing peristalsis, but was about 100 times less potent in inhibiting it. 3. Neither tolazoline (1 microM) nor naloxone (0.3 microM) affected the stimulatory action of pirenzepine on peristalsis. 4. Bicuculline increased the efficiency of peristalsis at concentrations of 1 microM and 10 microM; at 10 nM, bicuculline reduced significantly the increase of peristalsis by pirenzepine. gamma-Aminobutyric acid (GABA) did not affect peristaltic activity, but the stimulatory effect of pirenzepine was abolished in the presence of 100 microM GABA. 5. The results indicate that activation of neuronal M1-receptors causes inhibition of small intestinal peristalsis. Bicuculline-sensitive 'GABAergic' synapses are probably involved in this inhibition.

Adrenergic modulation of the release of 5-hydroxytryptamine from the vascularly perfused ileum of the guinea-pig.

1. Isolated segments of the guinea-pig ileum were vascularly perfused and the release of 5-hydroxytryptamine (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) into the portal venous effluent was determined by h.p.l.c. with electrochemical detection. Test substances were applied via the arterial perfusion medium. 2. Isoprenaline (0.1 microM) increased the outflow of 5-HT and 5-HIAA maximally by about 75% and this was antagonized by propranolol (0.1 microM). Forskolin (1-10 microM) increased the outflow of 5-HT by approximately 105% and that of 5-HIAA by approximately 55%. The phosphodiesterase inhibitor AH 21-132 (0.1-1 microM) increased the outflow of 5-HT and 5-HIAA by about 70%. Isoprenaline (1 nM) and AH 21-132 (10 nM), which alone had no effect, increased the outflow of 5-HT and 5-HIAA by 75%, when applied in combination. 3. Clonidine (1 microM) reduced the outflow of 5-HT by 45%, an effect blocked by tolazoline (1 microM), but not by prazosin (0.1 microM). 4. The effects of isoprenaline, forskolin and clonidine were also observed in the presence of tetrodotoxin (1 microM) demonstrating a direct modulation of 5-HT release from the enterochromaffin cells. 5. In conclusion, the release of 5-HT from enterochromaffin cells is facilitated by activation of beta-adrenoceptors and inhibited via alpha 2-adrenoceptors. Enhancing intracellular cyclic AMP, by direct stimulation of adenylate cyclase with forskolin or by inhibition of phosphodiesterase, also facilitates the release of 5-HT. The beta-adrenoceptor-mediated effect on 5-HT release appears to involve an increase in cyclic AMP, as the effect of isoprenaline was potentiated after inhibition of phosphodiesterase.

Effects of galanin, its analogues and fragments on rat isolated fundus strips.

1. Rat and porcine galanin (rGal and pGal) produced dose-dependent contraction of rat fundus strips in a concentration range of 6 nM-100 nM. 2. The stimulatory effect of rGal on rat fundus strips was not modified in the presence of somatostatin (250 nM), naloxone (1 microM), guanethidine (10 microM), a mixture of propranolol (3 microM) and phentolamine (3 microM), tetrodotoxin (1 microM), indomethacin (10 microM), atropine (1 microM), a mixture of methysergide (2.5 microM) and ketanserine (2.5 microM), a mixture of mepyramine (10 microM) and cimetidine (10 microM), and saralasin (10 microM) or when strips were desensitized to substance P and neurotensin. 3. These results suggest the localization of specific Gal receptors on the surface of smooth muscle cells of rat fundus. 4. The galanin analogues [D-Trp2]-rGal, [Nle4]-rGal, [D-Ala7]-rGal, [D-Trp2-NLe4-D-Ala7]-rGal and fragments [Cys23]-Gal (1-23), Gal (1-18) were fully active. In contrast, rGal (3-29) was completely inactive and showed no antagonistic properties to the contractile effect of intact galanin. 5. The order of potency of the galanin peptides, analogues and fragments to contract rat fundus strips was: pGal greater than rGal greater than [NLe4]-rGal greater than [Cys23]-Gal (1-23) greater than Gal (1-18) greater than [D-Ala7]-rGal greater than [Trp2]-rGal greater than [D-Trp2-NLe4-D-Ala7]-rGal. 6. The data originating from our structure-activity study suggest that the C-terminal portion of Gal contributes mainly to the affinity of Gal receptors whereas the N-terminal portion of Gal is responsible for the full activation of Gal receptors in this tissue. In particular the amino acids in position 1 and 2 of Gal (Gly-Trp) appear to be essential for binding and intrinsic activity.

