Pharmaceutical prokinetic and surgical interventions have opposing effects on gastroduodenal electromechanical coupling
Improper gastric emptying is implicated in several gastrointestinal disorders and may result from disrupted electromechanical coupling of the gastroduodenal junction (GDJ). Rhythmic “slow waves” and myogenic “spikes” are bioelectrical mechanisms that, alongside neural and hormonal co‐factors, contro...
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| Published in | Acta Physiologica Vol. 241; no. 5; pp. e70024 - n/a |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
Wiley Subscription Services, Inc
01.05.2025
John Wiley and Sons Inc |
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| Abstract | Improper gastric emptying is implicated in several gastrointestinal disorders and may result from disrupted electromechanical coupling of the gastroduodenal junction (GDJ). Rhythmic “slow waves” and myogenic “spikes” are bioelectrical mechanisms that, alongside neural and hormonal co‐factors, control GDJ motility.
Aim
To characterize the electromechanical effects of prokinetic (erythromycin) infusion and truncal vagotomy on pre‐clinical in vivo porcine models.
Methods
Following ethical approval, the GDJ was exposed in anesthetized crossbreed weaner pigs (N = 10), and custom high‐resolution electrodes were applied to the serosal surface. An EndoFLIP catheter (Medtronic, USA) was inserted orally and positioned across the pylorus to measure luminal diameter. In all subjects, control periods preceded intravenous infusion of erythromycin. In five of those subjects, truncal vagotomy was performed approximately an hour post‐infusion, before recording was resumed.
Results
Compared to control recordings, erythromycin increased contractile amplitude ([2.9 ± 1.1] mm vs. [2.2 ± 0.9] mm; p = 0.002) and was associated with more consistent gastric slow‐wave rhythms and increased amplitude of slow waves and spikes. Surgical vagotomy immediately decreased contractile amplitude ([2.90 ± 1.1] mm vs. [1.2 ± 0.6] mm; p = 0.049) and was associated with reduced slow‐wave amplitude, increased gastric and duodenal slow‐wave frequencies, and decreased spike patch coverage.
Conclusions
In conclusion, prokinetics and vagotomy produced opposing effects on GDJ electromechanical coupling and could inform diagnostic and interventional practices for patients with pathophysiological complications of this region. |
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| AbstractList | Improper gastric emptying is implicated in several gastrointestinal disorders and may result from disrupted electromechanical coupling of the gastroduodenal junction (GDJ). Rhythmic "slow waves" and myogenic "spikes" are bioelectrical mechanisms that, alongside neural and hormonal co-factors, control GDJ motility.Improper gastric emptying is implicated in several gastrointestinal disorders and may result from disrupted electromechanical coupling of the gastroduodenal junction (GDJ). Rhythmic "slow waves" and myogenic "spikes" are bioelectrical mechanisms that, alongside neural and hormonal co-factors, control GDJ motility.To characterize the electromechanical effects of prokinetic (erythromycin) infusion and truncal vagotomy on pre-clinical in vivo porcine models.AIMTo characterize the electromechanical effects of prokinetic (erythromycin) infusion and truncal vagotomy on pre-clinical in vivo porcine models.Following ethical approval, the GDJ was exposed in anesthetized crossbreed weaner pigs (N = 10), and custom high-resolution electrodes were applied to the serosal surface. An EndoFLIP catheter (Medtronic, USA) was inserted orally and positioned across the pylorus to measure luminal diameter. In all subjects, control periods preceded intravenous infusion of erythromycin. In five of those subjects, truncal vagotomy was performed approximately an hour post-infusion, before recording was resumed.METHODSFollowing ethical approval, the GDJ was exposed in anesthetized crossbreed weaner pigs (N = 10), and custom high-resolution electrodes were applied to the serosal surface. An EndoFLIP catheter (Medtronic, USA) was inserted orally and positioned across the pylorus to measure luminal diameter. In all subjects, control periods preceded intravenous infusion of erythromycin. In five of those subjects, truncal vagotomy was performed approximately an hour post-infusion, before recording was resumed.Compared to control recordings, erythromycin increased contractile amplitude ([2.9 ± 1.1] mm vs. [2.2 ± 0.9] mm; p = 0.002) and was associated with more consistent gastric slow-wave rhythms and increased amplitude of slow waves and spikes. Surgical vagotomy immediately decreased contractile amplitude ([2.90 ± 1.1] mm vs. [1.2 ± 0.6] mm; p = 0.049) and was associated