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Substance P-induced intestinal secretion of water and electrolytes.

This study was initiated to determine if raised (carcinoid) plasma concentrations of substance P induced jejunal secretion of water and electrolytes. Five dogs had isolated and cannulated 25 cm jejunal segments perfused at 2 ml/min with a neutral, isotonic perfusate. Saline, 1.0 ml, was infused intravenously during basal and recovery periods, while substance P was administered intravenously at 75 ng/kg/min (55 pmol/kg/min) during the four 15 minute experimental periods. Infusion increased plasma SP concentrations from basal (5.8 +/- 1.3 pg/ml) to a mean plateau level of 121.2 +/- 25.2 pg/ml (mean +/- SEM). During SP infusion, intestinal secretion of water, Na+, and Cl- were documented (H2O basal +102 +/- 60 to SP -275 +/- 60; microliter/min; Na+ basal +19.8 +/- 7.2 to SP -23.2 +/- 7.5 microEq/min; Cl- basal 21.7 +/- 7.5 to SP -16.5 +/- 5.6 microEq/min). Under basal conditions, there was minimal secretion of potassium (-0.264 +/- 0.282 microEq/min); during SP infusion, K+ flux was altered to significant secretion (-1.784 +/- 0.271 microEq/min). Serum concentrations of Na and Cl were unchanged during SP infusion, but serum potassium concentrations fell from 4.64 +/- 0.12 to 3.85 +/- 0.40 mEq/l. The data demonstrate that substance P at levels noted in the carcinoid syndrome induces significant jejunal secretion of water and electrolytes in the dog.

Animals↗

A ready-to-use activated charcoal mixture. Adsorption studies in vitro and in dogs: its influence on the intestinal secretion of theophylline in a rat model.

A practical, ready-to-use preparation of activated charcoal (AZU mixture) for application in toxicology has been formulated. To establish its efficacy, the formulation was tested in vitro and in dogs. The in vitro adsorption capacity was compared to that of freshly prepared charcoal suspension in water (CW) and to Carbomix. Langmuir adsorption coefficients demonstrated small but clinically insignificant differences in adsorption capacity between the preparations. The laxative sodium sulfate did not reduce the adsorption capacity of charcoal in vitro. Dogs were given 60 mg of paracetamol per kg as an oral solution followed by 5 g of activated charcoal preparation. The area under the plasma concentration versus time curve (control 2955 +/- 353 mg.min-1.l-1) was significantly reduced following CW (921 +/- 453) and AZU (786 +/- 270). The premixed AZU charcoal formulation is efficacious, inexpensive and overcomes the problems of bed-side preparation. An isolated vascularly perfused rat small intestine can be used to describe the effect of activated charcoal on the intestinal secretion of theophylline.

Acetaminophen↗

Effect of cycloheximide on intestinal secretion induced by hypertonic glucose.

Since intestinal fluid production in experimental cholera can be limited by cycloheximide, an inhibitor of protein synthesis, the same agent was used to determine whether there are similar mechanisms for fluid production in response to an osmotic gradient. Intestinal fluid production was measured by perfusion of paired rabbit jejunal loops (10 cm) in vivo, in controls, and in animals receiving 20 mg/kg intravenous cycloheximide one hour before perfusion. In each animal one loop was perfused with isotonic Ringer's lactate and the other with a hypertonic glucose-Ringer's lactate solution, 563 mOsm/litre. In control animals mean fluid production in the hypertonic loop was seven times that in the isotonic loop. Cycloheximide decreased the fluid response to the hypertonic stimulus by one half (p < 0.001). In a separate measurement of bidirectional sodium fluxes, using sodium(22), it was shown that the decreased net sodium movement into the lumen observed after cycloheximide was the result of decreased flux from blood to lumen. The major histological alteration after cycloheximide was on the crypt epithelial cells with sparing of villus crests. Glucose absorption was unaffected. These data parallel the observed effect of cycloheximide on cholera exotoxin induced secretion, suggesting that a process requiring continued protein synthesis is also necessary for the intestinal fluid response to an osmotic gradient.

Animals↗

Phosphate intestinal secretion and absorption by isolated ileal loop: effects of cholecalciferol and diet phosphate.

The effect of diet phosphate content and cholecalciferol on intestinal phosphate secretion and absorption was investigated in rachitic chicks. Phosphate absorption was determined by the in situ ligated loop technique. Phosphate secretion was estimated by a method proposed by the authors. Hydroxyapatite, placed in the lumen of a ligated loop, acts as trapping agent of 32P leaving the intestinal tissue. The fraction of rapid exchangeability of tissue phosphate was taken as the precursor pool of secreted phosphate. Control chicks fed diets containing 0.3% P (group 1) or 1.0% (group 2) showed similar Pi absorption; the secretion was larger for group 2. After cholecalciferol treatment for 2 or 4 consecutive days an increment of Pi absorption with simultaneous reduction of Pi secretion was evident for both groups of animals. Chicks treated for 7 days gave values similar to those of controls. It is concluded that the regulation of intestinal phosphate absorption and secretion could be one important mean of homeostatic control. Intestinal phosphate movement is adapted to dietary phosphate and is partially independent of cholecalciferol.

