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Abstract
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 μM) 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.
Keywords
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References
REFERENCES
- Acute acalculous cholecystitis.Mayo Clin. Proc. 1989; 64: 163
- Gallbladder contraction in patients with pigment and cholesterol stones.Gastroenterology. 1989; 97: 1479
- Cholinergic effects on gallbladder emptying in humans.Gastroenterology. 1985; 89: 716
- Common bile duct ligation in rabbit: A new model of acute cholecystitis—Description of histology and bile analysis.J. Surg. Res. 1988; 45: 556-564
- Effect of experimental acalculous cholecystitis on gallbladder smooth muscle contractility.Gastroenterology. 1998; 114: A536
- Motility of the biliary tree.in: Yamada T. Textbook of Gastroenterology. Lippincott, Philadelphia1991
- The role of cholecystokinin in ganglionic transmission in the guinea pig gallbladder.J. Physiol. 1991; 439: 89-102
- Intracellular recordings from gallbladder ganglia of opossums.Am. J. Physiol. 1991; 260: G299-G306
- Inhibitory effect of atropine on cholecystokinin-induced gallbladder contraction in man.Digestion. 1984; 29: 209-213
- Structure and chemical coding of human, canine and opossum gallbladder ganglia.Cell Tissue Res. 1996; 284: 289
- Modulation of gallbladder motility by intrinsic cholinergic neurons.Am. J. Physiol. 1984; 247: G662-G666
- Electric field stimulation (EFS)-induced guinea pig gallbladder contractions: Role of calcium channels in acetylcholine release.Dig. Dis. Sci. 1997; 42: 1919-1925
- Effect of modulating voltage dependent calcium channels on cholecystokinin and acetylcholine-induced guinea pig gallbladder contractions.Regul. Pept. 1996; 63: 31-37
- Effect of pregnancy on gallbladder contractility in the guinea pig.Gastroenterology. 1984; 87: 674-678
- Length–tension relationship of smooth muscle of the hog carotid artery.Circ. Res. 1973; 33: 275-283
- Calcium and gallbladder smooth muscle contraction in the guinea pig: Effects of pregnancy.Gastroenterology. 1985; 89: 1279-1285
- Subtypes of muscarinic receptors regulating gallbladder cholinergic contractions.Am. J. Physiol. 1999; 276: G1243-G1250
- Roles of lithogenic bile and cystic duct occlusion in the pathogenesis of acute cholecystitis.Am. J. Surg. 1980; 140: 126-130
- Increased intragallbladder pressure stimulates gallbladder eicosanoid release.Prostaglandins. 1994; 48: 53-66
- The role of prostaglandin I2 and biliary lipids during evolving cholecystitis in the rabbit.Gastroenterology. 1993; 104: 248
- Mechanisms of muscle dysfunction in symptomatic stone free gallbladders.Gastroenterology. 1996; 110: A1373
- Intrinsic nerves affect gallbladder contraction in the guinea pig.Gastroenterology. 1990; 99: 826-830
- Mechanism of cholecystokinin-induced contraction of the opossum gallbladder.Gastroenterology. 1990; 98: 299-1306
- Cholinergic dependence of gallbladder response to cholecystokinin in the guinea pig in vivo.Am. J. Physiol. 1991; 261: G565-569
- Inflammation impairs neurally mediated responses to electrical field stimulation in isolated strips of human gallbladder muscle.Dig. Dis. Sci. 1994; 39: 2229-2234
- Gallbladder relaxation in patients with pigment and cholesterol stones.Gastroenterology. 1997; 113: 930-937
- Decreased ileal muscle contractility and increased NOS II expression induced by lipopolysaccharide.Am. J. Physiol. 1996; 271: G454-G460
- Synergistic regulation of NOS II expression by IL-1-beta and TNF-alpha in cultured rat colonic smooth muscle cells.Am. J. Physiol. 1998; 274: G178-G185
Article info
Footnotes
☆This study was funded by NIH K08-DK02080, R01-DK 38342, and PHS Research Grant M01-RR00349 from the General Clinical Research Center Program, NCCR, NIH.
☆☆The results of this study were presented at the 1999 Meeting of the American Gastroenterological Association and published in abstract form in Gastroenterology116: A26, 1999.
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© 2000 Academic Press. Published by Elsevier Inc. All rights reserved.
