Distribution and release of peptide YY in dog measured by specific radioimmunoassay

Peptide YY (PYY), neuropeptide Y, and pancreatic polypeptide (PP) are the third family of structurally related peptides to be extracted from the brain-gut axis. In the present study we have validated a sensitive and specific assay for PYY and used it to measure the distribution of PYY in the canine gastrointestinal tract. In addition we have compared the PYY and PP responses to both an intragastric meal and to insulin hypoglycemia. The highest concentration of PYY was present in the canine ileum (1610 +/- 123 ng/g) and colon (1607 +/- 194 ng/g). Significant (p less than 0.05) increases in both circulating PP and PYY concentrations were observed in response to the meal (mean delta PP = 180 +/- 43 pg/ml; mean delta PYY = 205 +/- 61 pg/ml). In contrast, only serum PP concentrations (mean delta PP = 294 +/- 36 pg/ml) increased significantly (p less than 0.01) in response to insulin hypoglycemia, demonstrating differences in the sensitivity of the PP and PYY cells to vagal stimulation. The present demonstration of PYY release in response to a physiological stimulus fulfills one of the prerequisites for hormonal status.     

The effects of alpha adrenergic blockade on arachidonic acid metabolism and shock sequelae in endotoxemia

Previous studies have suggested that increased alpha adrenergic activity stimulated prostaglandin synthesis and may be involved in the modulation of eicosanoid metabolism. These observations prompted investigation of the effect of the alpha adrenergic receptor antagonist phenoxybenzamine and the cyclo-oxygenase inhibitor indomethacin on endotoxin-induced shock severity, and on plasma immunoreactive iTxB2 and i6-keto-PGF1 alpha, the stable metabolites of TxA2 and PGI2, respectively. Pretreatment with indomethacin alone blunted the endotoxin- (8 mg/kg) induced hypoglycemia. Phenoxybenzamine pretreatment also blunted endotoxin-induced mortality (LD80), hypoglycemia, hemoconcentration, and decreased plasma beta-glucuronidase (BG). The combination of phenoxybenzamine and indomethacin resulted in the improvement of all indices of shock severity. Rats pretreated with phenoxybenzamine and indomethacin alone or conjointly also exhibited significantly (P less than 0.05) enhanced survival compared to that of shocked control rats. Percent survival at 48 hr was 24, 64, 80, and 92 in untreated, indomethacin, phenoxybenzamine, and indomethacin + phenoxybenzamine treated, respectively. Mean plasma iTxB2 values at 30 min postendotoxin (15 mg/kg i.v.) were 1,532 +/- 319 pg/ml (N = 10). Phenoxybenzamine pretreatment decreased iTxB2 to 719 +/- 114 pg/ml (N = 10). Phenoxybenzamine pretreatment decreased iTxB2 to 719 +/- 114 pg/ml (N = 10) (P less than 0.05). Plasma i6-keto-PGF1 alpha was increased 4 hr after endotoxin in shocked controls to 4,161 +/- 885 pg/ml (N = 5) and attenuated by phenoxybenzamine to a value of 1,184 +/- 363 pg/ml (N = 4) (P less than 0.05). The results suggest that increased alpha adrenergic activity may be an important stimulus for arachidonic acid metabolism during endotoxemia.     

THE EFFECT OF CHOLINERGIC BLOCKADE ON THE ACTH, β-ENDORPHIN AND CORTISOL RESPONSES TO INSULIN-INDUCED HYPOGLYCAEMIA

To assess the effect of cholinergic blockade on the ACTH, beta-endorphin and cortisol responses to insulin-induced hypoglycaemia, six healthy male volunteers each underwent two insulin tolerance tests in random order, separated by at least 1 week with and without atropine. ACTH levels were significantly greater at +45 min (mean +/- SEM, 223 +/- 21 pg/ml vs 148 +/- 15 pg/ml, P less than 0.01) and at +120 min (54 +/- 11 pg/ml vs 29 +/- 10 pg/ml, P less than 0.05). beta-endorphin levels were significantly greater at +30 min (170 +/- 45 pg/ml vs 96 +/- 32 pg/ml, P less than 0.05) and at +105 min (81 +/- 14 pg/ml vs 54 +/- 7 pg/ml, P less than 0.01). Cholinergic blockade had no effect on plasma glucose or cortisol concentrations. This study demonstrates that cholinergic blockade with atropine facilitates the ACTH and beta-endorphin responses to insulin-induced hypoglycaemia without altering the cortisol responses.     

