Allen Mangel - Academia.edu (original) (raw)
Papers by Allen Mangel
Journal of Neurophysiology
... SRISAILA BASAVAPPA, CHIUN-CHIEN HUANG, ALLEN W. MANGEL, DMITRY V. LEBEDEV, PHILIP A. KNAUF, A... more ... SRISAILA BASAVAPPA, CHIUN-CHIEN HUANG, ALLEN W. MANGEL, DMITRY V. LEBEDEV, PHILIP A. KNAUF, AND J. CLIVE ELLORY University Laboratory of Physiology, University of Oxford, Oxford OX1 3PT ... 1992; Lambert and Hoffmann 1994; Strange and Jackson 1995 ) . ...
The American journal of physiology
Bombesin stimulates cholecystokinin (CCK) secretion, presumably by a direct effect on the intesti... more Bombesin stimulates cholecystokinin (CCK) secretion, presumably by a direct effect on the intestinal CCK cell. The present objectives were to characterize bombesin-stimulated CCK release and to investigate the role of calcium in CCK secretion in an intestinal CCK-producing cell line (STC-1). Bombesin caused a dose-dependent release of CCK, which was reduced either in the absence of extracellular calcium or by calcium channel blockade, suggesting that influx of calcium is necessary for CCK secretion. Bombesin caused an increase in intracellular calcium concentration ([Ca2+]i) and increased efflux of 45Ca2+ from 45Ca(2+)-loaded cells. Radioligand binding studies and Northern analysis were consistent with the expression of a bombesin receptor. Thus bombesin stimulation of CCK release occurs via binding to a receptor and is dependent on increased [Ca2+]i. We propose that the STC-1 cell line may provide a useful model for studying the regulation of intestinal CCK secretion.
The American journal of physiology
The secretion of cholecystokinin was examined in STC-1 cells, an intestinal cholecystokinin (CCK)... more The secretion of cholecystokinin was examined in STC-1 cells, an intestinal cholecystokinin (CCK)-secreting cell line. Exposure to the amino acid L-phenylalanine increased release of CCK by 135%, 180%, and 251% of control levels after 15-min treatments with 5, 20, and 50 mM phenylalanine, respectively. L-Phenylalanine-induced secretion of CCK was inhibited by the calcium channel blocker diltiazem (10 microM). L-Phenylalanine (20 mM) also significantly increased cytosolic calcium levels in fura 2-acetoxymethyl ester (fura 2-AM)-loaded cells, and this increase was diltiazem sensitive. D-Phenylalanine, over the dose range of 5-50 mM, produced nonsignificant increases in CCK release. Treatment of STC-1 cells with 300 ng/ml of pertussis toxin for either 4 or 24 h did not significantly affect either basal release of CCK or L-phenylalanine-stimulated secretion. Patch-clamp recordings from cell-attached membrane patches showed a stimulation in calcium channel activity after L-phenylalanine. These results indicate that, in STC-1 cells, L-phenylalanine stimulates release of cholecystokinin via a calcium-dependent process.
The American journal of physiology
The relationship of potassium channel activity to the secretion of cholecystokinin (CCK) was eval... more The relationship of potassium channel activity to the secretion of cholecystokinin (CCK) was evaluated in STC-1 cells, an intestinal CCK-secreting cell line. Patch-clamp and 86Rb efflux studies showed that an ATP-sensitive potassium channel was endogenously expressed in STC-1 cells. Furthermore, channels are present in sufficient number to significantly modulate whole cell potassium permeability after either channel activation or closure with diazoxide (100 microM) or disopyramide (200 microM), respectively. Inhibition of channel activity with glucose (5-20 mM) was found to depolarize the plasma membrane, increase cytosolic calcium levels, and stimulate CCK release. Glucose-mediated release of CCK, as well as the increase in cytosolic calcium, was inhibited by the calcium channel blocker diltiazem (10 microM). It is concluded that intestinal secretion of CCK may be tonically controlled by activity of basally active ATP-sensitive potassium channels, and after inhibition of channel activity, calcium-dependent CCK secretion is stimulated.
