On the origin of rhythmic contractile activity of the esophagus in early achalasia, a clinical case study.
On the origin of rhythmic contractile activity of the esophagus in early achalasia, a clinical case study.
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关于早期贲门失弛缓症食管节律性收缩活动的起源，临床案例研究。
DOI：
10.3389/fnins.2013.00077
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发表时间：
2013
影响因子：
4.3
通讯作者：
Huizinga JD
中科院分区：
文献类型：
--
作者：
Chen JH;Wang XY;Liu LW;Yu W;Yu Y;Zhao L;Huizinga JD
1例早期贲门失弛缓症患者出现自发性强节律性非推进性收缩，约为7次/min，与吞咽无关。我们的目的是评估的节律性收缩的特点，提供数据的起搏细胞在食管的结构和讨论的Cajal间质细胞（ICC）的起源的节律性的潜在作用。我们假设肌内ICC（ICC-IM）是主要的起搏细胞。磷酸二酯酶抑制剂屈他维林抑制节律性收缩的频率，但不抑制振幅，这与ICC-IM中cAMP抑制起搏电流一致。湿吞咽而非干吞咽增加了频率，这与导致ICC-IM中慢波频率增加的拉伸一致。对档案材料的新研究表明，ICC-IM存在于整个人类食管肌肉组织中，并且在早期失弛缓症中没有减少。尽管ICC-IM显示出低密度，但它们与PDGFRα阳性成纤维细胞样细胞连接，并与其形成致密的间隙连接偶联网络。在贲门失弛缓症早期，ICC的氮能神经支配强烈减弱，因为氮能神经的丢失。因此，ICC-IM可能在食管中起起搏细胞的作用，ICC和PDGFRα阳性细胞的网络允许起搏活动的耦合和传播。贲门失弛缓症患者ICC的氮能神经支配丧失可能使其更易兴奋，从而更容易表达其起搏活动。失弛缓症的传播损失可能是由于收缩诱导的反口氮能抑制的损失。
A patient with early achalasia presented spontaneous strong rhythmic non-propulsive contractions at ~7/min, independent of swallows. Our aim was to evaluate characteristics of the rhythmic contractions, provide data on the structure of pacemaker cells in the esophagus and discuss a potential role for interstitial cells of Cajal (ICC) in the origin of rhythmicity. We hypothesize that intramuscular ICC (ICC-IM) are the primary pacemaker cells. The frequency but not the amplitude of the rhythmic contractions was inhibited by the phosphodiesterase inhibitor drotaverine consistent with cAMP inhibiting pacemaker currents in ICC-IM. The frequency increased by wet swallows but not dry swallows, consistent with stretch causing increase in slow wave frequency in ICC-IM. New studies on archival material showed that ICC-IM were present throughout the human esophageal musculature and were not diminished in early achalasia. Although ICC-IM exhibited a low density, they were connected to PDGFRα-positive fibroblast-like cells with whom they formed a dense gap junction coupled network. Nitrergic innervation of ICC was strongly diminished in early achalasia because of the loss of nitrergic nerves. It therefore appears possibly that ICC-IM function as pacemaker cells in the esophagus and that the network of ICC and PDGFRα-positive cells allows for coupling and propagation of the pacemaker activity. Loss of nitrergic innervation to ICC in achalasia may render them more excitable such that its pacemaker activity is more easily expressed. Loss of propagation in achalasia may be due to loss of contraction-induced aboral nitrergic inhibition.
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影响因子：
3.5
作者：
Bredenoord AJ;Fox M;Kahrilas PJ;Pandolfino JE;Schwizer W;Smout AJ;International High Resolution Manometry Working Group
通讯作者：
International High Resolution Manometry Working Group
DOI：
10.1016/s0165-1838(00)00089-8
发表时间：
2000-05-12
期刊：
JOURNAL OF THE AUTONOMIC NERVOUS SYSTEM
影响因子：
--
作者：
Horiguchi, K;Komuro, T
通讯作者：
Komuro, T
影响因子：
3.2
作者：
Khajanchee, YS;VanAndel, R;Swanstrom, LL
通讯作者：
Swanstrom, LL
影响因子：
3.6
作者：
KOMURO, T;SEKI, K
通讯作者：
SEKI, K
影响因子：
5.5
作者：
Kim, TW;Beckett, EAH;Sanders, KM
通讯作者：
Sanders, KM