with reduced slow-wave amplitude, increased gastric and duodenal slow-wave frequencies, and decreased spike patch coverage.RESULTSCompared to control recordings, erythromycin increased contractile amplitude ([2.9 ± 1.1] mm vs. [2.2 ± 0.9] mm; p = 0.002) and was associated with more consistent gastric slow-wave rhythms and increased amplitude of slow waves and spikes. Surgical vagotomy immediately decreased contractile amplitude ([2.90 ± 1.1] mm vs. [1.2 ± 0.6] mm; p = 0.049) and was associated with reduced slow-wave amplitude, increased gastric and duodenal slow-wave frequencies, and decreased spike patch coverage.In conclusion, prokinetics and vagotomy produced opposing effects on GDJ electromechanical coupling and could inform diagnostic and interventional practices for patients with pathophysiological complications of this region.CONCLUSIONSIn conclusion, prokinetics and vagotomy produced opposing effects on GDJ electromechanical coupling and could inform diagnostic and interventional practices for patients with pathophysiological complications of this region. Improper gastric emptying is implicated in several gastrointestinal disorders and may result from disrupted electromechanical coupling of the gastroduodenal junction (GDJ). Rhythmic “slow waves” and myogenic “spikes” are bioelectrical mechanisms that, alongside neural and hormonal co‐factors, control GDJ motility. Improper gastric emptying is implicated in several gastrointestinal disorders and may result from disrupted electromechanical coupling of the gastroduodenal junction (GDJ). Rhythmic “slow waves” and myogenic “spikes” are bioelectrical mechanisms that, alongside neural and hormonal co‐factors, control GDJ motility. Aim To characterize the electromechanical effects of prokinetic (erythromycin) infusion and truncal vagotomy on pre‐clinical in vivo porcine models. Methods Following ethical approval, the GDJ was exposed in anesthetized crossbreed weaner pigs (N = 10), and custom high‐resolution electrodes were applied to the serosal surface. An EndoFLIP catheter (Medtronic, USA) was inserted orally and positioned across the pylorus to measure luminal diameter. In all subjects, control periods preceded intravenous infusion of erythromycin. In five of those subjects, truncal vagotomy was performed approximately an hour post‐infusion, before recording was resumed. Results Compared to control recordings, erythromycin increased contractile amplitude ([2.9 ± 1.1] mm vs. [2.2 ± 0.9] mm; p = 0.002) and was associated with more consistent gastric slow‐wave rhythms and increased amplitude of slow waves and spikes. Surgical vagotomy immediately decreased contractile amplitude ([2.90 ± 1.1] mm vs. [1.2 ± 0.6] mm; p = 0.049) and was associated with reduced slow‐wave amplitude, increased gastric and duodenal slow‐wave frequencies, and decreased spike patch coverage. Conclusions In conclusion, prokinetics and vagotomy produced opposing effects on GDJ electromechanical coupling and could inform diagnostic and interventional practices for patients with pathophysiological complications of this region. Improper gastric emptying is implicated in several gastrointestinal disorders and may result from disrupted electromechanical coupling of the gastroduodenal junction (GDJ). Rhythmic "slow waves" and myogenic "spikes" are bioelectrical mechanisms that, alongside neural and hormonal co-factors, control GDJ motility. To characterize the electromechanical effects of prokinetic (erythromycin) infusion and truncal vagotomy on pre-clinical in vivo porcine models. Following ethical approval, the GDJ was exposed in anesthetized crossbreed weaner pigs (N = 10), and custom high-resolution electrodes were applied to the serosal surface. An EndoFLIP catheter (Medtronic, USA) was inserted orally and positioned across the pylorus to measure luminal diameter. In all subjects, control periods preceded intravenous infusion of erythromycin. In five of those subjects, truncal vagotomy was performed approximately an hour post-infusion, before recording was resumed. Compared to control recordings, erythromycin increased contractile amplitude ([2.9 ± 1.1] mm vs. [2.2 ± 0.9] mm; p = 0.002) and was associated with more consistent gastric slow-wave rhythms and increased amplitude of slow waves and spikes. Surgical vagotomy immediately decreased contractile amplitude ([2.90 ± 1.1] mm vs. [1.2 ± 0.6] mm; p = 0.049) and was associated with reduced slow-wave amplitude, increased gastric and duodenal slow-wave frequencies, and decreased spike patch coverage. In conclusion, prokinetics and vagotomy produced opposing effects on GDJ electromechanical coupling and could inform diagnostic and interventional practices for patients with pathophysiological complications of this region. Improper gastric emptying