Animals↗

The reversal of bilirubin-induced intestinal secretion by agar.

Agar binds bilirubin in vitro and lowers serum bilirubin concentrations by interrupting the enterohepatic circulation and increasing the fecal excretion of bilirubin. Nonconjugated bilirubin has been reported to induce secretion of sodium and water by the small intestine of perfused hamsters. We investigated the possibility that agar could prevent the secretory effect of bilirubin on hamster gut by sequestering it and reducing its enterocyte exposure. The small intestine of hamsters was luminally perfused in vivo with 0.5 mM bilirubin either alone or simultaneously with 0.15 g% agar. Control perfusions demonstrated luminal absorption of water and sodium in the absence of bilirubin. The inclusion of bilirubin resulted in secretion of sodium and water. The addition of agar to the bilirubin-infused animals resulted in net absorption of sodium and water comparable to that of controls. An additional agar-containing control perfusion demonstrated apparent secretion of sodium and water.

Agar↗

Direct demonstration of small intestinal secretion and site-dependent absorption of the beta-blocker talinolol in humans.

OBJECTIVE: To examine the relevance of site-dependent small intestinal absorption for incomplete intestinal absorption of the poorly metabolized beta 1-adrenergic receptor antagonist talinolol. METHODS: The intestinal steady-state perfusion technique (triple lumen tubing system with a 30 cm test segment) for intraluminal measurements was combined with simultaneous determination of talinolol serum concentrations. Dissolved talinolol was perfused over 160 minutes into different parts of the small intestine. The middle of the test segment was located between 25 and 235 cm beyond the teeth. Each of the six healthy subjects was studied twice with a proximal and a more distal site of perfusion to allow for comparisons within an individual subject. RESULTS: The area under the curve for serum concentrations from 0 to 480 minutes [AUC(0-480 min)] and the maximum serum concentration after distal perfusions corresponded to only 15% to 73% and 7% to 90% of the proximal values, respectively. AUC decreased with increasing distance from the teeth. The mean amount of talinolol absorbed from the test segment per unit time (intestinal transport rate) corresponds to only one-tenth of the amount of drug offered to the test segment (perfusion rate). There was a direct correlation between the perfusion rate of talinolol and its transport rate for both regions and in all subjects investigated. However, to achieve the same transport rate in the distal region a higher perfusion rate is required, compared to the proximal small intestine. At perfusion rates lower than 600 micrograms/min, net secretion of talinolol into the intestinal lumen occurred against a steep concentration gradient blood: lumen of about 1:4200. CONCLUSION: Talinolol oral bioavailability of 55% is due to a low absorption rate and a decrease of absorption capabilities along the small intestine. Net absorption of talinolol is reduced by the involvement of active intestinal secretion.

Administration, Oral↗

Effects of indomethacin, acetazolamide, ethacrynate sodium, and atropine on intestinal secretion mediated by Escherichia coli heat-stable enterotoxin in pig jejunum.

Intraluminal perfusion of pig jejunum with Escherichia coli heat-stable enterotoxin reversed net absorption of water and electrolytes to net secretion. Addition of atropine (2 x 10(-5)M) to the perfusate reduced the secretory response to enterotoxin and enhanced sodium and chloride absorption in control segments. Indomethacin (1.4 x 10(-3)M), acetazolamide (2.2 x 10(-3)M), or ethacrynate sodium (3.1 x 10(-4)M) had no effect. Mucosal disaccharidase activity and Na-K-ATPase activity were not altered by enterotoxin. The results suggest that blockade of cholinergically mediated secretion in the small intestine attenuates the enterosorptive effects of heat-stable enterotoxin and may be useful therapeutically in the management of secretory diarrhea.

Acetazolamide↗

Octreotide (SMS 201-995) as an antisecretory agent in cholera toxin & bile acid induced intestinal secretion in an in vivo animal study.

The effect of Octreotide (SMS 201-995), synthetic somatostatin analogue on small intestinal and colonic fluid secretion induced respectively by cholera toxin (CT) and deoxycholic acid (DCA) was investigated in rabbits using in vivo isolated loops. After exposure to CT and DCA, marked fluid accumulation was observed in the small intestinal and colonic loops, along with elevation of jejunal and colonic mucosal cyclic AMP concentrations. Octreotide inhibited CT and DCA induced small intestinal and colonic secretion, dose-dependently. This anti-secretory effect was observed after both intramuscular and oral administration of octreotide. In contrast, octreotide did not affect the elevated mucosal cyclic AMP concentrations. These results suggest that octreotide inhibits CT and DCA induced intestinal secretion, and this anti-secretory effect is produced by affecting processes beyond cyclic AMP formation.

