Role of plasma vasopressin as a mediator of nausea and gastric slow wave dysrhythmias in motion sickness

1997 ◽  
Vol 272 (4) ◽  
pp. G853-G862 ◽  
Author(s):  
M. S. Kim ◽  
W. D. Chey ◽  
C. Owyang ◽  
W. L. Hasler

The possible role of vasopressin in nausea and gastric dysrhythmias in motion sickness was tested by electrogastrography in 14 subjects during circular vection (60 degrees/s) and vasopressin infusion. Tachygastria was expressed as the signal percent >4.5 cycles/min. Vection evoked nausea scores of 2.6 +/- 0.2 (0 = none to 3 = severe) in 10 subjects with increases in tachygastric activity (15 +/- 2 to 45 +/- 3%) and plasma vasopressin (4.5 +/- 1.5 to 8.4 +/- 2.5 pg/ml) that were blocked by atropine but not indomethacin. Four asymptomatic subjects had no tachygastria or vasopressin release. Vasopressin at 0.2 U/min (plasma level = 322.1 +/- 10.3 pg/ml) evoked nausea (2.6 +/- 0.4) and increases in tachyarrhythmic activity (41 +/- 5%) that were blunted by atropine but not indomethacin. There were no differences in nausea or dysrhythmias with vasopressin infusion in subjects who noted nausea during vection versus those who did not. To conclude, vection evokes nausea, dysrhythmias, and vasopressin release in motion sickness-susceptible humans via cholinergic prostaglandin-independent pathways. Supraphysiological vasopressin infusions evoke nausea and dysrhythmias by similar pathways to equal degrees in motion sickness-susceptible and -resistant subjects. Thus central but not peripheral actions of vasopressin may contribute to nausea and slow wave disruption with vection. Blunting of both the release and action of vasopressin by atropine may explain its beneficial action in motion sickness.

2003 ◽  
Vol 284 (3) ◽  
pp. G481-G489 ◽  
Author(s):  
Han-Chung Lien ◽  
Wei Ming Sun ◽  
Yen-Hsueh Chen ◽  
Hyerang Kim ◽  
William Hasler ◽  
...  

Ginger has long been used as an alternative medication to prevent motion sickness. The mechanism of its action, however, is unknown. We hypothesize that ginger ameliorates the nausea associated with motion sickness by preventing the development of gastric dysrhythmias and the elevation of plasma vasopressin. Thirteen volunteers with a history of motion sickness underwent circular vection, during which nausea (scored 0–3, i.e., none to severe), electrogastrographic recordings, and plasma vasopressin levels were assessed with or without ginger pretreatment in a crossover-design, double-blind, randomized placebo-controlled study. Circular vection induced a maximal nausea score of 2.5 ± 0.2 and increased tachygastric activity and plasma vasopressin. Pretreatment with ginger (1,000 and 2,000 mg) reduced the nausea, tachygastria, and plasma vasopressin. Ginger also prolonged the latency before nausea onset and shortened the recovery time after vection cessation. Intravenous vasopressin infusion at 0.1 and 0.2 U/min induced nausea and increased bradygastric activity; ginger pretreatment (2,000 mg) affected neither. Ginger effectively reduces nausea, tachygastric activity, and vasopressin release induced by circular vection. In this manner, ginger may act as a novel agent in the prevention and treatment of motion sickness.


1995 ◽  
Vol 268 (4) ◽  
pp. G539-G547 ◽  
Author(s):  
W. L. Hasler ◽  
M. S. Kim ◽  
W. D. Chey ◽  
V. Stevenson ◽  
B. Stein ◽  
...  