Stimulation of human pancreatic polypeptide secretion by hypoglycemia is independent of adrenergic mechanisms

Human pancreatic polypeptide (HPP) increases after insulin-induced hypoglycemia. To determine whether adrenergic mechanisms contribute to this increase in normal man, six subjects were studied on two occasions: once after insulin alone and once after insulin plus simultaneous alpha (phentolamine)- and beta (propranolol)-adrenergic blockade. Despite comparable hypoglycemia (51 +/- 4 vs. 49 +/- 4 mg/dl), the increase in HPP did not differ in the presence or absence of adrenergic blockade (721 +/- 215 vs. 736 +/- 193 pg/ml, respectively). These findings suggest that HPP secretion during hypoglycemia is not dependent on adrenergic mechanisms.     

Adrenergic modulation of pancreatic polypeptide secretion

In order to examine the effect of adrenergic influences on pancreatic polypeptide (PP) secretion, a series of insulin tolerance tests was carried out in five normal volunteers. Control ITT's, as well as ITT's following pretreatment with oral cyproheptadine (4 mg q 6 hr for 48 hr ITT-cyp), and intravenous phentolamine (5 mg stat, then 0.5 mg/min for 120 min, ITT-phe), and propranolol (3 mg stat, then 0.08 mg/min for 120 min, ITT-pro), were performed. Alpha blockade established during ITT-phe augmented the peak PP concentration after insulin from 1470 ± 472 to 2684 ± 840 pg/ml (p < 0.05) and resulted in an increase in net response of 57 ± 4.7% (p < 0.001) as assessed by areas under the curves. In contrast, beta adrenergic blockade during ITT-pro suppressed the PP peak down to 696 ± 218 pg/ml, or 49% of control (p < 0.01), and diminished the net response by 43% (p < 0.01), despite the prolongation of hypoglycemic values observed during ITT-pro. Pretreatment with cyproheptadine did not alter the PP response to ITT. When propranolol was infused without ITT, PP concentrations more than doubled from 89.6 ± 4.1 pg/ml to values ranging from 175 ± 36.2 to 213 ± 42.4 pg/ml at 30–120 min (p < 0.05). Phentolamine infusion alone did not influence PP. Alpha adrenergic blockade augments, and beta blockade suppresses, the PP response to insulin hypoglycemia. The mechanism of the rise in PP following propranolol infusion alone may be secretory agonism of the drug, a parasympathetic response to it, or an influence on PP clearance.     

Suppressor effect of morphine on the pancreatic polypeptide response to insulin-induced hypoglycemia in man

The effect of intravenous infusions of morphine and naloxone, alone or in combination, on basal plasma pancreatic polypeptide (PP) levels as well as on the PP response to insulin-induced hypoglycemia in normal subjects was investigated. Morphine infusion (150 micrograms/kg/120 min, intravenously) induced a progressive decrease in the basal plasma PP levels (basal value: 158 +/- 42 pg/mL; nadir, at 120 minutes: 108 +/- 26 pg/mL; P less than 0.05). In control experiments, insulin injection was followed by a 10-fold plasma PP elevation (peak: 1258 +/- 71 pg/mL). During morphine infusion, the PP response to hypoglycemia appeared consistently reduced (peak: 404 +/- 117 pg/mL, P less than 0.05 vs. control). Naloxone pretreatment (4.8 mg, intravenously) partially reversed the blocking effect of morphine on the PP secretion evoked by insulin-induced hypoglycemia (peak: 977 +/- 133 pg/mL, P less than 0.05 vs. control and morphine experiments). Similar degrees of hypoglycemia were achieved with and without morphine or naloxone. The intravenous infusion of naloxone alone failed to significantly modify both basal circulating PP levels and the PP response to hypoglycemia. The observation that morphine reduces PP output, both the basal value and that elicited by a parenteral stimulus, indicates that this effect is independent of its action on the gastrointestinal tract. On the other hand, the lack of effect of naloxone alone on PP secretion argues against the participation of endogenous opiates in the control of this process.     

