Sacral nerve stimulation with appropriate parameters improves constipation in rats by enhancing colon motility mediated via the autonomic-cholinergic mechanisms
Sacral nerve stimulation with appropriate parameters improves constipation in rats by enhancing colon motility mediated via the autonomic-cholinergic mechanisms
复制标题
采用适当参数的骶神经刺激可通过增强自主胆碱能机制介导的结肠运动来改善大鼠的便秘
DOI：
10.1152/ajpgi.00150.2018
复制
发表时间：
2019-11-01
影响因子：
4.5
通讯作者：
Chen, Jiande D. Z.
中科院分区：
文献类型：
--
作者：
Huang, Zhihui;Li, Shiying;Chen, Jiande D. Z.
尽管骶神经刺激（SNS）已被应用于治疗便秘。其参数取自针对大便失禁的 SNS，其效果有限，且机制很大程度上未知。我们研究了具有适当参数的 SNS 对洛哌丁胺治疗大鼠便秘的影响和机制。首先，使用直肠顺应性作为结果测量，进行实验以得出有效的 SNS 参数。然后，对洛哌丁胺诱导的便秘大鼠进行为期7天的SNS。通过对心电图得出的心率变异性 (HRV) 进行频谱分析来评估自主神经功能。评估结肠中胰多肽（PP）、去甲肾上腺素（NE）和乙酰胆碱（ACh）的血清水平。 1) 5 Hz、100 p..s 的急性 SNS 被发现可有效增强直肠顺应性并加速远端结肠转运（与假 SNS 相比，P < 0.05）。 2) 7 天 SNS 使洛哌丁胺诱导的便秘正常化，通过粪便颗粒的数量、重量和含水量进行评估，并加速远端结肠转运（假 SNS 为 29.4 +/- 3.7 分钟，而 SNS 为 16.4 +/- 5.3 分钟，但不影响胃排空或肠道转运。3）SNS 显着增加迷走神经活动（P = 0.035）并降低交感神经活动（P = 0.012），通过 HRV 光谱分析以及血清 PP 进行评估。 4) SNS增加结肠组织中的ACh；阿托品阻断了 SNS 对远端结肠运输的加速作用。我们得出的结论是，具有适当参数的 SNS 通过加速远端结肠运动（通过自主胆碱能功能介导）来改善洛哌丁胺引起的便秘。新的和值得注意的尽管骶神经刺激 (SNS) 已被用于治疗便秘，但其参数是从用于大便失禁的 SNS 中采用的，效果有限，且机制很大程度上未知。本文表明，具有适当参数的 SNS 通过加速自主胆碱能功能介导的远端结肠运动来改善洛哌丁胺引起的便秘。
Although sacral nerve stimulation (SNS) has been applied for treating constipation. its parameters were adopted from SNS for fecal incontinence, its effects are limited, and mechanisms are largely unknown. We investigated the effects and mechanism of SNS with appropriate parameters on constipation in rats treated with loperamide. First, using rectal compliance as an outcome measure, an experiment was performed to derive effective SNS parameters. Then, a 7-day SNS was performed in rats with constipation induced by loperamide. Autonomic functions were assessed by spectral analysis of heart rate variability (HRV) derived from an electrocardiogram. Serum levels of pancreatic polypeptide (PP), norepinephrine (NE), and acetylcholine (ACh) in colon were assessed. 1) Acute SNS at 5 Hz, 100 p..s was found effective in enhancing rectal compliance and accelerating distal colon transit (P < 0.05 vs. sham SNS). 2) The 7-day SNS normalized loperamide-induced constipation, assessed by the number, weight, and water content of fecal pellets, and accelerated the distal colon transit (29.4 +/- 3.7 min with sham SNS vs. 16.4 +/- 5.3 min with SNS but not gastric emptying or intestinal transit. 3) SNS significantly increased vagal activity (P = 0.035) and decreased sympathetic activity (P = 0.012), assessed by spectral analysis of HRV as well as by the serum PP. 4) SNS increased ACh in the colon tissue; atropine blocked the accelerative effect of SNS on distal colon transit. We concluded that SNS with appropriate parameters improves constipation induced by loperamide by accelerating distal colon motility, mediated via the autonomic-cholinergic function.NEW & NOTEWORTHY Although sacral nerve stimulation (SNS) has been applied for treating constipation, its parameters were adopted from SNS for fecal incontinence, effects are limited, and mechanisms are largely unknown. This paper shows that SNS with appropriate parameters improves constipation induced by loperamide by accelerating distal colon motility mediated via the autonomic-cholinergic function.