Glucocorticoid receptor expression in inflammatory bowel disease: evidence for a mucosal down-regulation in steroid-unresponsive ulcerative colitis.

BACKGROUND: Glucocorticoids (GC) play a major role in the attenuation of inflammation. Glucocorticoid receptor (GR) expression is an important determinant of steroid sensitivity. AIMS: To investigate whether GR mRNA expression is altered in inflammatory bowel disease, and whether GR mRNA expression correlates with disease activity and may predict response to GC therapy. METHODS: Mucosal biopsies were taken from 33 patients with ulcerative colitis, 21 with Crohn's disease and 11 controls. Peripheral blood mononuclear cells were isolated from 24 ulcerative colitis and 18 Crohn's disease patients and 11 controls. GR mRNA was measured by quantitative reverse transcriptase polymerase chain reaction (RT-PCR), and correlated to endoscopic findings, clinical activity and outcome of GC therapy. In a subset of subjects GR localisation was shown by immunohistochemistry. RESULTS: In patients with inflammatory bowel disease GR expression was not different from controls. However, GR was decreased in biopsies from ulcerative colitis patients with impaired GC response. The inhibitory subtype GRbeta was expressed 100-1000 times lower than GRalpha. GR immunoreactivity was identified in immune and epithelial cells except for colonic crypts. CONCLUSION: In inflammatory bowel disease systemic and mucosal GR mRNA expression is not altered. However, in ulcerative colitis patients, low mucosal GR expression may predict the outcome of GC therapy. The low expression of GRbeta challenges its role in steroid refractoriness in inflammatory bowel disease.

Pituitary adenylate cyclase activating polypeptide (PACAP) is a potent relaxant of the rat ileum.

The effect and mode of action of pituitary adenylate cyclase activating polypeptide (PACAP) were studied in rat ileal strips. PACAP relaxed, concentration dependently, rat ileum and was 50 times more potent than the structurally related vasoactive intestinal polypeptide (VIP). The inhibitory action of PACAP was not modified by TTX, omega-conotoxin, adrenergic, or ganglionic blockade, antagonists of adrenoreceptors and muscarinic receptors, indicating a direct myogenic effect probably through specific PACAP receptors. The lack of cross-tachyphylaxis between PACAP and VIP suggests that both peptides act by activation of distinct receptors. Structure-function analysis revealed that the N-terminal region of the PACAP molecule is crucial for biological activity.

Calcitonin gene-related peptide (CGRP) modulates cholinergic neurotransmission in the small intestine of man, pig and guinea-pig via presynaptic CGRP receptors.

The effect of calcitonin gene-related peptide (CGRP) on the cholinergically mediated twitch contraction in longitudinal muscle strips of the small intestine (duodenum, jejunum, ileum) of guinea-pig, pig and man was investigated. Independently of the anatomical region, CGRP inhibited the twitch response in the different specimens of all three species by about 40% with similar IC50 values (1.5-2.4 nmol/l). Only in the guinea-pig small intestine CGRP induced a contraction of the smooth muscle which was sensitive to scopolamine and tetrodotoxin. The electrically evoked [3H]acetylcholine release from jejunal longitudinal muscle strips with myenteric plexus attached of the guinea-pig, which were incubated with [3H]choline, was concentration-dependently inhibited by CGRP. A direct relaxant effect of CGRP on smooth muscle tone of carbachol precontracted preparations was only observed in specimens of the guinea-pig. In conclusion, presynaptic inhibitory CGRP receptors on cholinergic neurones modulate the release of acetylcholine in different parts of the small intestine.

Vasoactive intestinal polypeptide induces neurogenic contraction of guinea-pig ileum. Involvement of acetylcholine and substance P.