The American journal of physiology
Previously, it has been shown that an increase in adenosine 3',5'-cyclic monophos... more Previously, it has been shown that an increase in adenosine 3',5'-cyclic monophosphate (cAMP) levels stimulates intestinal secretion of cholecystokinin (CCK); however, the mechanisms for increasing intracellular cAMP levels are not known. Using the CCK-secreting intestinal cell line, STC-1, we evaluated whether beta-adrenergic receptors (beta-ARs) might be present on STC-1 cells and whether they stimulated CCK release through increases in cAMP. Photoaffinity labeling of beta-ARs from solubilized STC-1 cell membranes revealed photoincorporation of the agonist [125I]iodocyanopindolol into an approximately 75-kDa band. Addition of the beta-AR agonist, isoproterenol, in the presence of 3-isobutyl-1-methylxanthine, produced a concentration-dependent increase in both cAMP levels and CCK release. Blockade of beta 1- and/or beta 2-ARs significantly inhibited isoproterenol-stimulated increases in cAMP production and CCK release. With the use of fura 2-loaded cells to measure changes in intracellular Ca2+ concentration ([Ca2+]i), isoproterenol stimulation was found to increase cytosolic Ca2+ levels. To evaluate whether this increase in [Ca2+]i was due to release of Ca2+ or influx of Ca2+, cells were treated with the L-type calcium channel blocker, diltiazem, which inhibited isoproterenol-stimulated CCK secretion. Furthermore, in patch-clamp studies with inside-out membrane patches, addition of the catalytic subunit of protein kinase A activated diltiazem-sensitive Ca2+ channels. It is concluded that beta-ARs are present on STC-1 cells and are coupled to the production of cAMP, which may increase CCK release through a calcium-dependent process.
PloS one, 2015
For over a century, the behavior of the aorta and other large arteries has been described as pass... more For over a century, the behavior of the aorta and other large arteries has been described as passive elastic tubes in which no active contraction occurs in the smooth muscle wall. In response to pulsatile pressure changes, the vessels undergo a 'passive' elastic dilatation-contraction cycle, described as a "Windkessel" effect. However, Mangel and colleagues have presented evidence that is contrary to this view. They reported that in the rabbit, the aorta undergoes rhythmic 'active' (contraction) during the cardiac cycle; but these findings have been largely ignored. In the present study, we observed spontaneous contractions in synchrony with the heartbeat in another species (rat). In addition we demonstrate that aorta contractions are of neurogenic origin. Electrical stimulation of the aorta evoked contractions that occur at a rate that is in the range of the animal's heartbeat and are suppressed by tetrodotoxin and the alpha-adrenergic receptor blocker...
Clinical and Experimental Gastroenterology, 2014
While chronic constipation (CC) clinical trials have focused primarily on bowel symptoms (symptom... more While chronic constipation (CC) clinical trials have focused primarily on bowel symptoms (symptoms directly related to bowel movements), abdominal symptoms are also prevalent among patients. The United States Food and Drug Administration's (FDA's) guidance on the use of patient-reported outcome measures to support product approvals or labeling claims recommends that endpoints be developed with direct patient input and include all symptoms important to patients. To identify a comprehensive set of CC symptoms that are important to patients for measurement in clinical trials. Following a targeted literature review to identify CC symptoms previously reported by patients, 28 patient interviews were conducted consistent with the FDA's guidance on patient-reported outcomes. Subsequent to open-ended questions eliciting descriptions of all symptoms, rating and ranking methods were used to identify those of greatest importance to patients. All 67 studies reviewed included bowel symptoms; more than half also addressed at least one abdominal symptom. Interview participants reported 62 potentially distinct concepts: 12 bowel symptoms; 21 abdominal symptoms; and 29 additional symptoms/impacts. Patients' descriptions revealed that many symptom terms were highly related and/or could be considered secondary to CC. The rating and ranking task results suggest that both bowel (for example, stool frequency and consistency) and abdominal symptoms (for example, bloating, abdominal pain) comprise patients' most important symptoms. Further, improvements in both bowel and abdominal symptoms would constitute an improvement in patients' CC overall. Abdominal symptoms in CC patients are equal in relevance to bowel symptoms and should also be addressed in clinical trials to fully evaluate treatment benefit.
Gastroenterology, 2009
Background-There is debate about how best to measure patient reported outcomes (PROs) in irritabl... more Background-There is debate about how best to measure patient reported outcomes (PROs) in irritable bowel syndrome (IBS). We pooled data from clinical trials to measure the psychometric properties of IBS endpoints, including binary responses (e.g. "adequate relief") and 50% improvement in symptom severity.