Effect of beta-adrenergic blockade and sympathetic stimulation on canine bronchial mast cell response to immune degranulation in vivo

We examined the effect of beta-adrenoceptor blockade and residual alpha-adrenoceptor effects during sympathetic stimulation on mast cell secretion of histamine in 12 natively allergic mongrel dogs. Bronchial mast cell response was measured as the arteriovenous difference (AVd) in plasma histamine concentration [H] across the bronchus. Plasma [H] was determined simultaneously from the azygos outflow tract and femoral artery as a marker of mast cell response prior to and for 90 s after intra-arterial injection of sham diluent and 1:100 and 1:30 dilutions of Ascaris suum antigen. Sympathetic (alpha-adrenergic) stimulation was elicited with continuous infusion of the nicotinic agonist, dimethylphenylpiperazinium (DMPP) under conditions of muscarinic blockade with atropine and beta-adrenoceptor blockade with propranolol. Plasma epinephrine (EPI) increased from 315 +/- 106 to 34,127 +/- 10,711 pg/ml (p less than 0.02). Control animals receiving sham infusion in place of sympathetic stimulation additionally had neural blockade with hexamethonium and alpha-adrenoceptor blockade with phentolamine. Plasma EPI was 90 +/- 58 pg/ml and did not change significantly during mast cell degranulation. Significant AVd in [H] was elicited after 1:30 A. suum antigen in both control (72.9 +/- 12.5 ng/ml versus 2.8 +/- 10.1 ng/ml at baseline; p = 0.031) and beta-adrenergically blocked (alpha-stimulated) (106.1 +/- 20.1 versus -1.5 +/- 35.9 ng/ml at baseline; p = 0.031) animals. However, alpha-adrenoceptor stimulation did not elicit significantly augmented secretion of [H]. We demonstrate that beta-adrenoceptor blockade blocks completely the inhibition of mast cell secretion caused by sympathetic stimulation with DMPP. However, alpha-adrenoceptor stimulation does not cause significant augmentation of mast cell secretion in the large airways of the dog.     

The mechanism of vagal nerve stimulation of glucagon and insulin secretion in the dog

The mechanism of vagal nerve stimulation of glucagon (IRG) and insulin (IRI) secretion was investigated in halothane-anesthetized dogs. Both ventral and dorsal branches of the thoracic vagi were stimulated electrically (10 Hz, 5 msec, 13.5 mA, 10 min) below the heart. Arterial and superior pancreaticoduodenal venous plasma were sampled, superior pancreaticoduodenal venous plasma flow was measured, and net pancreatic output of IRG and IRI were calculated. During vagal nerve stimulation (n = 15) net pancreatic output of IRG doubled (delta = +0.83 +/- 0.28 ng/min, P less than 0.01; baseline = 0.81 +/- 0.15 ng/ min) and IRI quadrupled (delta = +3.5 +/- 1.5 mU/min, P less than 0.025; baseline = 1.1 +/- 0.3 mU/min). Arterial glucose levels increased by 7 +/- 2 mg/dl from 108 +/- 3 mg/dl (P less than 0.005). After atropine pretreatment (n = 7), the pancreatic IRI response to vagal nerve stimulation was +0.71 +/- 0.28 mU/min (P less than 0.025), a reduction of 80%. In contrast, atropine pretreatment changed neither the IRG response (delta = +0.87 +/- 0.36 ng/min; P less than 0.05) nor the arterial glucose response (delta = +9 +/- 3 mg/dl; P less than 0.025) to vagal nerve stimulation. Hexamethonium pretreatment (n = 9) abolished the pancreatic IRG response (delta = +0.13 +/- 0.11 ng/min; NS), the arterial glucose response (delta = +0.5 +/- 1.9 mg/dl; NS) and the pancreatic IRI response (delta = +0.16 +/- 0.31 mU/min; NS) to vagal nerve stimulation. It is concluded that vagal nerve stimulation in the dog produces a moderate increase of IRG secretion, mediated by a nonmuscarinic (peptidergic?) mechanism, and a marked increase of IRI secretion, mediated by a muscarinic mechanism. Both responses are dependent on nicotinic transmission.     

