A stomach road or "Magenstrasse" for gastric emptying
A stomach road or "Magenstrasse" for gastric emptying
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DOI：
10.1016/j.jbiomech.2006.06.006
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发表时间：
2007-01-01
影响因子：
2.4
通讯作者：
Abrahamsson, Bertil
中科院分区：
文献类型：
--
作者：
Pal, Anupam;Brasseur, James G.;Abrahamsson, Bertil
胃肌肉收缩在胃内研磨和混合固体/液体食物，并以受控的速度将其移动到肠道中。收缩有两种类型：近端胃(胃底)的缓慢缩容收缩和远端胃(胃窦)的蠕动收缩波。胃底挤压维持胃-十二指肠压差以驱动胃排空。通常认为是清空。从胃窦进入胃底，这样摄入的药物可能需要几个小时才能进入小肠并激活。相比之下，胃窦收缩波(ACW)会产生液体运动，分解并混合胃内容物。使用人体胃的计算机模型，我们发现这些收缩波除了研磨和混合之外还有一种新的功能。与胃底收缩相协调，胃窦收缩波将液体内容物从胃底沿一条非常狭窄的路径通过胃窦中心移动到十二指肠。利用生理数据，我们证明这种胃排空“Magenstrasse”(胃路)可以在10分钟内将液体胃内容物从胃底最远的地方直接输送到肠道。因此，虽然从Magenstrse释放的药物(片剂、胶囊、液体)可能需要数小时才能进入十二指肠，但在低浓度下，当药物在Magenstrse上释放时，药物可以在10分钟内进入十二指肠并在高浓度时激活。这一发现可能解释了观察到的药物起始时间的高变异性，并可能对药物输送和消化以及其他壁式驱动的弹性容器的排空具有重要意义。(C)2006爱思唯尔有限公司。保留所有权利。
Gastric muscle contractions grind and mix solid/liquid meal within the stomach, and move it into the bowels at a controlled rate. Contractions are of two types: slow volume-reducing contractions of the proximal stomach (the fundus), and peristaltic contraction waves in the distal stomach (the antrum). Fundic squeeze maintains gastro-duodenal pressure difference to drive gastric emptying. Emptying is generally assumed. to proceed from the antrum to the fundus, so that ingested drugs can take hours to enter the small intestines and activate. Antral contraction waves (ACW), in contrast, generate fluid motions that break down and mix gastric content. Using a computer model of the human stomach, we discover a new function of these contraction waves apart from grinding and mixing. In coordination with fundic contraction, antral contraction waves move liquid content from the fundus along a very narrow path to the duodenum through the center of the antrum. Using physiological data, we show that this gastric emptying "Magenstrasse" (stomach road) can funnel liquid gastric content from the farthest reaches of the fundus directly to the intestines within 10 min. Consequently, whereas drugs (tablets, capsules, liquid) released off the Magenstrasse may require hours to enter the duodenum, at low concentration, when released on the Magenstrasse the drug can enter the duodenum and activate within 10 min-at high concentration. This discovery might explain observed high variability in drug initiation time, and may have important implications to both drug delivery and digestion, as well as to other wall-driven emptying of elastic containers. (c) 2006 Elsevier Ltd. All rights reserved.