Effects of glyceryl trinitrate on the pyloric motor response to intraduodenal triglyceride infusion in humans

Abstract

The retardation of gastric emptying induced by infusion of triglyceride into the small intestine is associated with suppression of antral pressure waves and stimulation of basal pyloric tone in combination with phasic pressure waves localized to the pylorus. The role of nitric oxide (NO) mechanisms in the control of pyloric motility was evaluated in 12 healthy male subjects (21-43 years), using the NO donor glyceryl trinitrate (GTN). Antropyloric pressures were measured with a manometric assembly incorporating nine sideholes, spanning the antrum and proximal duodenum, and a pyloric sleeve sensor. On separate days, an intraduodenal triglyceride infusion (10% intralipid at 1 mL min-1) was started during antral phase I activity and continued for 60 min. On one of the days GTN (600 micrograms) was given sublingually 20 min after start of the triglyceride infusion. The tonic pyloric motor response to triglyceride [5.6 (SEM 0.8,) vs. 2.7 (1.3) mmHg, P < 0.001] and both the number 3.2 (0.2) vs. 2.2 (0.2) min-1, P < 0.05] and amplitude [40 (4) vs. 27 (5) mmHg, P < 0.05] of phasic isolated pyloric pressure waves were reduced by GTN. These observations suggest that NO mechanisms are involved in the regulation of pyloric motor activity in humans.

Insulin restores neuronal nitric oxide synthase expression and function that is lost in diabetic gastropathy

“…Exogenous NO reduces both the number and amplitude of isolated pyloric pressure waves in normal humans (18). NO donors also alter the distribution of liquid glucose within the stomach and may slow gastric emptying, perhaps by reducing tone in the proximal stomach (19).…”

Effects of the Nitric Oxide Synthase Inhibitor NG-Nitro-L-Arginine Methyl Ester (L-NAME) on Antropyloroduodenal Motility and Appetite in Response to Intraduodenal Lipid Infusion in Humans

“…The catheter was allowed to pass through the pylorus into the duodenum by peristalsis while the subject was in the recumbent position. The passage of the catheter was monitored by measurement of the transmucosal potential difference (TMPD) between the stomach and duodenum using a reference electrode (a 20 G intravenous cannula lled with saline) placed subcutaneously in the forearm (1,2,4,5,21,22). Another cannula was inserted into a vein of the controlateral arm for intravenous infusion.…”

“…In healthy humans, NO donors inhibit both phasic and tonic pyloric motility stimulated by intraduodenal triglyceride infusion (21), suppress antral pressure waves (22), relax the proximal stomach (23), and slow gastric emptying (22). The NOS inhibitor, L-NMMA, stimulates small intestinal phase 3 ORIGINAL ARTICLE activity (24), decreases proximal gastric relaxation (25), stimulates antral pressure waves (26), but in contrast to the effects of NOS inhibition in animals (11,14), accelerates gastric emptying (26).…”

“…Observations in animals suggest that nitric oxide (NO) may be an important modulator of gastroduodenal motility (9)(10)(11)(12)(13)(14)(15)(16)(17) and food intake (18)(19)(20)(21). The role of NO mechanisms is addressed optimally using speci c inhibitors of NO synthase (NOS), such as NG-L-arginine-methyl-ester (L-NAME) and NG-monomethyl-L-arginine (L-NMMA) (9-11, 13-17, 20).…”

A Novel Method for Study of Gastric Mechanical Functions in Conscious Mice

“…In our experiments the NO donor molsidomine decreased the rhythmic IGP wave frequency. This inhibitory effect of NO corresponds to findings in healthy volunteers in whom exogenous NO inhibited antral motor activity as measured by manometry [22]. In the literature, the effect of exogenous NO on gastric emptying is confusing.…”