Effect of acalculous cholecystitis on gallbladder neuromuscular transmission and contractility.

Autor: Parkman HP; Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA., James AN, Bogar LJ, Bartula LL, Thomas RM, Ryan JP, Myers SI
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2000 Feb; Vol. 88 (2), pp. 186-92.
DOI: 10.1006/jsre.1999.5788
Abstrakt: Background: Impaired smooth muscle contractility is important in the pathophysiology of acalculous cholecystitis. Common bile duct ligation (CBDL) is a model of acalculous cholecystitis, producing acute inflammatory changes and decrease in gallbladder smooth muscle contractility. The aim of this study was to determine whether there is coexistent dysfunction of neural efferent motor pathways of the gallbladder after CBDL.
Materials and Methods: Gallbladder muscle contractility was studied in vitro in normal, CBDL, and sham-operated guinea pigs. Electric field stimulation (EFS; 2-16 Hz) was used to activate intrinsic nerves and exogenous acetylcholine (ACh) was used to directly stimulate the muscle. H&E-stained slides of muscle strips were scored for inflammatory changes.
Results: After CBDL, there was a progressive increase in the inflammation score and decrease in gallbladder muscle contractility to ACh. There was also a progressive decline in EFS-induced contractility when expressed as absolute force or normalized to the maximal muscle contractile response to ACh. The nitric oxide synthase inhibitor l-NNA (10 microM) increased EFS-induced contractions by 50 +/- 25% (P = 0.05) in CBDL animals but had no effect in sham surgical controls.
Conclusions: CBDL with its acute gallbladder inflammation affects gallbladder contractility by two mechanisms: (1) decreased smooth muscle contractility, and (2) decreased neurally mediated contractions. The neurally mediated alterations result from dysfunction of cholinergic excitatory nerves and upregulation of nitric-oxide-mediated inhibition of smooth muscle contractility.
(Copyright 2000 Academic Press.)
Databáze: MEDLINE
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