Division of Gastroenterology, Department of Medicine, San Diego Veterans Affairs Health Care System & University of California, San Diego, California 92161, USA.
Am J Physiol Gastrointest Liver Physiol. 2011 Dec;301(6):G1014-9. doi: 10.1152/ajpgi.00273.2011. Epub 2011 Sep 1.
Several studies from our laboratory show that axial stretch of the lower esophageal sphincter (LES) in an oral direction causes neurally mediated LES relaxation. Under physiological conditions, axial stretch of the LES is caused by longitudinal muscle contraction (LMC) of the esophagus. Because longitudinal muscle is composed of skeletal muscle in mice, vagal-induced LMC and LES relaxation are both blocked by pancuronium. We conducted studies in rats (thought to have skeletal muscle esophagus) to determine if vagus nerve-mediated LES relaxation is also blocked by pancuronium. LMC-mediated axial stretch on the LES was monitored using piezoelectric crystals. LES and esophageal pressures were monitored with a 2.5-Fr solid-state pressure transducer catheter. Following bilateral cervical vagotomy, the vagus nerve was stimulated electrically. LES, along with the esophagus, was harvested after in vivo experiments and immunostained for smooth muscle (smooth muscle α-actin) and skeletal muscle (fast myosin heavy chain). Vagus nerve-stimulated LES relaxation and esophageal LMC were reduced in a dose-dependent fashion and completely abolished by pancuronium (96 μg/kg) in six rats (group 1). On the other hand, in seven rats, LES relaxation and LMC were only blocked completely by a combination of pancuronium (group 2) and hexamethonium. Immunostaining revealed that the longitudinal muscle layer was composed of predominantly skeletal muscle in the group 1 rats. On the other hand, the longitudinal muscle layer of group 2 rats contained a significant amount of smooth muscle (P < 0.05). Our study shows tight coupling between axial stretch on the LES and relaxation of the LES, which suggests a cause and effect relationship between the two. We propose that the vagus nerve fibers that cause LMC induce LES relaxation through the stretch-sensitive activation of inhibitory motor neurons.
我们实验室的几项研究表明,食管下括约肌(LES)的轴向拉伸向口腔方向会导致神经介导的 LES 松弛。在生理条件下,LES 的轴向拉伸是由食管的纵行肌收缩(LMC)引起的。由于纵行肌在小鼠中由骨骼肌组成,因此迷走神经诱导的 LMC 和 LES 松弛都被潘库溴铵阻断。我们在大鼠中进行了研究(被认为具有骨骼肌食管),以确定迷走神经介导的 LES 松弛是否也被潘库溴铵阻断。使用压电晶体监测 LES 上的 LMC 介导的轴向拉伸。使用 2.5-Fr 固态压力传感器导管监测 LES 和食管压力。在双侧颈迷走神经切断术后,用电刺激迷走神经。在体内实验后,收获 LES 及其周围的食管,并对平滑肌(平滑肌α-肌动蛋白)和骨骼肌(快肌肌球蛋白重链)进行免疫染色。在六只大鼠(第 1 组)中,迷走神经刺激的 LES 松弛和食管 LMC 以剂量依赖性方式减少,并被潘库溴铵(96 μg/kg)完全阻断。另一方面,在七只大鼠中,只有潘库溴铵(第 2 组)和六烃季铵的组合才能完全阻断 LES 松弛和 LMC。免疫染色显示,第 1 组大鼠的纵行肌层主要由骨骼肌组成。另一方面,第 2 组大鼠的纵行肌层含有大量的平滑肌(P<0.05)。我们的研究表明,LES 上的轴向拉伸与 LES 的松弛之间存在紧密的耦合,这表明两者之间存在因果关系。我们提出,导致 LMC 的迷走神经纤维通过对抑制性运动神经元的拉伸敏感激活来诱导 LES 松弛。