Chiu J H, Lui W Y, Chen Y L, Hong C Y
Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China.
Life Sci. 1998;63(6):413-28. doi: 10.1016/s0024-3205(98)00291-4.
To examine whether and how local somatothermal stimulation inhibits the function of the sphincter of Oddi (SO) in humans and in animals with different types of SO, we measured the activity of SO in anesthetized cats and rabbits by using continuously perfused open-tip manometric methods. Local somatothermal stimulation was achieved by applying an electroheating rod 0.5 cm away from the skin area near the right subcostal region. A heating pad was applied to the corresponding area in patients undergoing endoscopic retrograde cholangiopancreatography and biliary manometry. The motility of the biliary tract in cats, in terms of gall bladder pressure, tonic and phasic contraction pressure and frequency of SO before and during local heat were significantly different, respectively. The local heat-induced SO relaxation was not inhibited by pretreatment with atropine, propranolol, phentolamine or anti-cholecystokinin-octapeptide, but was almost completely blocked by infiltration of local anesthetics. Pretreatment with a nitric oxide synthesis inhibitor also blocked the relaxation, which was reversed by pretreatment with L-arginine, but not by D-arginine. The inhibition of SO motility by local heat in rabbits was also blocked by pretreatment with L-NAME, and this blockade was reversed by L-arginine. Application of local heat on patients demonstrated obvious inhibitory SO responses. We conclude that local somatothermal stimulation inhibits the SO motility in animals with different types of SO through the activation of heat-sensitive neural release of nitric oxide. This procedure may represent a simplified approach for the treatment of diseases with hypofunction of the L-arginine/NO pathway.
为了研究局部躯体热刺激是否以及如何抑制人类和具有不同类型Oddi括约肌（SO）的动物中SO的功能，我们通过使用连续灌注的开口尖端测压法测量了麻醉猫和兔的SO活性。通过在距右肋下区域附近皮肤区域0.5 cm处应用电热棒来实现局部躯体热刺激。在接受内镜逆行胰胆管造影和胆道测压的患者的相应区域应用加热垫。猫的胆道运动，就胆囊压力、SO的张力和相位收缩压力以及局部加热前和加热期间的频率而言，分别有显著差异。局部热诱导的SO松弛不受阿托品、普萘洛尔、酚妥拉明或抗胆囊收缩素八肽预处理的抑制，但几乎完全被局部麻醉剂浸润所阻断。一氧化氮合成抑制剂预处理也阻断了松弛，L-精氨酸预处理可逆转这种松弛，但D-精氨酸不能。L-NAME预处理也阻断了局部热对兔SO运动的抑制，L-精氨酸可逆转这种阻断。对患者应用局部热显示出明显的SO抑制反应。我们得出结论，局部躯体热刺激通过激活热敏感神经释放一氧化氮来抑制不同类型SO的动物中的SO运动。该程序可能代表一种治疗L-精氨酸/一氧化氮途径功能低下疾病的简化方法。