Animals↗

Loperamide modifies Escherichia coli, heat-stable enterotoxin-induced intestinal secretion.

We have shown previously that loperamide, an opiate analogue, inhibits cholera-toxin- and prostaglandin E2-induced secretion in the rat small intestine. In these studies loperamide modified secretion induced by partially purified Escherichia coli, heat-stable enterotoxin in infant mice. The drug was effective whether administered before or after established secretion. These experiments provide further suggestive evidence that loperamide has a broad spectrum of antisecretory activity.

Animals↗

The effect of dihydroxy bile acids on intestinal secretion, cyclic nucleotides, and Na+-K+-ATPase.

The effects of dihydroxy bile acids on intestinal cyclic nucleotides, Na+-K+-ATPase, and net secretion, and of propranolol pretreatment on these actions were determined. Ileal and colonic loops were constructed in each of 12 rabbits, six of which were treated with propranolol preoperatively. In random order, normal saline, 6mM deoxycholic, chenodeoxycholic, or ursodeoxycholic acids were injected into the intestinal loops. Five hours after, net luminal secretion and mucosal adenylate cyclase, phosphodiesterase, cGMP, and Na+-K+-ATPase were determined. Deoxycholic and chenodeoxycholic acids each increased adenylate cyclase activity (< 0.01) and net secretion (p < 0.01), and decreased cGMP (p < 0.05). Ursodeoxycholic acid did not alter adenylate cyclase activity or secretion but increased cGMP (p < 0.05). Phosphodiesterase and Na+-K+-ATPase were unchanged. Propranolol reversed all of the bile acid effects. In conclusion, chenodeoxycholic and deoxycholic acid induce net intestinal secretion, probably via cAMP. Ursodeoxycholic acid does not affect cAMP but increases cGMP and does not promote net secretion.

Animals↗

The involvement of intramural nerves in cholera toxin induced intestinal secretion.

In previous reports we have suggested that nervous reflexes are involved in the pathophysiology of cholera secretion and that these nervous reflexes involve a cholinergic synapse and a neuron with vasoactive intestinal polypeptide (VIP) as neurotransmitter. These proposals were further analyzed in this study. Tetrodotoxin (TTX) and lidocaine applied on the serosal surface inhibited cholera secretion in segments of rat small intestine. Fluid absorption in control rats was not significantly changed. Hexamethonium given i.v. decreased cholera secretion in the cat. No additional inhibition of cholera secretion was observed after giving TTX close i.a. Furthermore, the intestinal secretion evoked by VIP was not influenced by hexamethonium given i.v. or TTX given close i.a. The present observations support the hypothesis of a role for nervous reflexes in cholera secretion. The results suggest that at least a major part of the proposed nervous reflex(es) in cholera have a cholinergic synapse. Furthermore, the VIP-ergic neuron is situated "distal" to the cholinergic neuron in the reflex(es) closer to the effector cells.

Animals↗

Intestinal secretion of mucin in chronically reserpine-treated rats.

Intestinal glycoprotein synthesis and secretion were measured in vivo and in vitro in rats treated for 7 days with reserpine. Goblet cell mucin was measured by radioimmunoassay. Reserpine-treated rats contained 1.4 times more mucin in intestinal tissue than control rats (P less than 0.05) and incorporated [1-14C]glucosamine in vivo at 1.52 times the rate of controls (P less than 0.01). Intestinal slices incubated for 90 min in vivo incorporated 1.4 times more [14C]glucosamine (P less than 0.001) and 3.0 times more [3H]threonine (P less than 0.01) into protein of reserpine-treated tissue than controls. The extra 14C was localized to mucin and to smaller components that had affinity for Concanavalin-A-Sepharose, did not bind to mucin antibody, and were therefore nonmucin glycopeptides. In vitro secretion of mucin was three times greater for reserpine-treated tissue than for control tissue (P less than 0.0001). There was an impairment in the mucin secretory response of reserpine-treated tissue to the addition of cholera toxin. Thus, chronic reserpine treatment results primarily in a generalized increase in the rate of intestinal glycoprotein synthesis, subsequent accumulation in tissues, and an increased (but not fully proportional) secretion of mucin. We speculate that in cystic fibrosis a similar sequence of glycoprotein abnormalities may be responsible for the gradual obliteration of exocrine gland ducts with viscous mucus.

Animals↗