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食管壁内一氧化氮的实时动力学变化。

Real-time dynamics of nitric oxide shifts within the esophageal wall.

机构信息

Minimally Invasive Surgery Program, Legacy Health System, 1040 NW 22nd Avenue, Suite 560, Portland, OR 97210, USA.

出版信息

Surg Endosc. 2009 Oct;23(10):2273-8. doi: 10.1007/s00464-009-0361-2. Epub 2009 Mar 5.

Abstract

BACKGROUND

Currently, indirect evidence suggests that the neurotransmitter nitric oxide (NO) plays a crucial role in the genesis of aboral propagation of esophageal peristalses during swallowing. However, direct evidence in this regard currently is lacking. This study aimed to assess the feasibility of using NO-selective microprobes to detect real-time NO changes within the esophageal wall of North American opossums (Didelphis virginiana) during normal progressive esophageal peristalsis and induced esophageal dysmotility.

METHODS

Six adult opossums of both sexes (mean weight, 2.28 +/- 0.41 kg) were included in the study. All had normal esophageal motility, as documented by water-perfused esophageal manometry. A calibrated carbon fiber NO-selective microelectrode (ISNOP30, ISNOP100) was placed within the smooth muscle portion of the esophageal wall, and changes in NO levels were measured as redox current in pico-amperes (pA) with the Apollo-4000 NO meter. The dynamics of NO in response to reflexive deglutition were assessed during both normal propagative peristalsis and abnormal esophageal contractions induced by intravenous (i.v.) administration of the neural NO synthase inhibitor L-nitro L-arginine methyl ester (L-NAME) and banding of the gastroesophageal junction (GEJ) for 4-weeks.

RESULTS

During normal propagative esophageal peristalsis, a mean change of 2,158.85 +/- 715.93 pA was measured by the NO meter. Intravenous administration of L-NAME and chronic banding of the GEJ induced achalasia-like esophageal contractions. A significantly smaller change in levels of NO was detected within the esophageal wall during dysfunctional motility (331.94 +/- 188.17 pA; p < 0.001) than during normal propagative peristalsis (579 +/- 385 pA; p < 0.001).

CONCLUSION

The results of this study indicate that carbon fiber NO-selective microprobes can successfully measure changes in the concentration of NO, an important inhibitory neurotransmitter, within the esophageal wall and that these preliminary data support the involvement of this crucial neurotransmitter in programming normal propagation of peristaltic waves within the esophagus.

摘要

背景

目前,间接证据表明神经递质一氧化氮(NO)在吞咽过程中食管蠕动的逆行传播中起着至关重要的作用。然而,目前在这方面缺乏直接证据。本研究旨在评估使用 NO 选择性微探针检测北美的袋貂(Didelphis virginiana)正常进行性食管蠕动和诱导的食管动力障碍期间食管壁内实时 NO 变化的可行性。

方法

本研究纳入了 6 只成年袋貂(平均体重 2.28±0.41kg)。所有袋貂的食管运动均正常,通过水灌注食管测压法进行了记录。将校准的碳纤维一氧化氮选择性微电极(ISNOP30,ISNOP100)置于食管壁的平滑肌部分内,并通过 Apollo-4000NO 计以皮安(pA)为单位测量 NO 水平的氧化还原电流来测量 NO 水平的变化。在正常传播性蠕动期间以及通过静脉内(i.v.)给予神经型一氧化氮合酶抑制剂 L-硝基精氨酸甲酯(L-NAME)和胃食管交界处(GEJ) 4 周捆绑来诱导异常食管收缩时,评估了对反射性吞咽的 NO 动力学反应。

结果

在正常传播性食管蠕动期间,NO 计测量到的平均变化为 2,158.85±715.93pA。静脉内给予 L-NAME 和慢性 GEJ 捆绑诱导贲门失弛缓样食管收缩。在功能障碍性运动期间,食管壁内的 NO 水平变化明显较小(331.94±188.17pA;p<0.001),而在正常传播性蠕动期间(579±385pA;p<0.001)。

结论

本研究结果表明,碳纤维一氧化氮选择性微探针可以成功测量食管壁内重要抑制性神经递质一氧化氮(NO)浓度的变化,并且这些初步数据支持该关键神经递质参与食管蠕动波的正常传播。

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