Regulation of postprandial mesenteric blood flow in humans: evidence for a cholinergic nervous reflex.

Sieber, Cornel; Beglinger, Christoph; Jaeger, Kurt A.; Hildebrand, Pius; Stalder, G

doi:10.1136/gut.32.4.361

Cited by 76 publications

(70 citation statements)

References 32 publications

(4 reference statements)

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“…In mammalian studies, peptide dosages that stimulated vascular response were much greater than endogenous levels (Premen et al, 1985;Matheson et al, 2000). The fact that dosages administered at physiological levels failed to induce gastrointestinal vasodilation or increase in blood flow calls into question whether any of these peptides are involved in the postprandial regulation of gastrointestinal blood flow (Sieber et al, 1991;Matheson et al, 2000). Two pieces of evidence suggesting humoral modulation of gut blood flow originate from studies on the ball python, Python regius.…”

Section: Mechanisms Underlying Gastrointestinal Hyperemiamentioning

confidence: 99%

“…Although the small intestine is richly innervated by sympathetic and parasympathetic fibers, it is not clear what the role of the enteric nervous system is in moderating postprandial hyperemia (Sieber et al, 1991;Matheson et al, 2000). Originally it was suggested that cholinergic mechanisms were responsible for intestinal vasodilation (Secor and Diamond, 1997a;Secor and Diamond, 1997b).…”

Section: Mechanisms Underlying Gastrointestinal Hyperemiamentioning

confidence: 99%

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Prioritizing blood flow: cardiovascular performance in response to the competing demands of locomotion and digestion for the Burmese python,Python molurus

Secor

White

2010

Journal of Experimental Biology

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SUMMARYIndividually, the metabolic demands of digestion or movement can be fully supported by elevations in cardiovascular performance, but when occurring simultaneously, vascular perfusion may have to be prioritized to either the gut or skeletal muscles. Burmese pythons (Python molurus) experience similar increases in metabolic rate during the digestion of a meal as they do while crawling, hence each would have an equal demand for vascular supply when these two actions are combined. To determine, for the Burmese python, whether blood flow is prioritized when snakes are digesting and moving, we examined changes in cardiac performance and blood flow in response to digestion, movement, and the combination of digestion and movement. We used perivascular blood flow probes to measure blood flow through the left carotid artery, dorsal aorta, superior mesenteric artery and hepatic portal vein, and to calculate cardiac output, heart rate and stroke volume. Fasted pythons while crawling experienced a 2.7-and 3.3-fold increase, respectively, in heart rate and cardiac output, and a 66% decrease in superior mesenteric flow. During the digestion of a rodent meal equaling in mass to 24.7% of the snake's body mass, heart rate and cardiac output increased by 3.3-and 4.4-fold, respectively. Digestion also resulted in respective 11.6-and 14.1-fold increases in superior mesenteric and hepatic portal flow. When crawling while digesting, cardiac output and dorsal aorta flow increased by only 21% and 9%, respectively, a modest increase compared with that when they start to crawl on an empty stomach. Crawling did triggered a significant reduction in blood flow to the digesting gut, decreasing superior mesenteric and hepatic portal flow by 81% and 47%, respectively. When faced with the dual demands of digestion and crawling, Burmese pythons prioritize blood flow, apparently diverting visceral supply to the axial muscles.

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Section: Mechanisms Underlying Gastrointestinal Hyperemiamentioning

confidence: 99%

Section: Mechanisms Underlying Gastrointestinal Hyperemiamentioning

confidence: 99%

Prioritizing blood flow: cardiovascular performance in response to the competing demands of locomotion and digestion for the Burmese python,Python molurus

Secor

White

2010

Journal of Experimental Biology

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“…Food is a very potent hyperemic stimulus in the splanchnic vascular area, both in normal subjects, [13][14][15] as well as in patients with portal hypertension. 16,17 It has been hypothesized that postprandial hyperemia may acutely augment portal pressure, and by this mechanism may probably increase the risk of bleeding from gastroesophageal varices.…”

mentioning

confidence: 99%

Hemodynamic effects of the somatostatin analog lanreotide in humans: Placebo-controlled, cross-over dose-ranging echo-doppler study