Activation of the parasympathetic nervous system is necessary for normal meal-induced insulin secretion in rhesus macaques

Meal-induced insulin secretion is thought to be regulated primarily by absorbed nutrients and incretin hormones released from the gastrointestinal tract. In addition, the parasympathetic nervous system (PNS) is known to mediate preabsorptive, or cephalic phase, insulin secretion. Despite evidence that the PNS remains activated during the absorptive phase of the meal, its role in mediating postprandial insulin secretion has not been established. To study the role of the PNS in absorptive phase insulin release, we measured plasma concentrations of glucose as well as islet hormones and incretins in six healthy rhesus monkeys before and for 60 min after meals while they were infused with saline (control), atropine (muscarinic blockade), or trimethaphan (nicotinic blockade). During the infusion of saline, plasma levels of glucose, pancreatic polypeptide (PP), insulin, glucose-dependent insulinotropic polypeptide, and glucagon-like peptide-1 increased promptly after meal ingestion and remained elevated throughout the 60 min of the study. The PP response was nearly abolished in animals treated with trimethaphan, indicating functional blockade of PNS input to the islet, and in contrast to the control study, there were minimal changes in plasma concentrations of glucose, incretin hormones, and insulin. Because trimethaphan inhibited glycemic and incretin stimuli in addition to blocking PNS input to the islet, it was not possible to discern the relative roles of these factors in the stimulation of insulin secretion. Atropine also significantly decreased PNS transmission to the islet, as reflected by PP levels similar to those observed with trimethaphan. Unlike the trimethaphan study, plasma glucose levels rose normally during atropine treatment and were similar to those in the control study over the course of the experiments (114 +/- 22 and 132 +/- 23 mmol/L.60 min, respectively). In addition, the rise in plasma glucagon-like peptide-1 following the meal was not suppressed by atropine, and the glucose-dependent insulinotropic polypeptide responses were only modestly decreased. Despite the significant increases in circulating glucose and incretins, plasma insulin levels were greatly attenuated by atropine, so that the 60 min responses were more comparable to those during trimethaphan treatment than to those in the control study (atropine, 3,576 +/- 1,284; trimethaphan, 4,128 +/- 2,616; control, 15,834 +/- 5,586 pmol/L.60 min; P: < 0.05). Thus, muscarinic blockade markedly suppressed the meal-induced insulin response despite normal postprandial glycemia and significant elevations of incretins. These results indicate that activation of the PNS during the absorptive phase of meals contributes significantly to the postprandial insulin secretory response.     

Altered adrenocorticotropin, corticosterone and oxytocin responses to stress during chronic salt load.

We have investigated the effects of stress on the plasma levels of adrenocorticotropin (ACTH), corticosterone and oxytocin (OT) in rats given 2% saline to drink for 12 days. Plasma ACTH levels were markedly decreased from 972 +/- 165 pg/ml in the control animals on water to 349 +/- 114 pg/ml in animals given 2% saline to drink. Stress-induced release of ACTH observed in animals on water (controls = 972 +/- 165 pg/ml and stressed animals = 1,439 +/- 105 pg/ml) was completely abolished following 2% saline treatment for 12 days (controls = 349 +/- 114 pg/ml and stressed animals = 205 +/- 27 pg/ml). After 2% saline, plasma corticosterone levels were unaltered in control and stressed animals as compared to control animals on water in which stress increased plasma corticosterone from 28.8 +/- 7.9 to 99.5 +/- 8 ng/ml. In contrast to ACTH, the OT response to stress was intact in animals on 2% saline despite raised plasma OT in the control group due to the osmotic stimulus. Removal of the source of circulating glucocorticoids by adrenalectomy partially restored both basal levels of ACTH and the response to stress in animals on 2% saline. Our results demonstrate that 2% saline treatment activates an inhibitory mechanism over the release of ACTH.     

Meal-induced pancreatic polypeptide release in a validated pancreatic denervation model: a role for the distal pancreas?