The effect and mode of action of vasoactive intestinal polypeptide (VIP), a peptidergic neuromodulator in the gastrointestinal nervous system, were investigated in isolated muscle strips of the guinea-pig ileum. VIP induced concentration-dependent (20 nM-1 microM) contractions of longitudinal ileal strips. TTX (1 microM), a mixture of atropine (3 microM) and spantide (30 microM), a mixture of atropine (3 microM) and omega-conotoxin GVIA (100 nM), somatostatin (60 nM) and dynorphin (100 nM) abolished the effect of VIP. In most cases a small relaxation became evident. Desensitization to substance P in the presence of atropine prevented VIP-induced contraction. A partial inhibition was observed in the presence of atropine (3 microM), spantide (30 microM), omega-conotoxin GVIA (100 nM), beta-endorphin (265 nM), met-enkephalin (1100 nM) and a mixture of spantide (30 microM) and omega-conotoxin GVIA (100 nM). The action of VIP was not significantly modified by guanethidine (3 microM) or hexamethonium (150 microM). In circular ileal strips VIP (10-300 nM) caused concentration-dependent relaxations through a direct myogenic effect. These results indicate that the VIP produced contractions of the guinea-pig ileum are exclusively neurally mediated and involve a cholinergic as well as a noncholinergic-nonadrenergic (NANC) pathway. It is concluded that besides acetylcholine (Ach) VIP releases the peptidergic transmitter substance P from postganglionic nerve fibers of myenteric plexus. Opioid peptides and somatostatin modulate the activity of cholinergic and peptidegic nerves in the guinea-pig ileum. The release of substance P appears to depend completely on N-type voltage sensitive calcium channels.

Specific monoclonal antibodies neutralize the action of PACAP 1-27 or PACAP 1-38 on intestinal muscle strips in vitro.

The gut-brain neuropeptide pituitary adenylate cyclase activating polypeptide (PACAP) is a novel highly conserved member of the secretin-glucagon-VIP peptide family comprising 38 or 27 amino acid residues. In this study, we investigate the actions of PACAP 1-27 or PACAP 1-38 on jejunal and caecal muscle strips from pig or guinea pig and demonstrate the neutralizing effect of two PACAP-specific monoclonal antibodies of the IgG1 subtype, RSP27II and RSP38. These antibodies were used to set up assay systems specific for PACAP 1-27 or PACAP 1-38. Monoclonal antibody RSP27II recognizes exclusively PACAP 1-27, whereas RSP38 binds only PACAP 1-38. PACAP 1-27 and PACAP 1-38 relax taenia caeci dose-dependently in the presence of guanethidine and scopolamine. Both peptides inhibit the spontaneous contractions of porcine jejunal muscle strips equipotently. Monoclonal antibodies RSP27II and RSP38 specifically neutralize the actions of either exogenously applied or endogenously released PACAP. Thus, they represent processing-specific tools to examine the physiological role of both molecular forms of PACAP in the gastrointestinal tract.

Regulation of 5-HT release from enterochromaffin cells.

Large amounts of 5-HT are present in the mammalian intestine where the amine is concentrated in the enterochromaffin cells (ECs) of the mucosa. ECs have the enzymes to synthesize 5-HT, are endowed with a specific, imipramine-sensitive 5-HT uptake mechanism and can store 5-HT in specific secretory vesicles. ECs can secrete 5-HT in a calcium-dependent manner. In particular, calcium influx through voltage-regulated channels and receptor-mediated liberation of intracellular calcium can evoke 5-HT release. 5-HT secretion from ECs occurs predominantly at the interstitial side and is controlled by a complex pattern of receptor-mediated mechanisms. Stimulatory receptors (beta-adrenoceptors, muscarine, nicotine and 5-HT3 receptors) and inhibitory receptors (alpha 2-adrenoceptors, histamine H3, GABAA- and GABAB-, A2 and P2y alpha purine and 5-HT4 receptors as well as receptors for vasoactive intestinal polypeptide (VIP), pituitary adenylate cyclase stimulating peptide (PACAP) and somatostatin) have been shown to be involved in the control of 5-HT release from the ECs.

