Murphey Charles P, Shulgach Jonathan A, Amin Pooja R, Douglas Nerone K, Bielanin John P, Sampson Jacob T, Horn Charles C, Yates Bill J
Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States.
Front Physiol. 2023 Jan 19;14:1077207. doi: 10.3389/fphys.2023.1077207. eCollection 2023.
Nausea is a common disease symptom, yet there is no consensus regarding its physiological markers. In contrast, the process of vomiting is well documented as sequential muscular contractions of the diaphragm and abdominal muscles and esophageal shortening. Nausea, like other self-reported perceptions, is difficult to distinguish in preclinical models, but based on human experience emesis is usually preceded by nausea. Here we focused on measuring gastrointestinal and cardiorespiratory changes prior to emesis to provide additional insights into markers for nausea. Felines were instrumented to chronically record heart rate, respiration, and electromyographic (EMG) activity from the stomach and duodenum before and after intragastric delivery of saline or copper sulfate (CuSO, from 83 to 322 mg). CuSO is a prototypical emetic test agent that triggers vomiting primarily by action on GI vagal afferent fibers when administered intragastrically. CuSO infusion elicited a significant increase in heart rate, decrease in respiratory rate, and a disruption of gastric and intestinal EMG activity several minutes prior to emesis. The change in EMG activity was most consistent in the duodenum. Administration of the same volume of saline did not induce these effects. Increasing the dose of CuSO did not alter the physiologic changes induced by the treatment. It is postulated that the intestinal EMG activity was related to the retrograde movement of chyme from the intestine to the stomach demonstrated to occur prior to emesis by other investigators. These findings suggest that monitoring of intestinal EMG activity, perhaps in combination with heart rate, may provide the best indicator of the onset of nausea following treatments and in disease conditions, including GI disease, associated with emesis.
恶心是一种常见的疾病症状,但关于其生理标志物尚无共识。相比之下,呕吐过程有充分记录,表现为膈肌和腹部肌肉的相继收缩以及食管缩短。恶心与其他自我报告的感觉一样,在临床前模型中难以区分,但根据人类经验,呕吐通常先于恶心出现。在此,我们专注于测量呕吐前胃肠道和心肺的变化,以深入了解恶心的标志物。对猫进行仪器植入,以便在胃内注入生理盐水或硫酸铜(83至322毫克的CuSO₄)前后,长期记录心率、呼吸以及胃和十二指肠的肌电图(EMG)活动。CuSO₄是一种典型的催吐试验剂,经胃内给药时主要通过作用于胃肠道迷走传入纤维引发呕吐。注入CuSO₄会在呕吐前几分钟引起心率显著增加、呼吸频率降低以及胃和肠道EMG活动紊乱。十二指肠的EMG活动变化最为一致。注入相同体积的生理盐水未诱发这些效应。增加CuSO₄的剂量并未改变该治疗所诱导的生理变化。据推测,肠道EMG活动与其他研究者所证明的呕吐前食糜从肠道向胃的逆行运动有关。这些发现表明,监测肠道EMG活动,或许结合心率,可能为治疗后以及包括胃肠道疾病在内的与呕吐相关的疾病状态下恶心发作提供最佳指标。
Front Physiol. 2023-1-19
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