In previous studies, postprandial pancreatic polypeptide (PP) release was diminished when pancreatic denervation was combined with distal pancreatectomy in animals without chronic fistulae. In contrast, postprandial PP release was reported to be unchanged when the pancreas was denervated without performing a distal pancreatectomy. These findings were unexpected given that the distal pancreas is a PP-poor region. To clarify this issue, we performed extrinsic pancreatic denervation, distal pancreatectomy, and insertion of chronic pancreatic fistulae in nine mongrel dogs. Insulin (0.5 U/kg) and meal-stimulated PP release were measured pre- and postoperatively. In addition, insulin- and meal-induced exocrine secretion was measured postoperatively. Preoperatively, insulin-induced hypoglycemia stimulated significant PP release (80,553 +/- 18,540 pg/min/ml). This response was completely abolished postoperatively (-1,669 +/- 5,054 pg/min/ml). Exocrine secretion did not increase above basal levels after administration of insulin in postoperative animals. These findings suggest adequate pancreatic denervation. Ingestion of a meal evoked significant PP response preoperatively (97,909 +/- 18,394 pg/min/ml). Postoperatively, the response was significantly blunted (17,231 +/- 6,407 pg/min/ml). This finding is in contrast to a previous report using a similar experimental preparation without distal pancreatic resection. We speculate that although the distal pancreas is PP-poor, it may play a role in the regulation of PP release from the PP-rich pancreatic head.     

Opposing adrenergic actions of intravenous metformin on arterial pressure in female spontaneously hypertensive rats.

OBJECTIVE: Intravenous (i.v.) injection of the antidiabetic drug metformin rapidly lowers mean arterial pressure (MAP) in spontaneously hypertensive rats (SHR). However, if autonomic ganglia or alpha-adrenoceptors are first blocked then metformin rapidly raises MAP in SHR. This study was conducted to further characterize the adrenergic mechanisms of these opposing i.v. actions of the drug. METHODS: Conscious, undisturbed female SHR with indwelling vascular catheters were used to measure acute effects of i.v. metformin (100 mg/kg; before and after sustained ganglionic blockade, GB, with chlorisondamine, 5 mg/kg) on: (1) circulating levels of catecholamines, (2) MAP after pharmacologic modulation of beta- as well as alpha-adrenoceptors and (3) all the above in the absence as well as presence of the adrenal medulla. RESULTS: Plasma norepinephrine (NE) and epinephrine (E) levels (pg/ml) were rapidly increased by i.v. metformin (8 SHR, p < 0.05) both before GB (delta NE = +146 +/- 41; delta E = +119 +/- 31) and after GB (delta NE = +79 +/- 24; delta E = +120 +/- 32). Similar increases in plasma NE (though not E) were seen in SHR without adrenal medullae. Blockade of beta-adrenoceptors with propranolol (pro; 3 mg/kg, 8 SHR) enhanced the rapid depressor response to i.v. metformin before GB (delta MAP, mmHg: -38 +/- 4 with pro vs -17 +/- 3 without pro; p < 0.05) and attenuated the rapid pressor response to i.v. metformin after GB (delta MAP, mmHg: +8 +/- 3 with pro vs +30 +/- 4 without pro; p < 0.05). Results were similar in SHR without adrenal medullae. Finally, if baseline MAP under GB was raised back to hypertensive levels with i.v. infusion of either NE or phenylephrine then i.v. metformin did not raise but rather reduced MAP in SHR. CONCLUSION(S): The acute depressor action of i.v. metformin in female SHR (1) is most likely due to a direct vasodilator action which includes inhibition of alpha-receptor-mediated vasoconstriction and (2) is buffered by an acute beta-receptor-mediated pressor action likely due to a direct metformin-induced release of NE from postganglionic sympathetic nerve endings.     

Sodium salicylate augments the plasma adrenocorticotropin and cortisol responses to insulin hypoglycemia in man

