Differences in the sensorimotor response to distension between the proximal and distal stomach in humans

Kj, Lee; Vos, Robin; Janssens, Jozef; Tack, Jan

doi:10.1136/gut.2003.025031

Cited by 44 publications

(49 citation statements)

References 20 publications

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“…1) Evidence is lacking that the antral wall is stretched or that there is a substantial increase in the antral slow-wave frequency after a meal. Other studies show that no differential intraluminal pressures are generated in different parts of the stomach after a meal, which does not support the differential stretches between the antrum and the corpus (95 2) The ICC-MY in the stomach have been proposed as pacemakers of the slow waves in the circular smooth muscle cells as well as the synchronizers of the regenerative potentials in the ICC-IM. It is not apparent how the signal generated by the mechanical stretch in the ICC-IM, can increase the pacemaker frequency of the ICC-MY, which would, in turn, increase the frequency of the slow waves in the circular muscle cells (11,71).…”

Section: Icc As Mechanosensorsmentioning

confidence: 92%

Are interstitial cells of Cajal plurifunction cells in the gut?

Sarna¹

2008

American Journal of Physiology-Gastrointestinal and Liver Physi

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The proposed functions of the interstitial cells of Cajal (ICC) are to 1) pace the slow waves and regulate their propagation, 2) mediate enteric neuronal signals to smooth muscle cells, and 3) act as mechanosensors. In addition, impairments of ICC have been implicated in diverse motility disorders. This review critically examines the available evidence for these roles and offers alternate explanations. This review suggests the following: 1) The ICC may not pace the slow waves or help in their propagation. Instead, they may help in maintaining the gradient of resting membrane potential (RMP) through the thickness of the circular muscle layer, which stabilizes the slow waves and enhances their propagation. The impairment of ICC destabilizes the slow waves, resulting in attenuation of their amplitude and impaired propagation.2) The one-way communication between the enteric neuronal varicosities and the smooth muscle cells occurs by volume transmission, rather than by wired transmission via the ICC. 3) There are fundamental limitations for the ICC to act as mechanosensors.4) The ICC impair in numerous motility disorders. However, a cause-and-effect relationship between ICC impairment and motility dysfunction is not established. The ICC impair readily and transform to other cell types in response to alterations in their microenvironment, which have limited effects on motility function. Concurrent investigations of the alterations in slow-wave characteristics, excitationcontraction and excitation-inhibition couplings in smooth muscle cells, neurotransmitter synthesis and release in enteric neurons, and the impairment of the ICC are required to understand the etiologies of clinical motility disorders. smooth muscle; slow waves; enteric neurons; excitation-contraction coupling; peristaltic reflex; motility disorders; volume transmission; synaptic transmission, ICC THE INTERSTITIAL CELLS WERE characterized originally by Raymond V. Cajal (20,21). These cells got his attention and that of others because they are intercalated between the autonomic nerves and the effector cells. On the basis of the understanding of the interneuronal communication in the central nervous system (CNS) at that time, Cajal proposed that the intercalating cells [later called the interstitial cells of Cajal (ICC)] mediate the transmission of signals from the autonomic neurons to the smooth muscle cells. A few years later, Keith (84) observed a collar of similar cells in the myenteric plexus of the rat ileocecal junction. He was looking for a pacemaker of the gut smooth muscle electrical activity because a few years earlier he had identified such a pacemaker in the sinoatrial node of the heart. He hypothesized that those interstitial cells were the pacemaker cells in the gut. In the late 1960s and early 1970s, several investigators described a plexus of the ICC within the myenteric and submucosal plexi of the small and large intestines. They also identified close connections between the enteric axonal varicosities and ICC processes on one side and g...

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Section: Icc As Mechanosensorsmentioning

confidence: 92%

Are interstitial cells of Cajal plurifunction cells in the gut?

Sarna¹

2008

American Journal of Physiology-Gastrointestinal and Liver Physi

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“…35,40 Recent studies indicate that not only the proximal stomach but also, and maybe more intensely, the distal stomach may be involved in symptom generation due to gastric distension. [41][42][43][44] …”

Section: Hypersensitivity To Gastric Distensionmentioning

confidence: 99%

Pathophysiology and treatment of functional dyspepsia

2004

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“…In studies using waterfilled balloon distension and positional changes, both antral and fundic hypersensitivity, as well as impaired duodeno-fundic and antro-fundic reflex activity were involved in symptom generation, and over-distension in the antrum was the most important site for symptom generation [30] . In a double antral and fundic barostat study, we showed that symptom profiles induced by gastric distention did not differ between proximal and distal gastric distension and that mechanoreceptors from both sites may contribute to symptoms [31] . Barostat and SPECT studies confirmed that meal ingestion also elicited antral relaxation [31,32] .…”

Section: Impaired Gastric Accommodation To a Mealmentioning

confidence: 83%

Pathogenesis of Dyspepsia

Mimidis¹,

Tack

2008

Dig Dis

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Functional dyspepsia (FD) is a highly prevalent and heterogeneous disorder. Although recent studies have investigated various pathophysiological mechanisms, the pathogenesis of FD remains obscure. Pathophysiological mechanisms currently proposed to be involved in FD symptom generation include delayed gastric emptying, impaired gastric accommodation to a meal, hypersensitivity to gastric distention, altered duodenal sensitivity to lipids or acid, abnormal duodenojejunal motility, and others. Pathogenetic factors implicated in the occurrence of FD include genetic susceptibility, Helicobacter pylori status, acute gastrointestinal infections and psychosocial factors. The present article provides an overview of pathogenetic factors, pathophysiologic mechanisms and their potential roles in FD.

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Differences in the sensorimotor response to distension between the proximal and distal stomach in humans

Cited by 44 publications

References 20 publications

Are interstitial cells of Cajal plurifunction cells in the gut?

Are interstitial cells of Cajal plurifunction cells in the gut?

Pathophysiology and treatment of functional dyspepsia

Pathogenesis of Dyspepsia

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