GABA receptors are involved in the modulation of the release of 5-hydroxytryptamine from the vascularly perfused small intestine of the guinea-pig.

Isolated small intestinal segments of the guinea-pig were perfused arterially and the release of 5-hydroxytryptamine (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) into the portal venous effluent was determined by HPLC with electrochemical detection. Test substances were applied intraarterially. Muscimol (1 microM) time dependently first increased then decreased the release of 5-HT and 5-HIAA. The stimulatory effect was prevented by tetrodotoxin (TTx) or scopolamine, indicating that it was mediated by the release of acetylcholine. Bicuculline concentration dependently decreased (1 microM) or increased (10, 50 microM) the release of 5-HT and 5-HIAA, indicating that endogenous GABA also activates stimulatory and inhibitory GABAA receptors. Bicuculline antagonized the stimulatory and inhibitory effect of muscimol. (-)-Baclofen, but not its (+) enantiomer, inhibited the release of 5-HT in the absence and presence of TTx. It was concluded that the release of 5-HT from enterochromaffin cells is directly inhibited by GABAA and GABAB receptors. In addition, acetylcholine released after activation of GABAA receptors stimulates 5-HT release.

Characterization of the role of calcium and sodium channels in the stimulus secretion coupling of 5-hydroxytryptamine release from porcine enterochromaffin cells.

Strips of the porcine small intestine were incubated in vitro and the outflow of 5-hydroxytryptamine (5-HT) was determined by HPLC with electrochemical detection. Spontaneous outflow of 5-HT from the porcine small intestine was reduced by about 70% after removal of the extracellular calcium or by addition of 1 mM gadolinium. Tetrodotoxin reduced the outflow of 5-HT by 30%, an effect which has previously been shown to be caused by inhibition of an excitatory cholinergic input. The sodium channel opener veratridine (up to 100 microM) did not affect the outflow of 5-HT. omega-Conotoxin GVIA (500 nM) or nifedipine (10 microM) reduced the outflow of 5-HT only by about 50%, and their effects were not additive. The inhibitory effects of omega-conotoxin GVIA occurred also in the presence of tetrodotoxin. Elevation of extracellular potassium to 40 mM caused a marked and sustained increase in 5-HT outflow. High potassium evoked release of 5-HT was blocked by omega-conotoxin GVIA, nifedipine and gadolinium. When omega-conotoxin GVIA and nifedipine were present in combination, their inhibitory effects on the high potassium evoked 5-HT release vanished. BAY K 8644 (1-10 microM) did not facilitate 5-HT release, but markedly reduced the spontaneous and high potassium evoked release of 5-HT. In conclusion, the enterochromaffin cells are endowed with multiple calcium channels, but voltage-sensitive calcium channels of a neuronal L-type which are sensitive to dihydropyridines and omega-conotoxin GVIA appear to play a major role.

Autoreceptors can modulate 5-hydroxytryptamine release from porcine and human small intestine in vitro.

The effects of 5-hydroxytryptamine (5-HT) receptor agonists and antagonists were studied on the release of 5-HT from enterochromaffin cells of incubated strips of porcine and human small intestine. Tetrodotoxin (1 micromol/l) was present in the incubation medium to block neuronally mediated inputs to the enterochromaffin cells. The 5-HT1A receptor agonist (+)-8-hydroxy-dipropylaminotetralin (8-OH-DPAT, 1 micromol/l) and the 5-HT2 receptor agonist alpha-methyl-5-HT (1 micromol/l) increased 5-HT release by 40% in about 60% of the human preparations. These agonists showed no effect on 5-HT release in porcine intestinal mucosa. The 5-HT3 receptor agonist 2-methyl-5-HT (3-100 micromol/l) increased 5-HT release in both species by 60% (pig) and 90% (man), respectively. These stimulatory effects were antagonized by tropisetron (10 nmol/l). The 5-HT4 receptor agonist 5-methoxytryptamine (0.3-30 micromol/l) reduced 5-HT release by about 50% in both species. These inhibitory effects were antagonized by tropisetron (3 micromol/l). The basal outflow of 5-HT from the intestinal mucosa was not significantly affected by tropisetron (10 nmol/l; 3 micromol/l). The specific 5-HT4 receptor antagonist GR 113808 ((1-[2-methylsulphonyl)amino]ethyl]-4-piperidinyl]methyl-1-methyl-1H-ind ole-3-carboxylate) (0.1 micromol/l) which by itself did not significantly affect 5-HT release from human duodenal specimens blocked the inhibitory effect of 5-methoxytryptamine (30 micromol/l). These findings indicate that stimulatory 5-HT3 and inhibitory 5-HT4 receptors are present on enterochromaffin cells of the porcine and human intestinal mucosa. Under the present experimental conditions endogenous 5-HT does not significantly activate these receptors. Stimulatory 5-HT1A and 5-HT2 receptors may additionally be present on human enterochromaffin cells.

