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Pharmaceutical prokinetic and surgical interventions have opposing effects on gastroduodenal electromechanical coupling.

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Title: Pharmaceutical prokinetic and surgical interventions have opposing effects on gastroduodenal electromechanical coupling.
Authors: Simmonds, Sam (AUTHOR), Wang, Tim H.‐H. (AUTHOR), Matthee, Ashton (AUTHOR), Dowrick, Jarrah M. (AUTHOR), Taberner, Andrew J. (AUTHOR), Du, Peng (AUTHOR), Angeli‐Gordon, Timothy R. (AUTHOR)
Source: Acta Physiologica. May2025, Vol. 241 Issue 5, p1-13. 13p.
Subjects: Erythromycin, Electromechanical effects, Animal models in research, Gastrointestinal motility, Gastric outlet obstruction, Operative surgery, Gastric emptying
Abstract: Improper gastric emptying is implicated in several gastrointestinal disorders and may result from disrupted electromechanical coupling of the gastroduodenal junction (GDJ). Rhythmic "slow waves" and myogenic "spikes" are bioelectrical mechanisms that, alongside neural and hormonal co‐factors, control GDJ motility. Aim: To characterize the electromechanical effects of prokinetic (erythromycin) infusion and truncal vagotomy on pre‐clinical in vivo porcine models. Methods: Following ethical approval, the GDJ was exposed in anesthetized crossbreed weaner pigs (N = 10), and custom high‐resolution electrodes were applied to the serosal surface. An EndoFLIP catheter (Medtronic, USA) was inserted orally and positioned across the pylorus to measure luminal diameter. In all subjects, control periods preceded intravenous infusion of erythromycin. In five of those subjects, truncal vagotomy was performed approximately an hour post‐infusion, before recording was resumed. Results: Compared to control recordings, erythromycin increased contractile amplitude ([2.9 ± 1.1] mm vs. [2.2 ± 0.9] mm; p = 0.002) and was associated with more consistent gastric slow‐wave rhythms and increased amplitude of slow waves and spikes. Surgical vagotomy immediately decreased contractile amplitude ([2.90 ± 1.1] mm vs. [1.2 ± 0.6] mm; p = 0.049) and was associated with reduced slow‐wave amplitude, increased gastric and duodenal slow‐wave frequencies, and decreased spike patch coverage. Conclusions: In conclusion, prokinetics and vagotomy produced opposing effects on GDJ electromechanical coupling and could inform diagnostic and interventional practices for patients with pathophysiological complications of this region. [ABSTRACT FROM AUTHOR]
Copyright of Acta Physiologica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Label: Title
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  Data: Pharmaceutical prokinetic and surgical interventions have opposing effects on gastroduodenal electromechanical coupling.
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  Data: <searchLink fieldCode="AR" term="%22Simmonds%2C+Sam%22">Simmonds, Sam</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wang%2C+Tim+H%2E‐H%2E%22">Wang, Tim H.‐H.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Matthee%2C+Ashton%22">Matthee, Ashton</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Dowrick%2C+Jarrah+M%2E%22">Dowrick, Jarrah M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Taberner%2C+Andrew+J%2E%22">Taberner, Andrew J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Du%2C+Peng%22">Du, Peng</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Angeli‐Gordon%2C+Timothy+R%2E%22">Angeli‐Gordon, Timothy R.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Acta+Physiologica%22">Acta Physiologica</searchLink>. May2025, Vol. 241 Issue 5, p1-13. 13p.
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  Data: <searchLink fieldCode="DE" term="%22Erythromycin%22">Erythromycin</searchLink><br /><searchLink fieldCode="DE" term="%22Electromechanical+effects%22">Electromechanical effects</searchLink><br /><searchLink fieldCode="DE" term="%22Animal+models+in+research%22">Animal models in research</searchLink><br /><searchLink fieldCode="DE" term="%22Gastrointestinal+motility%22">Gastrointestinal motility</searchLink><br /><searchLink fieldCode="DE" term="%22Gastric+outlet+obstruction%22">Gastric outlet obstruction</searchLink><br /><searchLink fieldCode="DE" term="%22Operative+surgery%22">Operative surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Gastric+emptying%22">Gastric emptying</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Improper gastric emptying is implicated in several gastrointestinal disorders and may result from disrupted electromechanical coupling of the gastroduodenal junction (GDJ). Rhythmic "slow waves" and myogenic "spikes" are bioelectrical mechanisms that, alongside neural and hormonal co‐factors, control GDJ motility. Aim: To characterize the electromechanical effects of prokinetic (erythromycin) infusion and truncal vagotomy on pre‐clinical in vivo porcine models. Methods: Following ethical approval, the GDJ was exposed in anesthetized crossbreed weaner pigs (N = 10), and custom high‐resolution electrodes were applied to the serosal surface. An EndoFLIP catheter (Medtronic, USA) was inserted orally and positioned across the pylorus to measure luminal diameter. In all subjects, control periods preceded intravenous infusion of erythromycin. In five of those subjects, truncal vagotomy was performed approximately an hour post‐infusion, before recording was resumed. Results: Compared to control recordings, erythromycin increased contractile amplitude ([2.9 ± 1.1] mm vs. [2.2 ± 0.9] mm; p = 0.002) and was associated with more consistent gastric slow‐wave rhythms and increased amplitude of slow waves and spikes. Surgical vagotomy immediately decreased contractile amplitude ([2.90 ± 1.1] mm vs. [1.2 ± 0.6] mm; p = 0.049) and was associated with reduced slow‐wave amplitude, increased gastric and duodenal slow‐wave frequencies, and decreased spike patch coverage. Conclusions: In conclusion, prokinetics and vagotomy produced opposing effects on GDJ electromechanical coupling and could inform diagnostic and interventional practices for patients with pathophysiological complications of this region. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Acta Physiologica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1111/apha.70024
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      – Code: eng
        Text: English
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        PageCount: 13
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      – SubjectFull: Erythromycin
        Type: general
      – SubjectFull: Electromechanical effects
        Type: general
      – SubjectFull: Animal models in research
        Type: general
      – SubjectFull: Gastrointestinal motility
        Type: general
      – SubjectFull: Gastric outlet obstruction
        Type: general
      – SubjectFull: Operative surgery
        Type: general
      – SubjectFull: Gastric emptying
        Type: general
    Titles:
      – TitleFull: Pharmaceutical prokinetic and surgical interventions have opposing effects on gastroduodenal electromechanical coupling.
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            – D: 01
              M: 05
              Text: May2025
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              Y: 2025
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