title: Interrelationship between esophageal challenge with mechanical and chemical stimuli and salivary protective mechanisms.
abstract: Using our newly developed model of esophageal perfusion in humans, we were able to study the esophagosalivary reflex in 20 healthy volunteers (12M, 8F; mean age 40 yr). The placement of the intraesophageal catheter resulted in a 6.3-fold increase in the salivation rate over the baseline value (2.27 +/- 0.28 vs. 0.36 +/- 0.06 ml/min; p = 0.02), whereas inflation of the catheter balloons evoked a 6.9-fold increase (2.52 +/- 0.21; p < 0.001) in the rate of salivation. A stepwise and significant decline of salivation (p = 0.02), observed during subsequent perfusion with NaCl was prevented when perfusion with HCl and HCl/pepsin solutions was implemented. The placement of the intraesophageal catheter resulted in a significant increase of salivary pH over its basal value (7.77 +/- 0.05 vs. 6.89 +/- 0.11; p < 0.001). A gradual decline of salivary pH during subsequent perfusion with NaCl was eliminated when saline was replaced with HCl or HCl/pepsin (7.76 +/- 0.04 vs. 7.46 +/- 0.09; p < 0.01). Intraesophageal tubing enormously potentiated the viscosity of saliva (44.50 +/- 9.0 vs. 9.3 +/- 1.0 mPa.s; p < 0.001). A subsequent decline of viscosity during continuous perfusion with saline was also prevented when HCl was substituted for NaCl (29.95 +/- 4.5 vs. 19.50 +/- 3.30; p < 0.05). A significant potentiation of salivary volume, viscosity, and pH during esophageal stimulation of mechano- and chemoreceptors may suggest a contributing role of the esophagosalivary reflex in the maintenance of the esophageal mucosal integrity under the impact gastroesophageal reflux.
authors.affiliation: University of Virginia Health Sciences Center, Charlottesville.
authors.forename: Z
authors.initials: Z
authors.lastname: Namiot
authors.forename: R M
authors.initials: RM
authors.lastname: Rourk
authors.forename: R
authors.initials: R
authors.lastname: Piascik
authors.forename: D P
authors.initials: DP
authors.lastname: Hetzel
authors.forename: J
authors.initials: J
authors.lastname: Sarosiek
authors.forename: R W
authors.initials: RW
authors.lastname: McCallum
mesh_terms: D000328:Adult; D002404:Catheterization / Q000295:instrumentation; D002628:Chemoreceptor Cells / Q000502:physiology; D004947:Esophagus / Q000294:innervation*; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology; D006801:Humans; D006851:Hydrochloric Acid; D008297:Male; D008465:Mechanoreceptors / Q000502:physiology; D010434:Pepsin A; D012018:Reflex / Q000502:physiology*; D012463:Saliva / Q000737:chemistry / Q000378:metabolism; D012472:Salivation / Q000502:physiology*; D012965:Sodium Chloride; D014783:Viscosity
chemical_list: D012965:Sodium Chloride; D010434:Pepsin A; D006851:Hydrochloric Acid