Tugtepe Halil, Tugay Melih, Bozkurt Süheyla, Yildiz Firuzan, Utkan Tijen, Yegen Berrak C, Dagli Tolga E
Department of Pediatric Surgery, Medical Faculty of Marmara University, 34668 Istanbul, Turkey.
J Pediatr Surg. 2007 Apr;42(4):641-6. doi: 10.1016/j.jpedsurg.2006.12.048.
Esophagitis is associated with an impaired esophageal peristalsis. A few studies have been aimed at understanding the pathophysiology of abnormal peristaltic activity. The mechanism of impaired esophageal smooth muscle reactivity in the chronic gastroesophageal reflux (GER) model is investigated in vitro for the first time.
The chronic GER rat model was created by partial gastric outlet obstruction. The histopathological findings related to esophagitis were evaluated. Smooth muscle strips of the tunica muscularis mucosa of esophagus were studied in standard organ chambers. Carbachol- and KCl-induced contractile responses and serotonin- and papaverine- induced relaxant responses in both reflux and sham-operated control groups were determined.
Histopathologically, chronic reflux esophagitis was observed in all specimens of the reflux group. Contractile (carbachol- and KCl-induced) smooth muscle responses were significantly decreased in the reflux group. When compared to control group, relaxant response of smooth muscle to serotonin was also significantly decreased in the reflux group. However, there was no difference in papaverine-induced relaxant responses between 2 groups.
Our study describes the effects of chronic GER on rat esophageal smooth muscle contractility in vitro. We found that both receptor- (carbachol, serotonin) and nonreceptor-mediated (KCl) esophageal smooth muscle reactivity were impaired in chronic reflux esophagitis. These changes may correspond to the functional motor abnormalities of the esophagus seen in patients with chronic reflux esophagitis.
食管炎与食管蠕动受损有关。已有一些研究旨在了解异常蠕动活动的病理生理学。首次在体外研究慢性胃食管反流(GER)模型中食管平滑肌反应性受损的机制。
通过部分胃出口梗阻建立慢性GER大鼠模型。评估与食管炎相关的组织病理学发现。在标准器官腔中研究食管肌层黏膜的平滑肌条。测定反流组和假手术对照组中卡巴胆碱和氯化钾诱导的收缩反应以及血清素和罂粟碱诱导的舒张反应。
组织病理学上,反流组所有标本均观察到慢性反流性食管炎。反流组中收缩性(卡巴胆碱和氯化钾诱导)平滑肌反应显著降低。与对照组相比,反流组平滑肌对血清素的舒张反应也显著降低。然而,两组间罂粟碱诱导的舒张反应无差异。
我们的研究描述了慢性GER对大鼠食管平滑肌体外收缩性的影响。我们发现,在慢性反流性食管炎中,受体介导(卡巴胆碱、血清素)和非受体介导(氯化钾)的食管平滑肌反应性均受损。这些变化可能与慢性反流性食管炎患者食管的功能性运动异常相对应。