To test the hypothesis that prostaglandins attenuate neuroendocrine responses to changes in circulating glucose levels in man, we studied the effects of sodium salicylate (SS), a prostaglandin synthesis inhibitor, on the plasma ACTH and cortisol responses to insulin hypoglycemia. Six normal men were given insulin (0.05 U/kg, iv) on 2 different days during the infusion of either SS (40 mg/min) or saline. Compared to the saline control, SS had no significant effect on either the rate of fall of plasma glucose after insulin or the glucose nadir (mean +/- SEM, 33 +/- 3 vs. 36 +/- 3 mg/dl; P = NS). Peak ACTH levels after insulin were higher during SS compared to those during saline in all six subjects (316 +/- 95 vs. 102 +/- 26 pg/ml; P less than 0.05), and SS had a clear effect to increase both the overall ACTH response (F = 21.3; P less than 0.01, by analysis of variance) and the plasma cortisol response (F = 6.72; P less than 0.05, by analysis of variance). The most striking example of this effect of SS occurred in one subject whose peak plasma ACTH was only 44 pg/ml during saline but reached 750 pg/ml during SS despite an identical fall of plasma glucose to 42 mg/dl. Augmentation of the ACTH and cortisol responses to insulin hypoglycemia may be the result of an alteration by SS of recognition of glucose levels by glucose-sensitive cells of the brain, and effect which could be due to the inhibition of prostaglandin synthesis.     

Cholinergic regulation of PP release is mediated through muscarinic M1-receptors

The effects of the selective muscarinic M1-receptor antagonist pirenzepine and the nonselective muscarinic antagonist atropine on bombesin- and peptone-stimulated release of pancreatic polypeptide (PP) were studied in healthy subjects. To exclude any effect of changes in intraduodenal pH continuous intragastric titration was performed during all tests. Both pirenzepine (i.v. bolus 0.6 mg/kg) and atropine (i.v. bolus 15 micrograms/kg, followed by an infusion of 5 micrograms/kg.h) significantly reduced peptone-induced integrated mean rise of plasma PP from 28 +/- 5 to 8 +/- 4 and -2 +/- 5 pmol/l, respectively (n = 4). Both drugs also reduced bombesin-induced rise of plasma PP in all 4 subjects, from 27 +/- 12 to 6 +/- 4 and 7 +/- 1 pmol/l (0.05 less than p less than 0.1). It is concluded that cholinergic regulation of PP release is mediated mainly through muscarinic M1-receptors.     

Effects of bucindolol on neurohormonal activation in congestive heart failure.

To examine the effects of beta-adrenergic blockade on neurohormonal activation in patients with congestive heart failure, 15 men had assessments of hemodynamics and supine peripheral renin and norepinephrine levels before and after 3 months of oral therapy with bucindolol, a nonselective beta antagonist. At baseline, plasma renin activity did not correlate with any hemodynamic parameter. However, norepinephrine levels had a weak correlation with left ventricular end-diastolic pressure (r = 0.74, p less than 0.01), stroke volume index (r = 0.61, p less than 0.02) and pulmonary vascular resistance (r = 0.54, p less than 0.05). Plasma renin decreased with bucindolol therapy, from 11.6 +/- 13.4 to 4.3 +/- 4.1 ng/ml/hour (mean +/- standard deviation; p less than 0.05), whereas plasma norepinephrine was unchanged, from 403 +/- 231 to 408 +/- 217 pg/ml. A wide diversity of the norepinephrine response to bucindolol was observed with reduction of levels in some patients and elevation in others. Although plasma norepinephrine did not decrease, heart rate tended to decrease (from 82 +/- 20 vs 73 +/- 11 min-1, p = 0.059) with beta-adrenergic blockade, suggesting neurohormonal antagonism at the receptor level. No changes in I-123 metaiodobenzylguanidine uptake occurred after bucindolol therapy, suggesting unchanged adrenergic uptake of norepinephrine with beta-blocker therapy. Despite reductions in plasma renin activity and the presence of beta blockade, the response of renin or norepinephrine levels to long-term bucindolol therapy did not predict which patients had improved in hemodynamic status (chi-square = 0.37 for renin, 0.82 for norepinephrine).(ABSTRACT TRUNCATED AT 250 WORDS)     

Overexpression of vasopressin in the rat transgenic for the metallothionein-vasopressin fusion gene

