[Effect of endogenous opioids on gastric functions in man]

Recent studies have demonstrated the presence of opioid peptides in the stomach, neurons of the vagus and the intrinsic nervous system. To evaluate the role of endogenous opioids on gastric mucosal blood flow, serum hormonal response, and gastric secretion, naloxone, a pure opioid antagonist, was infused or sprayed into healthy men, Furthermore, the effect of pentagastrin-induced gastric acid secretion on plasma beta-endorphin concentrations was investigated. Gastric mucosal blood flow was periodically determined by inhaled hydrogen gas clearance. The antrum and the corpus of the stomach could be investigated separately. Intravenous naloxone (40 micrograms/kg/hr) over 30 min caused a significant decline in the antral mucosal blood flow from 55.4 +/- 3.4 (mean +/- SE) ml/min/100 g before infusion to 47.2 +/- 3.0 ml/min/100 g 15 min after the start of injection (P < 0.05), and to 44.8 +/- 3.0 ml/min/100 g after 30 min (P < 0.05) (n = 12). Corresponding corpus mucosal blood flow did not change after infusion of naloxone (n = 8). No change occurred in the antral mucosal blood flow in response to naloxone spraying (0.6 mg) (n = 8). Intravenous administration of naloxone (40 micrograms/kg/hr) had no effect on serum gastrin and secretin concentrations or on the gastric acid secretion stimulated by pentagastrin (n = 8). The status of stimulated gastric acid secretion did not correlate with the release of plasma beta-endorphin. Since naloxone probably mirrors the action of endogenous opioids, these results indicate in humans that (1) endogenous opioids may be involved in the physiological regulation and augmentation of mucosal blood flow for the antrum, (2) the inhibitory effect of naloxone on gastric mucosal blood flow in the antrum does not seem to be mediated via opioid receptors of the mucosa, (3) endogenous opioids have no effect on basal acid secretion and acid secretion stimulated by pentagastrin, and (4) there is no interplay between acid secretion and plasma beta-endorphin.