Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Am J Physiol Gastrointest Liver Physiol. 2014 Aug 15;307(4):G471-8. doi: 10.1152/ajpgi.00156.2014. Epub 2014 Jul 3.
Acid reflux-induced heartburn and noncardiac chest pain are processed peripherally by sensory nerve endings in the wall of the esophagus, but the underlying mechanism is still unclear. This study aims to determine the effects of acid on esophageal vagal nociceptive afferent subtypes. Extracellular single-unit recordings were performed in guinea pig vagal nodose or jugular C fiber neurons by using ex vivo esophageal-vagal preparations with intact nerve endings in the esophagus. We recorded action potentials (AP) of esophageal nodose or jugular C fibers evoked by acid perfusion and compared esophageal distension-evoked AP before and after acid perfusion. Acid perfusion for 30 min (pH range 7.4 to 5.8) did not evoke AP in nodose C fibers but significantly decreased their responses to esophageal distension, which could be recovered after washing out acid for 90 min. In jugular C fibers, acid perfusion not only evoked AP but also inhibited their responses to esophageal distension, which were not recovered after washing out acid for 120 min. Lower concentration of capsaicin perfusion mimicked acid-induced effects in nodose and jugular C fibers. Pretreatment with TRPV1 antagonist AMG9810, but not acid-sensing ion channel (ASIC) inhibitor amiloride, significantly inhibited acid-induced effects in nodose and jugular C fiber. These results demonstrate that esophageal vagal nociceptive afferent nerve subtypes display distinctive responses to acid. Acid activates jugular, but not nodose, C fibers and inhibits both of their responses to esophageal distension. These effects are mediated mainly through TRPV1. This inhibitory effect is a novel finding and may contribute to esophageal sensory/motor dysfunction in acid reflux diseases.
酸反流引起的烧心和非心源性胸痛是通过食管壁的感觉神经末梢在周围处理的,但潜在机制仍不清楚。本研究旨在确定酸对食管迷走神经传入感觉纤维亚型的影响。通过使用食管-迷走神经外植体,在保持食管神经末梢完整的情况下,在豚鼠迷走神经结或颈 C 纤维神经元上进行细胞外单细胞记录。我们记录了酸灌注诱发的食管迷走神经结或颈 C 纤维的动作电位 (AP),并比较了酸灌注前后食管扩张诱发的 AP。酸灌注 30 分钟(pH 值范围为 7.4 至 5.8)不会诱发迷走神经结 C 纤维的 AP,但显著降低了它们对食管扩张的反应,这种反应可以在用酸冲洗 90 分钟后恢复。在颈 C 纤维中,酸灌注不仅诱发了 AP,还抑制了它们对食管扩张的反应,在用酸冲洗 120 分钟后,这种反应没有恢复。较低浓度的辣椒素灌注可模拟迷走神经结和颈 C 纤维中的酸诱导效应。TRPV1 拮抗剂 AMG9810 的预处理,而不是酸敏感离子通道 (ASIC) 抑制剂阿米洛利,显著抑制了迷走神经结和颈 C 纤维中的酸诱导效应。这些结果表明,食管迷走神经传入感觉纤维亚型对酸有不同的反应。酸激活颈 C 纤维,但不激活迷走神经结 C 纤维,并抑制它们对食管扩张的反应。这些效应主要通过 TRPV1 介导。这种抑制作用是一个新的发现,可能导致酸反流疾病中食管感觉/运动功能障碍。