Arginine vasopressin (AVP) is a major antidiuretic hormone, the overproduction of which causes diluting hyponatremia in humans and is called the syndrome of inappropriate antidiuresis (SIAD). To study physiological changes resulting from AVP overproduction and to develop an animal model of hyponatremia, the human AVP gene was expressed under the control of the metallothionein promoter in transgenic (Tg) rats. Analyses of AVP immunoreactivity (irAVP) in the tissues revealed that the transgene is expressed mainly in the central nervous system. Gel filtration showed that irAVP in the brain and plasma was properly processed AVP. AVP purified from the brains of both Tg and control rats also exerted equal bioactivity to generate cAMP in LLC-PK1 cells. The founder rats did not show any physical or anatomical abnormalities. Under basal conditions, Tg rats had high plasma AVP levels (Tg 13.8 +/- 2.5 pg/ml; control 2.7 +/- 1.2 pg/ml; n=6 in both groups; means +/- S.E.M.), decreased urine volume, and normal plasma [Na(+)]. Hypertonic saline injected i.p. did not affect AVP secretion in Tg rats. In response to a zinc-supplemented liquid diet, plasma AVP decreased in control rats, but increased in Tg rats (Tg 32.7 +/- 2.7 pg/ml; control 1.0+/-0.1 pg/ml; n=6), resulting in hyponatremia (Tg 135.2 +/- 2.5 mEq/l; control 140.8 +/- 0.4 mEq/l; n=6). To our knowledge, this is the first transgenic animal to show diluting hyponatremia. This transgenic rat may therefore provide a useful model in which to investigate various physiological alterations resulting from the oversecretion of AVP which involve SIAD, stress response, behavior, and blood pressure.     

Evidence for cholinergic modulation of aldosterone secretion in man

Acetylcholine stimulates aldosterone secretion in bovine glomerulosa cells in vitro via specific cholinergic receptors. In this study we examined the effect of peripheral muscarinic blockade with atropine on metoclopramide-, angiotensin-II-, and ACTH-stimulated aldosterone secretion in man. Atropine (0.6 mg, iv) administered 10 min before MCP delayed the onset of the plasma aldosterone response and attenuated the mean peak response from 502 +/- 103 (+/- SE) to 322 +/- 72 pmol/L (P less than 0.05) without affecting zero time mean plasma aldosterone levels (144 +/- 28 vs. 136 +/- 36 pmol/L for control and atropine, respectively). This inhibitory effect was not mediated by changes in PRA or plasma potassium or ACTH (as reflected by cortisol) concentrations. Atropine also attenuated the plasma aldosterone response to a low dose angiotensin II infusion (2 ng/kg.min; control, 449 +/- 99 pmol/L; atropine, 297 +/- 78 pmol/L; P less than 0.05). In contrast, atropine had no effect on the plasma aldosterone response to a bolus dose (250 micrograms) of ACTH. Neither atropine (0.6 mg, iv) nor the cholinergic muscarinic agonist bethanechol (5 mg, sc) alone elicited a change in plasma aldosterone. Collectively, these data provide evidence for cholinergic modulation of aldosterone secretion in man. We conclude that cholinergic mechanisms may facilitate the aldosterone responses to angiotensin-II and metoclopramide, but not to ACTH.     

Carotid sinus hypersensitivity: evaluation of the vasodepressor component

The basis of the vasodepressor response in patients with carotid sinus hypersensitivity (CSH) is unknown, and prevention of recurrent vasodepressor-induced hypotension in these patients has not been possible. In this study we assessed the effectiveness of atrioventricular sequential pacing and pharmacologic interventions in the prevention of carotid sinus massage (CSM)-induced vasodepressor responses in eight patients with CSH. Maintenance of constant heart rate (80 beats/min) and atrioventricular synchrony (atrioventricular interval 150 msec) with sequential pacing did not significantly alter mean CSM-induced fall in systolic pressure (CSM control, -60 +/- 12 mm Hg vs CSM with atrioventricular sequential pacing, -48 +/- 19 mm Hg). Similarly, neither pharmacologic muscarinic blockade nor combined muscarinic and beta-adrenergic blockade significantly attenuated CSM-induced fall in systolic pressure (CSM with atropine, -43 +/- 16 mm Hg; CSM with atropine plus propranolol, -47 +/- 18 mm Hg; both p = NS vs atrioventricular sequential pacing alone). On the other hand, intravenous norepinephrine and oral ephedrine blunted the CSM-induced drop in systolic pressure (CSM with norepinephrine, -19 +/- 12 mm Hg; CSM with ephedrine, -21 +/- 11 mm Hg; both p less than .01 vs atrioventricular sequential pacing alone). Thus, vasodepressor responses were not prevented by control of heart rate, maintenance of atrioventricular synchrony, pharmacologic muscarinic blockade, or combined muscarinic and beta-adrenergic blockade, but were attenuated by drugs believed to be predominantly alpha-adrenergic agonists. Consequently, atrioventricular sequential pacing alone may be inadequate to prevent hypotension in patients with pronounced vasodepressor responses, whereas administration of vasoconstrictors such as ephedrine may diminish symptoms.     