Effects of cromakalim on acetylcholine release and smooth muscle contraction in guinea-pig small intestine.

The effects of the potassium channel opener cromakalim on smooth muscle contraction and 3H-acetyl-choline release were studied simultaneously in guinea-pig longitudinal muscle myenteric plexus preparations which had been preincubated with 3H-choline. Cromakalim (10 mumol/l) inhibited more markedly the smooth muscle contractions caused by the release of endogenous acetylcholine (via electrical stimulation or via activation of nicotine- and 5-HT3-receptors) than contractions induced by pilocarpine. Cromakalim (10 mumol/l) did not affect the release of 3H-acetylcholine evoked by electrical stimulation or by stimulation of nicotine- and 5-HT3-receptors. In contrast, the release of 3H-acetylcholine caused by stimulation of M1-receptors was concentration-dependently reduced by cromakalim (1-100 mumol/l). The results suggest that the relaxant effect of cromakalim on smooth muscle contraction is not caused by a reduction of acetylcholine release from myenteric neurones. An opening of cromakalim-sensitive potassium channels may be involved in the inhibition of the M1-receptor mediated acetylcholine release.

Cisplatin increases the release of 5-hydroxytryptamine (5-HT) from the isolated vascularly perfused small intestine of the guinea-pig: involvement of 5-HT3 receptors.

Isolated segments of the guinea-pig small intestine were vascularly perfused and the release of 5-hydroxytryptamine (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) into the portal venous effluent determined by high pressure liquid chromatography with electrochemical detection. Release of acetylcholine from isolated superfused intestinal segments was determined as outflow of [3H]radioactivity from preparations preincubated with [3H]choline. Cisplatin (3 microM) increased the outflow of 5-HT and 5-HIAA by about 90%. At 30 and 100 microM cisplatin decreased the outflow of 5-HT and its metabolite by 40%-50%. The stimulatory effect of cisplatin was consistently observed only when the bicarbonate-phosphate buffer of the Tyrode's solution was replaced by HEPES-buffer. The stimulatory effect of cisplatin was abolished in the absence of extracellular calcium or presence of tetrodotoxin (1 microM). The stimulatory effect of cisplatin was also prevented by hexamethonium (100 microM) or scopolamine (100 nM). The 5-HT3 receptor antagonists ondansetron and ICS 205-930 in concentrations as low as 1 pM also abolished the stimulatory effect of cisplatin. The 5-HT3 receptor antagonist MDL 72222 prevented the stimulatory effect of cisplatin only at a concentration of 1 microM. None of the 5-HT3 receptor antagonists alone significantly altered the outflow of 5-HT and 5-HIAA. Cisplatin (3 microM) enhanced the outflow of [3H]radioactivity from intestinal segments and caused longitudinal muscle contractions that were abolished by 100 nM scopolamine. In conclusion, cisplatin, at concentrations which occur during anti-cancer therapy in humans and induce emesis, increases the release of 5-HT from the enterochromaffin cells of the small intestine of the guinea-pig.(ABSTRACT TRUNCATED AT 250 WORDS)

Cholinergic modulation of the release of 5-hydroxytryptamine from the guinea pig ileum.