Clinical and Experimental Gastroenterology, 2014
For decades, it was believed that the diameter of gastrointestinal smooth muscle cells is suffici... more For decades, it was believed that the diameter of gastrointestinal smooth muscle cells is sufficiently narrow, and that the diffusion of calcium across the plasma membrane is sufficient, to support contractile activity. Thus, depolarization-triggered release of intracellular calcium was not believed to be operative in gastrointestinal smooth muscle. However, after the incubation of muscle segments in solutions devoid of calcium and containing the calcium chelator ethylene glycol tetraacetic acid, an alternative electrical event occurred that was distinct from normal slow waves and spikes. Subsequently, it was demonstrated in gastrointestinal smooth muscle segments that membrane depolarization associated with this alternative electrical event triggered rhythmic contractions by release of intracellular calcium. Although this concept of depolarization-triggered calcium release was iconoclastic, it has now been demonstrated in multiple gastrointestinal smooth muscle preparations. On the basis of these observations, we investigated whether a rhythmic electrical and mechanical event would occur in aortic smooth muscle under the same calcium-free conditions. The incubation of aortic segments in a solution with no added calcium plus ethylene glycol tetraacetic acid induced a fast electrical event without corresponding tension changes. On the basis of the frequency of these fast electrical events, we pursued, contrary to what has been established dogma for more than three centuries, the question of whether the smooth muscle wall of the aorta undergoes rhythmic activation during the cardiac cycle. As with depolarization-triggered contractile activity in gastrointestinal smooth muscle, it was "well known" that rhythmic activation of the aorta does not occur in synchrony with the heartbeat. In a series of experiments, however, it was demonstrated that rhythmic contractions occur in the aortic wall in synchrony with the heartbeat and share a common pacemaker with the heart. We conclude that important observations in the vascular system became derivative from those in the gastrointestinal system. The challenging of scientific dogma potentially leads to the expansion of our fundamental knowledge base.
![Research paper thumbnail of Corrigendum to “Calcium-dependent, swelling-activated K+ conductance in human neuroblastoma cells” [Biochem. Biophys. Res. Commun. 308 (2003) 759–763]](https://attachments.academia-assets.com/45888105/thumbnails/1.jpg)
](Biochemical and Biophysical Research Communications, 2006
On page 761, , the scale bar should read 10 pA instead of 10 pS. Also, the wrong voltages were li... more On page 761, , the scale bar should read 10 pA instead of 10 pS. Also, the wrong voltages were listed for some of the traces, and incorrect traces were included for some of the voltages. The correct version of and legend appear below for the reader's convenience.
Biochemical and Biophysical Research Communications, 2003
In most mammalian cells, regulatory volume decrease (RVD) is mediated by swelling-activated Cl(-)... more In most mammalian cells, regulatory volume decrease (RVD) is mediated by swelling-activated Cl(-) and K(+) channels. Previous studies in the human neuroblastoma cell line CHP-100 have demonstrated that exposure to hypoosmotic solutions activates Cl(-) channels which are sensitive to Ca(2+). Whether a Ca(2+)-dependent K(+) conductance is activated after cell swelling was investigated in the present studies. Reducing the extracellular osmolarity from 290 to 190 mOsm/kg H(2)O rapidly activated 86Rb effluxes. Hypoosmotic stress also increased cytosolic Ca(2+) in fura-2 loaded cells. Pretreatment with 2.5 mM EGTA and nominally Ca(2+) free extracellular solution significantly decreased the hypoosmotically induced rise in cytosolic Ca(2+) and the swelling-activated 86Rb efflux. In cell-attached patch-clamp studies, decreasing the extracellular osmolarity activated a K(+) conductance that was blocked by Ba(2+). In addition, the swelling-activated K(+) channels were significantly inhibited in the presence of nominally free extracellular Ca(2+) and 2.5mM EGTA. These results suggest that in response to hypoosmotic stress, a Ca(2+)-dependent K(+) conductance is activated in the human neuroblastoma cell line CHP-100.
Biochemical and Biophysical Research Communications, 1993
Following blockade of plasma membrane potassium channels with barium or tetraethylammonium chlori... more Following blockade of plasma membrane potassium channels with barium or tetraethylammonium chloride, release of cholecystokinin was increased in an intestinal cell line (STC-1). Treatment with calcium channel blockers inhibited barium- or TEA-induced secretion. Barium chloride also stimulated 45Ca efflux from STC-1 cells. Whole cell patch clamp recordings revealed a voltage-activated, L-type calcium current. We conclude that, inhibition of basally active potassium channels may depolarize STC-1 cells, producing activation of voltage-gated calcium influx pathways. Influx of calcium may lead to a release of intracellular calcium which stimulates cholecystokinin secretion.
