Schloithe A C, Sutherland K, Woods C M, Blackshaw L A, Davison J S, Toouli J, Saccone G T P
Department of General and Digestive Surgery, Flinders University, Flinders Medical Centre, Adelaide, SA, Australia.
Neurogastroenterol Motil. 2008 Sep;20(9):1060-9. doi: 10.1111/j.1365-2982.2008.01141.x. Epub 2008 May 12.
The management of pancreatic pain is a significant clinical problem so understanding of how sensory signals are generated in pancreatic tissue is fundamental. We aimed to characterize mechanosensitive and chemosensitive properties of pancreatic spinal and vagal afferents in vitro. Spinal and vagal afferent preparations from Sprague-Dawley rats were established incorporating the left splanchnic nerve or vagus nerves respectively. The common bile duct was cannulated for distension of the pancreatic duct with fluid. Nerve discharge evoked by blunt probing, duct distension or electrical stimulation was obtained from teased nerve bundles using standard extra-cellular recording. Discharge from 197 spinal afferent bundles was recorded, of which 57% displayed spontaneous activity. Blunt probing revealed 61 mechanosensitive receptive fields which were associated primarily with arteries/blood vessels (33/61) and the parenchyma (22/61). All mechanosensitive responses were slowly adapting, with 33% continuing to discharge after termination of the stimulus and 60% displaying a response threshold <10 g. Application of chemical mediators (bradykinin, histamine, 5-hydroxytryptamine, cholecystokinin octapeptide) evoked a response from 31/57 units, with 33% excitatory and 23% inhibitory. Spontaneous discharge was recorded from 72% of 135 vagal bundles. Mechanosensitive receptive fields were not identified in the pancreas but were evident in adjacent organs. No spinal or vagal afferent response to duct distension was obtained. In conclusion, pancreatic mechanosensitive spinal afferents are common, in contrast to pancreatic mechanosensitive vagal afferents indicating that pancreatic sensory innervation is predominantly spinal. Chemosensitive spinal afferent nerve endings are present in the pancreas and respond to a variety of inflammatory and physiological mediators.
胰腺疼痛的管理是一个重大的临床问题,因此了解胰腺组织中感觉信号是如何产生的至关重要。我们旨在体外表征胰腺脊髓和迷走神经传入纤维的机械敏感性和化学敏感性特性。分别建立了来自Sprague-Dawley大鼠的脊髓和迷走神经传入纤维标本,分别纳入左内脏神经或迷走神经。将胆总管插管,以便用液体扩张胰管。使用标准细胞外记录从分离的神经束中获取由钝性探查、导管扩张或电刺激诱发的神经放电。记录了197个脊髓传入纤维束的放电,其中57%表现出自发性活动。钝性探查发现61个机械敏感感受野,主要与动脉/血管(33/61)和实质(22/61)相关。所有机械敏感反应都是慢适应性的,33%在刺激终止后继续放电,60%的反应阈值<10 g。应用化学介质(缓激肽、组胺、5-羟色胺、胆囊收缩素八肽)诱发了31/57个单位的反应,其中33%为兴奋性,23%为抑制性。在135个迷走神经束中有72%记录到自发性放电。在胰腺中未发现机械敏感感受野,但在相邻器官中明显可见。未获得脊髓或迷走神经传入纤维对导管扩张的反应。总之,与胰腺机械敏感迷走神经传入纤维相反,胰腺机械敏感脊髓传入纤维很常见,这表明胰腺感觉神经支配主要是脊髓性的。胰腺中存在化学敏感脊髓传入神经末梢,并对多种炎症和生理介质作出反应。