Isolated segments of the guinea pig ileum were vascularly perfused and the release of 5-HT and its metabolite 5-HIAA into the portal venous effluent determined by HPLC with electrochemical detection. Test substances were applied via the arterial perfusion medium. Oxotremorine inhibited concentration-dependently the release of 5-HT and 5-HIAA (by 47% at 1 mumol/l). Scopolamine (0.1 mumol/l) did not affect the release of 5-HT and 5-HIAA, but antagonized the effect of oxotremorine. In the presence of TTX (1 mumol/l), oxotremorine (1 mumol/l) increased the release of 5-HT by 150% and that of 5-HIAA by 220%. This increase was completely blocked by scopolamine. Hexamethonium (100 mumol/l) and TTX (1 mumol/l) reduced the release of 5-HT by 32 and 40%, respectively. DMPP (10 mumol/l) increased the release of 5-HT by 57%, and this effect was prevented by hexamethonium. Neither DMPP nor hexamethonium significantly affected the release of 5-HIAA. The enhancing effect of DMPP on 5-HT release was increased and prolonged in the presence of TTX or scopolamine. Nicotine (1, 10 or 30 mumol/l) alone did not cause a consistent increase in the release of 5-HT. However, in the presence of scopolamine nicotine increased the release of 5-HT by 57%. In conclusion, the release of intestinal 5-HT is facilitated via muscarine and nicotine receptors located on the enterochromaffin cells. Indirect evidence suggests that the release of 5-HT is additionally modulated by an as yet unknown inhibitory neurotransmitter released by muscarine receptor activation.

Temperature-dependent effects of increased intraluminal pressure on serotonin release from the vascularly perfused guinea pig ileum.

Isolated segments of the guinea pig ileum were vascularly perfused and the release of endogenous serotonin into the portal effluent was measured. Peristalsis was induced by raising the intraluminal hydrostatic pressure by 500 Pa for 5 min. Serotonin release increased during peristalsis induced by fluid of 37 degrees C, but decreased when the temperature of the intraluminal fluid was between 13 degrees C and 22 degrees C. In the presence of naloxone (0.3 mumol/l) raising the intraluminal pressure with fluid of 37 degrees C caused an inhibition of the serotonin release which was blocked by scopolamine (0.1 mumol/l). Naloxone did not affect the inhibition of serotonin release during peristalsis caused by fluid of 19 degrees C, neither did indomethacin (1 mumol/l). In conclusion, liquid distension of the guinea pig isolated ileum elicits peristaltic activity, and affects the release of serotonin into the portal circulation. The changes in serotonin release depend on the temperature of the fluid passing through the intestinal lumen, whereas peristalsis is not affected by the temperature of the intraluminal fluid.

Characterization of the muscarine receptors involved in the modulation of serotonin release from the vascularly perfused small intestine of guinea pig.

Isolated small intestinal segments of the guinea pig were arterially perfused and the release of 5-hydroxytryptamine (5-HT) and its metabolite 5-hydroxyindoleacetic acid (5-HIAA) into the portal venous effluent measured by HPLC with electrochemical detection. Test substances were applied via the arterial perfusion medium. McN-A-343, pilocarpine and oxotremorine inhibited concentration-dependently the outflow of 5-HT and 5-HIAA. Pirenzepine (0.03-0.1 mumol/l) which can discriminate between M1 and M2-receptor subtypes antagonized completely this inhibitory effect. In the presence of 1 mumol/l tetrodotoxin (TTx), all three muscarine receptor agonists increased the outflow of 5-HT and 5-HIAA. Oxotremorine (1 mumol/l) was most effective and increased the outflow of 5-HT by 145%, that of 5-HIAA by 235%. McN-A-343 and pilocarpine, both at a concentration of 10 mumol/l, increased the outflow of 5-HT by about 40%, that of 5-HIAA by 50% and 71%, respectively. The stimulatory effect of oxotremorine was competitively antagonized by pirenzepine; a pA2 value of 7.70 was calculated. In conclusion, the cholinergic modulation of the release of 5-HT from the enterochromaffin cells consists of an indirect inhibitory (via the release of a neurotransmitter) and a direct stimulatory component. Muscarine receptors mediating the indirect effect may belong to the M1-subtype whereas the direct stimulatory effect may be mediated by a mixed population of M1 and M2 receptors or by a subtype of M1 receptors.