Archives of Internal Medicine, 2001
Background: Several studies have suggested that physical activity is positively associated with c... more Background: Several studies have suggested that physical activity is positively associated with cognitive function in elderly persons. Evidence about this association has been limited by the cross-sectional design of most studies and by the frequent lack of adjustment for potential confounding variables. We determined whether physical activity is associated with cognitive decline in a prospective study of older women.
The American journal of physiology
The purpose of this study is to determine whether or not the sympathetic nervous system provides ... more The purpose of this study is to determine whether or not the sympathetic nervous system provides a tonic inhibitory input to the colon in chloralose-anesthetized cats. Proximal and midcolonic motility were monitored using extraluminal force transducers. An intravenous bolus injection of 5 mg of phentolamine in 14 animals elicited a pronounced increase in proximal colon contractility. The minute motility index changed from 0 +/- 0 to 26 +/- 4 after phentolamine administration. Midcolonic motility also increased in response to phentolamine. Specific blockade of alpha 2-receptors, but not alpha 1-receptors, caused the same response seen with phentolamine. alpha-Adrenergic blockade increased colon contractility after spinal cord transection but not after ganglionic blockade. Blockade of alpha-adrenergic receptors was also performed before vagal and pelvic nerve stimulation and in both cases increased colonic motility. Vagal stimulation alone had no effect on colonic contractility, while pelvic nerve stimulation increased motility at the midcolon. alpha-Receptor blockade did not alter the ineffectiveness of vagal stimulation but did unmask excitatory effects of pelvic nerve stimulation on the proximal colon. All excitatory colonic responses were prevented by blocking muscarinic cholinergic receptors. These data indicate that tonic sympathetic nervous system activity exerts an inhibitory effect on colonic motility. The inhibitory effect is mediated through alpha 2-adrenergic receptors. Based on these findings, we suggest that alterations in sympathetic nervous system activity may be extremely important for the regulation of circular muscle contractions in the colon.
Gastroenterology
symptoms: epigastric pain/discomfort, heartburn, acid regurgitation, excessive burping/belching, ... more symptoms: epigastric pain/discomfort, heartburn, acid regurgitation, excessive burping/belching, increased abdominat bloating, nausea, feeling of abnormal or slow digestion or eariy satiety. Patients were excluded if they had recently been(<6 months) investigated by radiology or EBB, had more than two occasions of investigation in the past ten years or had a history of upper GI pathology or surgery. Prompt EGD was to be performed within ten days of presentation to the FP and results were sent to the FP who then decided patient management. Abnormality was defined as any notation of visible abnormality on EGD. RESULTS: 1040 patients underwent EGD (50% male; age 18-84 yr) of whom 661 (64%) were < 50 yrs. 29%
ISRN gastroenterology, 2011
The membrane of most gastrointestinal smooth muscles shows slow waves, slow rhythmic changes in m... more The membrane of most gastrointestinal smooth muscles shows slow waves, slow rhythmic changes in membrane potential. Slow waves serve to bring the membrane potential of smooth muscle cells to a threshold level that elicits a second electrical event known as the spike or action potential. The inward current of the spike, in most gastrointestinal smooth muscle preparations, is carried, at least in part, by calcium. Indeed, considering the narrow diameter of smooth muscle cells, some have hypothesized that the influx of calcium during the spike is sufficient for activation of the contractile machinery. Findings consistent with this include marked reduction in contractility during exposure of muscle segments to blockers of L-type calcium channels or following reductions in external calcium levels. However, it has also been observed that following exposure of muscle segments to external bathing solutions containing no added calcium plus 5 mM EGTA to remove any remaining extracellular calc...
American Journal of Gastroenterology, 2001
signifying significant improved quality of life. The SFI st baseline averaged 41.8, similar to th... more signifying significant improved quality of life. The SFI st baseline averaged 41.8, similar to the 42.2 in the validation study. After treatment, all patients experienced a decrease SFI with an average decrease of 21.5 (significant at p Ͻ 0.001.) Conclusions: A subset of IBS patients appear to have an imbalanced gut flora including a deficiency of probiotics. This imbalance may also predispose to an overgrowth of pathogenic bacteria and yeast. Supplementation with probiotics and treating culture positive growth of bacteria and yeast improved some of the most common IBS symptoms as measured by IBS-QOL validated instrument.
