Involvement of nitric oxide in the reflex relaxation of the stomach to accommodate food or fluid

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Abstract
THE fundus of the guinea-pig stomach actively dilates in response to low increases in intragastric pressure 1. This physiological response, now called adaptive relaxation 2,3, accommodates the intake of liquid or food. It is independent of external innervation, resistant to ganglion blockade, but reflex in origin. The nerves involved are neither adrenergic nor cholinergic in nature. Non-adrenergic, non-cholinergic (NANC) nerves have now been recognized in many parts of the gastrointestinal tract 4 and have recently been linked with release of nitric oxide (NO) on electrical stimulation 5-7. Here we show that adaptive relaxation in isolated stomach of the guinea pig is mediated by a NANC neurotransmitter substance indistinguishable from NO derived from L-arginine 8. This is substantiated by inhibition of adaptive relaxation by N(G)-monomethyl-L-arginine or N-omega-nitro-L-arginine methyl ester, both inhibitors of NO synthesis 9,10, and by methylene blue, an inhibitor of soluble guanylate cyclase 11. There are two distinct neuronal pathways signalling NO-dependent adaptive relaxation, as evidenced by tetrodotoxin sensitivity. The first is a local reflex arc, the afferent fibres of which sense changes in intragastric pressure. The second is stimulated by an agonist for ganglionic nicotinic receptors. Thus, the functional significance of NO release from NANC nerves in the stomach is to bring about adaptive relaxation through a reflex response to increases in intragastric pressure.

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