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Published on: June 25, 2012
Signal transduction pathways in esophageal and lower esophageal sphincter circular muscle
P Biancani1, U D Sohn, H G Rich
1Department of Medicine, Rhode Island Hospital, Brown Medical School, Providence 02903, USA.
Insights
Esophageal reflux involves distinct muscle contractions. Lower esophageal sphincter (LES) tone reduction in esophagitis alters signaling pathways, impacting LES pressure and potentially causing heartburn.
Area of Science:
- Gastroenterology
- Molecular Biology
- Physiology
Background:
- Esophageal reflux affects millions, potentially leading to serious complications like Barrett's esophagus.
- Lower esophageal sphincter (LES) pressure impairment is common in chronic heartburn patients.
- Esophagitis involves multifactorial causes, including LES relaxation and impaired esophageal clearance.
Purpose of the Study:
- To investigate the distinct cellular mechanisms of acetylcholine (ACh)-induced contraction in esophageal and LES circular muscles.
- To elucidate the role of calcium (Ca2+) sources and signal transduction pathways in LES pressure regulation.
- To examine how experimental esophagitis affects LES tone and contraction signaling.
Main Methods:
- Comparative analysis of Ca2+ sources and phospholipid metabolism in esophageal versus LES muscle.
- Investigation of signal transduction pathways, including protein kinase C (PKC), calmodulin, and myosin light chain kinase.
- Induction of experimental esophagitis to assess changes in basal LES tone and ACh-induced contraction pathways.
Main Results:
- Esophageal muscle contraction relies on extracellular Ca2+ influx, phosphatidylcholine metabolism, and PKC activation.
- LES muscle contraction primarily uses intracellular Ca2+ release (via phosphatidylinositol metabolism) and a calmodulin-myosin light chain kinase pathway.
- Esophagitis induction reduced basal PI hydrolysis and intracellular Ca2+ stores, decreasing resting LES tone and shifting ACh signaling to an extracellular Ca2+-dependent PKC pathway.
Conclusions:
- Distinct signaling pathways govern ACh-induced contractions in esophageal and LES muscles.
- Impaired LES tone in esophagitis is linked to reduced intracellular Ca2+ signaling and a shift towards extracellular Ca2+ dependence.
- These findings offer insights into the mechanisms underlying LES dysfunction and heartburn in reflux disease.
Abstract:
Esophageal reflux is a common condition that affects children and 1 in 10 adults, and if untreated may result in chronic esophagitis, aspiration pneumonia, esophageal strictures, and Barrett's esophagus, a premalignant condition. Although esophagitis is a multifactorial disease that may depend on transient lower esophageal sphincter (LES) relaxation, speed of esophageal clearance, mucosal resistance, and other factors, impairment of LES pressure is a common finding in patients complaining of chronic heartburn. Our data suggest that esophageal and LES circular muscle utilize distinct Ca2+ sources, phospholipid pools, and signal transduction pathways to contract in response to acetylcholine (ACh): (1) In esophageal muscle ACh-induced contraction requires influx of extracellular Ca2+ and may be linked to phosphatidylcholine metabolism, production of diacylglycerol (DAG) and arachidonic acid, and activation of a protein kinase C (PKC)-dependent pathway. (2) In LES muscle ACh-induced contraction utilizes intracellular Ca2+ release arising from metabolism of phosphatidylinositol (PI), and a calmodulin-myosin light chain kinase-dependent pathway. Resting LES tone, on the other hand, may be due to relatively low basal PI hydrolysis resulting in submaximal levels of inositol triphosphate (IP3)-induced calcium release and interaction with DAG to activate PKC. (3) After induction of experimental esophagitis, basal levels of PI hydrolysis and intracellular calcium stores are substantially reduced, resulting in a reduction of resting tone. In addition the signal transduction pathway responsible for LES contraction in response to ACh changes from one that depends on IP3 production, calcium release, and calmodulin activation to one that relies on influx of extracellular calcium and activation of PKC.
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