The American Journal of Gastroenterology, 2000
Journal of Neurophysiology
... SRISAILA BASAVAPPA, CHIUN-CHIEN HUANG, ALLEN W. MANGEL, DMITRY V. LEBEDEV, PHILIP A. KNAUF, A... more ... SRISAILA BASAVAPPA, CHIUN-CHIEN HUANG, ALLEN W. MANGEL, DMITRY V. LEBEDEV, PHILIP A. KNAUF, AND J. CLIVE ELLORY University Laboratory of Physiology, University of Oxford, Oxford OX1 3PT ... 1992; Lambert and Hoffmann 1994; Strange and Jackson 1995 ) . ...
The American journal of physiology
Bombesin stimulates cholecystokinin (CCK) secretion, presumably by a direct effect on the intesti... more Bombesin stimulates cholecystokinin (CCK) secretion, presumably by a direct effect on the intestinal CCK cell. The present objectives were to characterize bombesin-stimulated CCK release and to investigate the role of calcium in CCK secretion in an intestinal CCK-producing cell line (STC-1). Bombesin caused a dose-dependent release of CCK, which was reduced either in the absence of extracellular calcium or by calcium channel blockade, suggesting that influx of calcium is necessary for CCK secretion. Bombesin caused an increase in intracellular calcium concentration ([Ca2+]i) and increased efflux of 45Ca2+ from 45Ca(2+)-loaded cells. Radioligand binding studies and Northern analysis were consistent with the expression of a bombesin receptor. Thus bombesin stimulation of CCK release occurs via binding to a receptor and is dependent on increased [Ca2+]i. We propose that the STC-1 cell line may provide a useful model for studying the regulation of intestinal CCK secretion.
The American journal of physiology
The secretion of cholecystokinin was examined in STC-1 cells, an intestinal cholecystokinin (CCK)... more The secretion of cholecystokinin was examined in STC-1 cells, an intestinal cholecystokinin (CCK)-secreting cell line. Exposure to the amino acid L-phenylalanine increased release of CCK by 135%, 180%, and 251% of control levels after 15-min treatments with 5, 20, and 50 mM phenylalanine, respectively. L-Phenylalanine-induced secretion of CCK was inhibited by the calcium channel blocker diltiazem (10 microM). L-Phenylalanine (20 mM) also significantly increased cytosolic calcium levels in fura 2-acetoxymethyl ester (fura 2-AM)-loaded cells, and this increase was diltiazem sensitive. D-Phenylalanine, over the dose range of 5-50 mM, produced nonsignificant increases in CCK release. Treatment of STC-1 cells with 300 ng/ml of pertussis toxin for either 4 or 24 h did not significantly affect either basal release of CCK or L-phenylalanine-stimulated secretion. Patch-clamp recordings from cell-attached membrane patches showed a stimulation in calcium channel activity after L-phenylalanine. These results indicate that, in STC-1 cells, L-phenylalanine stimulates release of cholecystokinin via a calcium-dependent process.
The American journal of physiology
The relationship of potassium channel activity to the secretion of cholecystokinin (CCK) was eval... more The relationship of potassium channel activity to the secretion of cholecystokinin (CCK) was evaluated in STC-1 cells, an intestinal CCK-secreting cell line. Patch-clamp and 86Rb efflux studies showed that an ATP-sensitive potassium channel was endogenously expressed in STC-1 cells. Furthermore, channels are present in sufficient number to significantly modulate whole cell potassium permeability after either channel activation or closure with diazoxide (100 microM) or disopyramide (200 microM), respectively. Inhibition of channel activity with glucose (5-20 mM) was found to depolarize the plasma membrane, increase cytosolic calcium levels, and stimulate CCK release. Glucose-mediated release of CCK, as well as the increase in cytosolic calcium, was inhibited by the calcium channel blocker diltiazem (10 microM). It is concluded that intestinal secretion of CCK may be tonically controlled by activity of basally active ATP-sensitive potassium channels, and after inhibition of channel activity, calcium-dependent CCK secretion is stimulated.
