title: L-arginine/nitric oxide pathway modulates gastric motility and gallbladder emptying induced by erythromycin and liquid meal in humans.
abstract: There is recent evidence that nitric oxide, a soluble gas produced from L-arginine, is released by the smooth muscle cells and neurons of the gastrointestinal tract where it exerts a myorelaxive action. However, little is known about the effects nitric oxide has on gastric and gallbladder motility during the inter- and postprandial phases in man. We therefore investigated the effects 200 mg/kg/hr L-arginine exerts on the gastric and gallbladder motility induced by 2 mg/kg erythromycin or a liquid meal in 21 subjects in a double-blind, placebo-controlled study. Gastric and gallbladder emptying were evaluated by sonography. Fasting antral motility was expressed as antral motility index (MI). In fasting subjects, L-arginine administration determined a threefold increase in plasma nitrite concentrations. Administration of erythromycin caused a significant rise in the antral MI, which was inhibited by L-arginine (P < 0.05). Ingestion of a liquid meal also significantly increased antral MI, but it returned to basal values 90 min after the end of the meal. Although L-arginine administration caused a significant reduction in the antral MI (P < 0.05), it did not inhibit gastric emptying. L-Arginine provoked an approximately 40% increase in basal gallbladder volume, completely blocked erythromycin-induced emptying, and partially, but significantly, prevented the emptying induced by a liquid meal (P < 0.01). Our study suggests that nitric oxide may be implicated in the physiological modulation of gastric and gallbladder motility during the inter- and postprandial phases in man.
authors.affiliation: Dipartimento di Medicina Clinica, Farmacologia e Patologia, Clinica di Gastroenterologia ed Endoscopia Digestiva, University of Perugia, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Fiorucci
authors.forename: E
authors.initials: E
authors.lastname: Distrutti
authors.forename: A
authors.initials: A
authors.lastname: Quintieri
authors.forename: L
authors.initials: L
authors.lastname: Sarpi
authors.forename: Z
authors.initials: Z
authors.lastname: Spirchez
authors.forename: N
authors.initials: N
authors.lastname: Gulla
authors.forename: A
authors.initials: A
authors.lastname: Morelli
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001120:Arginine / Q000494:pharmacology*; D004311:Double-Blind Method; D004347:Drug Interactions; D004917:Erythromycin / Q000494:pharmacology*; D005215:Fasting / Q000502:physiology; D005247:Feeding Behavior / Q000187:drug effects* / Q000502:physiology; D005260:Female; D016473:Gallbladder Emptying / Q000187:drug effects* / Q000502:physiology; D005769:Gastrointestinal Motility / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008297:Male; D009569:Nitric Oxide / Q000502:physiology*; D009573:Nitrites / Q000097:blood
chemical_list: D009573:Nitrites; D009569:Nitric Oxide; D004917:Erythromycin; D001120:Arginine