is implicated in several gastrointestinal disorders and may result from disrupted electromechanical coupling of the gastroduodenal junction (GDJ). Rhythmic “slow waves” and myogenic “spikes” are bioelectrical mechanisms that, alongside neural and hormonal co‐factors, control GDJ motility. Aim To characterize the electromechanical effects of prokinetic (erythromycin) infusion and truncal vagotomy on pre‐clinical in vivo porcine models. Methods Following ethical approval, the GDJ was exposed in anesthetized crossbreed weaner pigs (N = 10), and custom high‐resolution electrodes were applied to the serosal surface. An EndoFLIP catheter (Medtronic, USA) was inserted orally and positioned across the pylorus to measure luminal diameter. In all subjects, control periods preceded intravenous infusion of erythromycin. In five of those subjects, truncal vagotomy was performed approximately an hour post‐infusion, before recording was resumed. Results Compared to control recordings, erythromycin increased contractile amplitude ([2.9 ± 1.1] mm vs. [2.2 ± 0.9] mm; p = 0.002) and was associated with more consistent gastric slow‐wave rhythms and increased amplitude of slow waves and spikes. Surgical vagotomy immediately decreased contractile amplitude ([2.90 ± 1.1] mm vs. [1.2 ± 0.6] mm; p = 0.049) and was associated with reduced slow‐wave amplitude, increased gastric and duodenal slow‐wave frequencies, and decreased spike patch coverage. Conclusions In conclusion, prokinetics and vagotomy produced opposing effects on GDJ electromechanical coupling and could inform diagnostic and interventional practices for patients with pathophysiological complications of this region. |
| Author | Wang, Tim H.‐H. Du, Peng Simmonds, Sam Matthee, Ashton Taberner, Andrew J. Angeli‐Gordon, Timothy R. Dowrick, Jarrah M. |
| AuthorAffiliation | 1 Auckland Bioengineering Institute University of Auckland Auckland New Zealand 4 Te Manawahoukura Rangahau Centre Te Wānanga o Aotearoa Te Awamutu New Zealand 3 Department of Engineering Science and Biomedical Engineering University of Auckland Auckland New Zealand 2 Department of Surgery University of Auckland Auckland New Zealand |
| AuthorAffiliation_xml | – name: 4 Te Manawahoukura Rangahau Centre Te Wānanga o Aotearoa Te Awamutu New Zealand – name: 2 Department of Surgery University of Auckland Auckland New Zealand – name: 3 Department of Engineering Science and Biomedical Engineering University of Auckland Auckland New Zealand – name: 1 Auckland Bioengineering Institute University of Auckland Auckland New Zealand |
| Author_xml | – sequence: 1 givenname: Sam orcidid: 0000-0003-0095-7235 surname: Simmonds fullname: Simmonds, Sam organization: University of Auckland – sequence: 2 givenname: Tim H.‐H. orcidid: 0000-0001-6200-2384 surname: Wang fullname: Wang, Tim H.‐H. organization: University of Auckland – sequence: 3 givenname: Ashton orcidid: 0000-0002-5277-6965 surname: Matthee fullname: Matthee, Ashton organization: University of Auckland – sequence: 4 givenname: Jarrah M. orcidid: 0000-0002-6674-6548 surname: Dowrick fullname: Dowrick, Jarrah M. organization: University of Auckland – sequence: 5 givenname: Andrew J. surname: Taberner fullname: Taberner, Andrew J. organization: University of Auckland – sequence: 6 givenname: Peng surname: Du fullname: Du, Peng organization: University of Auckland – sequence: 7 givenname: Timothy R. orcidid: 0000-0003-1610-3787 surname: Angeli‐Gordon fullname: Angeli‐Gordon, Timothy R. email: t.angeli@auckland.ac.nz organization: Te Wānanga o Aotearoa |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/40186361$$D View this record in MEDLINE/PubMed |
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| Keywords | in vivo experimentation slow waves motility prokinetics electrophysiology vagotomy |
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| Snippet | Improper gastric emptying is implicated in several gastrointestinal disorders and may result from disrupted electromechanical coupling of the gastroduodenal... |
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| SubjectTerms | Animal models Animals Contractility Duodenum - drug effects Duodenum - physiology electrophysiology Erythromycin Erythromycin - pharmacology Female Gastric emptying Gastric Emptying - drug effects Gastric Emptying - physiology Gastrointestinal Agents - pharmacology Gastrointestinal diseases Gastrointestinal Motility - drug effects Gastrointestinal Motility - physiology in vivo experimentation motility prokinetics Research Paper slow waves Stomach - drug effects Stomach - physiology Swine Vagotomy |
| Title | Pharmaceutical prokinetic and surgical interventions have opposing effects on gastroduodenal electromechanical coupling |
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