The American journal of physiology
Previously, it has been shown that an increase in adenosine 3',5'-cyclic monophos... more Previously, it has been shown that an increase in adenosine 3',5'-cyclic monophosphate (cAMP) levels stimulates intestinal secretion of cholecystokinin (CCK); however, the mechanisms for increasing intracellular cAMP levels are not known. Using the CCK-secreting intestinal cell line, STC-1, we evaluated whether beta-adrenergic receptors (beta-ARs) might be present on STC-1 cells and whether they stimulated CCK release through increases in cAMP. Photoaffinity labeling of beta-ARs from solubilized STC-1 cell membranes revealed photoincorporation of the agonist [125I]iodocyanopindolol into an approximately 75-kDa band. Addition of the beta-AR agonist, isoproterenol, in the presence of 3-isobutyl-1-methylxanthine, produced a concentration-dependent increase in both cAMP levels and CCK release. Blockade of beta 1- and/or beta 2-ARs significantly inhibited isoproterenol-stimulated increases in cAMP production and CCK release. With the use of fura 2-loaded cells to measure changes in intracellular Ca2+ concentration ([Ca2+]i), isoproterenol stimulation was found to increase cytosolic Ca2+ levels. To evaluate whether this increase in [Ca2+]i was due to release of Ca2+ or influx of Ca2+, cells were treated with the L-type calcium channel blocker, diltiazem, which inhibited isoproterenol-stimulated CCK secretion. Furthermore, in patch-clamp studies with inside-out membrane patches, addition of the catalytic subunit of protein kinase A activated diltiazem-sensitive Ca2+ channels. It is concluded that beta-ARs are present on STC-1 cells and are coupled to the production of cAMP, which may increase CCK release through a calcium-dependent process.
PloS one, 2015
For over a century, the behavior of the aorta and other large arteries has been described as pass... more For over a century, the behavior of the aorta and other large arteries has been described as passive elastic tubes in which no active contraction occurs in the smooth muscle wall. In response to pulsatile pressure changes, the vessels undergo a 'passive' elastic dilatation-contraction cycle, described as a "Windkessel" effect. However, Mangel and colleagues have presented evidence that is contrary to this view. They reported that in the rabbit, the aorta undergoes rhythmic 'active' (contraction) during the cardiac cycle; but these findings have been largely ignored. In the present study, we observed spontaneous contractions in synchrony with the heartbeat in another species (rat). In addition we demonstrate that aorta contractions are of neurogenic origin. Electrical stimulation of the aorta evoked contractions that occur at a rate that is in the range of the animal's heartbeat and are suppressed by tetrodotoxin and the alpha-adrenergic receptor blocker...
Clinical and Experimental Gastroenterology, 2014
While chronic constipation (CC) clinical trials have focused primarily on bowel symptoms (symptom... more While chronic constipation (CC) clinical trials have focused primarily on bowel symptoms (symptoms directly related to bowel movements), abdominal symptoms are also prevalent among patients. The United States Food and Drug Administration&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s (FDA&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s) guidance on the use of patient-reported outcome measures to support product approvals or labeling claims recommends that endpoints be developed with direct patient input and include all symptoms important to patients. To identify a comprehensive set of CC symptoms that are important to patients for measurement in clinical trials. Following a targeted literature review to identify CC symptoms previously reported by patients, 28 patient interviews were conducted consistent with the FDA&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s guidance on patient-reported outcomes. Subsequent to open-ended questions eliciting descriptions of all symptoms, rating and ranking methods were used to identify those of greatest importance to patients. All 67 studies reviewed included bowel symptoms; more than half also addressed at least one abdominal symptom. Interview participants reported 62 potentially distinct concepts: 12 bowel symptoms; 21 abdominal symptoms; and 29 additional symptoms/impacts. Patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; descriptions revealed that many symptom terms were highly related and/or could be considered secondary to CC. The rating and ranking task results suggest that both bowel (for example, stool frequency and consistency) and abdominal symptoms (for example, bloating, abdominal pain) comprise patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; most important symptoms. Further, improvements in both bowel and abdominal symptoms would constitute an improvement in patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; CC overall. Abdominal symptoms in CC patients are equal in relevance to bowel symptoms and should also be addressed in clinical trials to fully evaluate treatment benefit.
Gastroenterology, 2009
Background-There is debate about how best to measure patient reported outcomes (PROs) in irritabl... more Background-There is debate about how best to measure patient reported outcomes (PROs) in irritable bowel syndrome (IBS). We pooled data from clinical trials to measure the psychometric properties of IBS endpoints, including binary responses (e.g. "adequate relief") and 50% improvement in symptom severity.