Mottet¹,

Sieber²,

Nauer³

et al. 1998

Hepatology

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Because of their vasoactive effects, somatostatin and its analogs are increasingly used in the management of complications of chronic liver diseases such as variceal bleeding. Postprandial hyperemia augments splanchnic blood flow, subsequently increasing portal pressure. The aim of this study was to explore effects of the somatostatin analog, lanreotide, on food-stimulated hemodynamic parameters in healthy human subjects. A dose-response curve was constructed in eight healthy male subjects in a placebo-controlled cross-over study. On 4 different days, either 0 (placebo), 50, 100, or 200 g/h of lanreotide was infused intravenously in random order, starting at 45 minutes for 7 hours. On each day, a liquid test meal (Ensure plus, 1.5 kcal/mL) was perfused intraduodenally at a rate of 3 mL/min over 7 hours after a 45-minute basal period. Diastolic arterial pressure (dBP), heart rate (HR), superior mesenteric arterial (SMA) average flow velocity (SMA-V), SMA pulsatility index (SMA-PI), portal venous volume flow (PV-F), and renal artery (RA) resistance index (RA-RI) were measured on regular intervals (flows using Echo-Doppler technology). Lanreotide at all doses abolished food-stimulated splanchnic hyperemia both in the SMA and PV over 7 hours. The fall in dBP and increase in HR after food perfusion were blunted under lanreotide. Food as well as lanreotide did not modify RA-RI. In summary: 1) lanreotide inhibits food-induced splanchnic hyperemia in normal subjects; 2) in parallel, systemic hemodynamic alterations to food stimulation are abolished with lanreotide; and 3) renal vascular resistance is unchanged. Because of its persistent splanchnic vasoconstrictive effect, lanreotide should be tested in patients with portal hypertension. (HEPATOLOGY 1998;27: 920-925.) Natural somatostatin, and especially its analog, octreotide, are increasingly used in the treatment of esophageal variceal bleeding. [1][2][3][4] In patients with cirrhosis and portal hypertension, it reduces splanchnic and azygos blood flow, 5,6 whereas the action with regard to portal pressure is modest. [5][6][7] Conversely, the effect(s) of natural somatostatin and its analog, octreotide, upon renal hemodynamics and function are unclear and have been a reason for debate. [8][9][10][11] Hemodynamic effects, at least for octreotide, have recently been shown to be only short-lasting, even when the drug is infused constantly. 12 In addition, no clear dose-response with regard to splanchnic hemodynamics has been performed, making a dose justification for the use of this compound difficult.Food is a very potent hyperemic stimulus in the splanchnic vascular area, both in normal subjects, 13-15 as well as in patients with portal hypertension. 16,17 It has been hypothesized that postprandial hyperemia may acutely augment portal pressure, and by this mechanism may probably increase the risk of bleeding from gastroesophageal varices. 18,19 It has also been shown that octreotide blunts this postprandial increase both in normal subjects 20,21 and cirrhotic patients....

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“…Cholinergic nerves play a role in postprandial hyperemia 36) , and beta adrenoreceptors form part of a humoral mechanism 37) . The effects of these nervous activities on vasodilation in the gastrointestinal tract are relatively small.…”

Section: Effect Of Food Ingestion On the Gastrointestinal Tract At Rementioning

confidence: 99%

Blood flow in non-muscle tissues and organs during exercise: Nature of splanchnic and ocular circulation

Hayashi

Yamaoka-Endo

Someya

et al. 2012

JPFSM

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In response to increased vascular conductance associated with vasodilation in exercising muscles, many non-exercising organs suppress their blood flow by vasoconstriction, thus helping to maintain blood pressure. This vasoconstriction in non-exercising organs contributes to ensuring a favorable distribution of the blood flow. However, a consequent excessive decrease of blood flow in non-exercising organs should be avoided so that they can maintain appropriate functioning during and/or after exercise. There is now evidence of a decrease in splanchnic blood flow with vasoconstriction during dynamic exercise, which indirectly contributes to an increase in flow in exercising muscles. Hypoperfusion in the splanchnic area, induced by such vasoconstriction, may result in gastrointestinal symptoms. On the other hand, such vasoconstriction is suppressed when exercise is performed after food intake, which may be associated with the maintenance of digestive and absorptive functions in the gastrointestinal tract. In contrast to organs that decrease their blood flow, the choroidal flow, which forms part of the ocular blood flow, increases with exercise intensity, but without vasodilation. The relevance of this phenomenon to visual function and the nature of ocular circulation remain unclear. Competition in blood flow between exercising muscles and non-exercising organs should be examined from the viewpoint of the functions of non-exercising organs and exercising condition, such as the postprandial condition.

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Regulation of postprandial mesenteric blood flow in humans: evidence for a cholinergic nervous reflex.

Cited by 76 publications

References 32 publications

Prioritizing blood flow: cardiovascular performance in response to the competing demands of locomotion and digestion for the Burmese python,Python molurus

Prioritizing blood flow: cardiovascular performance in response to the competing demands of locomotion and digestion for the Burmese python,Python molurus

Hemodynamic effects of the somatostatin analog lanreotide in humans: Placebo-controlled, cross-over dose-ranging echo-doppler study

Blood flow in non-muscle tissues and organs during exercise: Nature of splanchnic and ocular circulation

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