Reversal of defective glucagon responses to hypoglycemia in insulin-dependent autoimmune diabetic BB rats

The intraislet insulin hypothesis has been proposed to explain absent glucagon responses to hypoglycemia. Recently we directly confirmed this hypothesis by restoring glucagon secretion via provision of a pancreatic artery insulin infusion, which was switched off at the time of hypoglycemia in Wistar rats made diabetic by streptozotocin. The current study examined this hypothesis in a model of spontaneous, autoimmune diabetes, the insulin-dependent diabetic BB rat. The insulin switch-off signal restored the defective glucagon responses to hypoglycemia. However, the magnitude of the restored response was markedly less than that observed in control nondiabetic BB rats (4- to 5-month-old diabetic BB rats = 147 +/- 27; 2-month-old nondiabetic BB rats = 1038 +/- 112 pg/ml, peak delta; P < 0.0001). Because time was required for the BB rat to spontaneously develop diabetes, we asked whether the incomplete restoration of the glucagon response might be related to the animals' growth and development. This led us to compare the glucagon response to hypoglycemia in nondiabetic BB and Wistar rats at 2 and 4-5 months of age. We observed age-related deterioration of not only glucose tolerance and insulin sensitivity but also glucagon responses to hypoglycemia in both strains. There was no significant difference between the glucagon responses to hypoglycemia in age-matched nondiabetic BB rats and diabetic BB rats provided with the insulin switch-off signal. We conclude that defective glucagon responses to hypoglycemia in BB rats can be corrected by restoring regulation of alpha-cell function by insulin.     

Influence of gastric acid on circulating somatostatin-14 and -28 released after insulin-induced hypoglycemia in conscious dogs.

Insulin hypoglycemia is a potent mechanism for somatostatin secretion into the circulation. Whether the associated increase in gastric acid mediates the rise of one or both principle molecular forms of somatostatin, somatostatin-14 (S-14) and somatostatin-28 (S-28), was examined in four conscious dogs. Somatostatin molecular forms were separated by gel filtration chromatography after extraction of acidified plasma on octadecyl silyl cartridges and quantified by RIA. Basal plasma levels of S-14 and S-28 were 3.4 +/- 0.2 and 4.1 +/- 0.6 fmol/ml, respectively. After hypoglycemia induced by insulin, plasma S-14 increased by 29.5 +/- 3.9 fmol/ml (P less than 0.001), and plasma S-28 increased by 7.2 +/- 0.9 fmol/ml (P less than 0.01). Suppression of hypoglycemia-mediated gastric acid secretion after the administration of omeprazole or ranitidine inhibited elevations of S-14 by 82 +/- 6% (P less than 0.001) and 81 +/- 7% (P less than 0.001), respectively, but had no effect on the rise of S-28. Atropine (50 micrograms/kg, iv), which also suppresses gastric acid secretion after insulin hypoglycemia, decreased S-14 by 59 +/- 3% (P less than 0.01) without influencing S-28. Atropine given after omeprazole treatment, however, increased S-14 levels observed after atropine (P less than 0.001) or omeprazole (P less than 0.001) alone and was equivalent to control levels. S-28 remained unaltered after atropine and omeprazole treatment. These results in conscious dogs indicate that after vagal stimulation induced by insulin hypoglycemia 1) both S-14 and S-28 are released into the circulation, but S-14 predominates; 2) gastric acid contributes directly to the stimulation of S-14, but not S-28, secretion; 3) muscarinic inhibitory mechanisms participate in the regulation of S-14 secretion, and this mechanism is amplified when vagally stimulated gastric acid secretion is suppressed; and 4) nonmuscarinic mechanisms mediate in part S-28 secretion. This study suggests the presence of a reciprocal functional relationship between gastric acid secretion and circulating S-14 that is mediated by vagal muscarinic mechanisms.