Clinical and Experimental Gastroenterology, 2014
For decades, it was believed that the diameter of gastrointestinal smooth muscle cells is suffici... more For decades, it was believed that the diameter of gastrointestinal smooth muscle cells is sufficiently narrow, and that the diffusion of calcium across the plasma membrane is sufficient, to support contractile activity. Thus, depolarization-triggered release of intracellular calcium was not believed to be operative in gastrointestinal smooth muscle. However, after the incubation of muscle segments in solutions devoid of calcium and containing the calcium chelator ethylene glycol tetraacetic acid, an alternative electrical event occurred that was distinct from normal slow waves and spikes. Subsequently, it was demonstrated in gastrointestinal smooth muscle segments that membrane depolarization associated with this alternative electrical event triggered rhythmic contractions by release of intracellular calcium. Although this concept of depolarization-triggered calcium release was iconoclastic, it has now been demonstrated in multiple gastrointestinal smooth muscle preparations. On the basis of these observations, we investigated whether a rhythmic electrical and mechanical event would occur in aortic smooth muscle under the same calcium-free conditions. The incubation of aortic segments in a solution with no added calcium plus ethylene glycol tetraacetic acid induced a fast electrical event without corresponding tension changes. On the basis of the frequency of these fast electrical events, we pursued, contrary to what has been established dogma for more than three centuries, the question of whether the smooth muscle wall of the aorta undergoes rhythmic activation during the cardiac cycle. As with depolarization-triggered contractile activity in gastrointestinal smooth muscle, it was &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;well known&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; that rhythmic activation of the aorta does not occur in synchrony with the heartbeat. In a series of experiments, however, it was demonstrated that rhythmic contractions occur in the aortic wall in synchrony with the heartbeat and share a common pacemaker with the heart. We conclude that important observations in the vascular system became derivative from those in the gastrointestinal system. The challenging of scientific dogma potentially leads to the expansion of our fundamental knowledge base.
Biochemical and Biophysical Research Communications, 2006
On page 761, , the scale bar should read 10 pA instead of 10 pS. Also, the wrong voltages were li... more On page 761, , the scale bar should read 10 pA instead of 10 pS. Also, the wrong voltages were listed for some of the traces, and incorrect traces were included for some of the voltages. The correct version of and legend appear below for the reader's convenience.
Biochemical and Biophysical Research Communications, 2003
In most mammalian cells, regulatory volume decrease (RVD) is mediated by swelling-activated Cl(-)... more In most mammalian cells, regulatory volume decrease (RVD) is mediated by swelling-activated Cl(-) and K(+) channels. Previous studies in the human neuroblastoma cell line CHP-100 have demonstrated that exposure to hypoosmotic solutions activates Cl(-) channels which are sensitive to Ca(2+). Whether a Ca(2+)-dependent K(+) conductance is activated after cell swelling was investigated in the present studies. Reducing the extracellular osmolarity from 290 to 190 mOsm/kg H(2)O rapidly activated 86Rb effluxes. Hypoosmotic stress also increased cytosolic Ca(2+) in fura-2 loaded cells. Pretreatment with 2.5 mM EGTA and nominally Ca(2+) free extracellular solution significantly decreased the hypoosmotically induced rise in cytosolic Ca(2+) and the swelling-activated 86Rb efflux. In cell-attached patch-clamp studies, decreasing the extracellular osmolarity activated a K(+) conductance that was blocked by Ba(2+). In addition, the swelling-activated K(+) channels were significantly inhibited in the presence of nominally free extracellular Ca(2+) and 2.5mM EGTA. These results suggest that in response to hypoosmotic stress, a Ca(2+)-dependent K(+) conductance is activated in the human neuroblastoma cell line CHP-100.
Biochemical and Biophysical Research Communications, 1993
Following blockade of plasma membrane potassium channels with barium or tetraethylammonium chlori... more Following blockade of plasma membrane potassium channels with barium or tetraethylammonium chloride, release of cholecystokinin was increased in an intestinal cell line (STC-1). Treatment with calcium channel blockers inhibited barium- or TEA-induced secretion. Barium chloride also stimulated 45Ca efflux from STC-1 cells. Whole cell patch clamp recordings revealed a voltage-activated, L-type calcium current. We conclude that, inhibition of basally active potassium channels may depolarize STC-1 cells, producing activation of voltage-gated calcium influx pathways. Influx of calcium may lead to a release of intracellular calcium which stimulates cholecystokinin secretion.
Archives of Internal Medicine, 2001
Background: Several studies have suggested that physical activity is positively associated with c... more Background: Several studies have suggested that physical activity is positively associated with cognitive function in elderly persons. Evidence about this association has been limited by the cross-sectional design of most studies and by the frequent lack of adjustment for potential confounding variables. We determined whether physical activity is associated with cognitive decline in a prospective study of older women.
The American journal of physiology
The purpose of this study is to determine whether or not the sympathetic nervous system provides ... more The purpose of this study is to determine whether or not the sympathetic nervous system provides a tonic inhibitory input to the colon in chloralose-anesthetized cats. Proximal and midcolonic motility were monitored using extraluminal force transducers. An intravenous bolus injection of 5 mg of phentolamine in 14 animals elicited a pronounced increase in proximal colon contractility. The minute motility index changed from 0 +/- 0 to 26 +/- 4 after phentolamine administration. Midcolonic motility also increased in response to phentolamine. Specific blockade of alpha 2-receptors, but not alpha 1-receptors, caused the same response seen with phentolamine. alpha-Adrenergic blockade increased colon contractility after spinal cord transection but not after ganglionic blockade. Blockade of alpha-adrenergic receptors was also performed before vagal and pelvic nerve stimulation and in both cases increased colonic motility. Vagal stimulation alone had no effect on colonic contractility, while pelvic nerve stimulation increased motility at the midcolon. alpha-Receptor blockade did not alter the ineffectiveness of vagal stimulation but did unmask excitatory effects of pelvic nerve stimulation on the proximal colon. All excitatory colonic responses were prevented by blocking muscarinic cholinergic receptors. These data indicate that tonic sympathetic nervous system activity exerts an inhibitory effect on colonic motility. The inhibitory effect is mediated through alpha 2-adrenergic receptors. Based on these findings, we suggest that alterations in sympathetic nervous system activity may be extremely important for the regulation of circular muscle contractions in the colon.
Gastroenterology
symptoms: epigastric pain/discomfort, heartburn, acid regurgitation, excessive burping/belching, ... more symptoms: epigastric pain/discomfort, heartburn, acid regurgitation, excessive burping/belching, increased abdominat bloating, nausea, feeling of abnormal or slow digestion or eariy satiety. Patients were excluded if they had recently been(<6 months) investigated by radiology or EBB, had more than two occasions of investigation in the past ten years or had a history of upper GI pathology or surgery. Prompt EGD was to be performed within ten days of presentation to the FP and results were sent to the FP who then decided patient management. Abnormality was defined as any notation of visible abnormality on EGD. RESULTS: 1040 patients underwent EGD (50% male; age 18-84 yr) of whom 661 (64%) were < 50 yrs. 29%
ISRN gastroenterology, 2011
The membrane of most gastrointestinal smooth muscles shows slow waves, slow rhythmic changes in m... more The membrane of most gastrointestinal smooth muscles shows slow waves, slow rhythmic changes in membrane potential. Slow waves serve to bring the membrane potential of smooth muscle cells to a threshold level that elicits a second electrical event known as the spike or action potential. The inward current of the spike, in most gastrointestinal smooth muscle preparations, is carried, at least in part, by calcium. Indeed, considering the narrow diameter of smooth muscle cells, some have hypothesized that the influx of calcium during the spike is sufficient for activation of the contractile machinery. Findings consistent with this include marked reduction in contractility during exposure of muscle segments to blockers of L-type calcium channels or following reductions in external calcium levels. However, it has also been observed that following exposure of muscle segments to external bathing solutions containing no added calcium plus 5 mM EGTA to remove any remaining extracellular calc...
American Journal of Gastroenterology, 2001
signifying significant improved quality of life. The SFI st baseline averaged 41.8, similar to th... more signifying significant improved quality of life. The SFI st baseline averaged 41.8, similar to the 42.2 in the validation study. After treatment, all patients experienced a decrease SFI with an average decrease of 21.5 (significant at p Ͻ 0.001.) Conclusions: A subset of IBS patients appear to have an imbalanced gut flora including a deficiency of probiotics. This imbalance may also predispose to an overgrowth of pathogenic bacteria and yeast. Supplementation with probiotics and treating culture positive growth of bacteria and yeast improved some of the most common IBS symptoms as measured by IBS-QOL validated instrument.
The American Journal of Gastroenterology, 2000