Motion sickness is associated with gastric slow wave disruption. Animal models of slow wave disturbances show dependence on neural and prostaglandin pathways. Roles of these pathways in circular vection-evoked gastric dysrhythmias and nausea were tested. Eight volunteers with histories of motion sickness underwent vection (60 degrees/s), during which nausea (0 = none to 3 = severe) and electrogastrographic parameters were assessed. Tachygastric activity was expressed as the signal percentage at frequencies of > 4.5 cycles/min. Circular vection induced a maximal nausea score of 2.8 +/- 0 at 513 +/- 66 s. Tachygastric activity increased from 18 +/- 2 to 37 +/- 4% (P < 0.05) and peaked before maximal nausea. Atropine reduced nausea scores to 0 +/- 0 (P < 0.01) with no increase in tachygastric activity (14 +/- 6%). In contrast, the peripheral muscarinic antagonist methscopolamine did not reduce tachygastric activity (46 +/- 4%), nausea (1.8 +/- 0.5), or time to maximal tachygastric activity (504 +/- 80 s) with vection. Phentolamine reduced nausea (1.5 +/- 0.3, P < 0.01) and tachygastric activity, and delayed their onset, whereas propranolol and naloxone had no effect. Pretreatment with oral indomethacin (50 mg) three times daily for 3 days had no effect on vection-evoked tachygastric activity or nausea. To conclude, circular vection evokes gastric dysrhythmias that correlate temporally with maximal nausea and are suppressed by atropine, but not methscopolamine, and are reduced by phentolamine. In contrast to other models of slow wave disruption, endogenous prostaglandins play no role. Thus central cholinergic pathways mediate vection-evoked dysrhythmias with additional modulation by alpha-adrenergic pathways.


1994 ◽  
Vol 267 (4) ◽  
pp. R923-R928 ◽  
Author(s):  
M. Ota ◽  
J. T. Crofton ◽  
H. Liu ◽  
G. Festavan ◽  
L. Share

It has been demonstrated that the neurohypophysial hormones can be released intrahypothalamically by the paraventricular (PVN) and supraoptic nuclei. The present experiments were undertaken to determine whether a physiological stimulus for vasopressin release, increased plasma osmolality, will stimulate the release of vasopressin by the PVN into the surrounding interstitial fluid, and whether the responses are affected by gender. Intravenous infusion of 2.5 M NaCl for 60 min (0.1 ml.kg-1.min-1) in conscious rats resulted in an increased vasopressin concentration in the dialysate from a microdialysis probe adjacent to the PVN. This response was greater in nonestrous females than in males. On the other hand, the rise in the plasma vasopressin concentration was greater in males than in nonestrous females. Mean arterial blood pressure increased and heart rate decreased, but these responses were not affected by gender. The role of centrally released vasopressin in the control of the peripheral release of vasopressin is conjectural, but both responses may be modulated by the gonadal steroid hormones.


1993 ◽  
Vol 265 (4) ◽  
pp. E578-E584 ◽  
Author(s):  
L. H. Xu ◽  
K. L. Koch ◽  
J. Summy-Long ◽  
R. M. Stern ◽  
J. F. Seaton ◽  
...  

The physiology of nausea, a uniquely human symptom, is poorly understood. The purpose of this study was to measure the temporal sequences of neurohormonal responses and gastric myoelectrical activity in healthy subjects during the rotation of an optokinetic drum that produced nausea and other symptoms of motion sickness. Plasma catecholamines, vasopressin, and cortisol were measured at baseline, during minutes 1-5, 6-10, and 11-15 of drum rotation, and after rotation stopped. Electrogastrograms were recorded throughout the study. Twelve subjects (80%) developed nausea and 4-9 cycles/min of gastric tachyarrhythmias; three subjects had no nausea and no gastric dysrhythmias. Tachyarrhythmias began 3.4 +/- 0.8 min after the onset of drum rotation, and nausea was reported, on average, 3 min later. During minutes 6-10 of drum rotation, vasopressin levels significantly increased in the subjects with nausea compared with subjects without nausea (P < 0.04). In the subjects with nausea, epinephrine and vasopressin increased significantly (P < 0.05) compared with baseline during minutes 6-10 and 11-15 of drum rotation. As nausea resolved during recovery, vasopressin decreased by 74%, whereas epinephrine increased 13%. We conclude that 1) in nauseated subjects, endogenous vasopressinergic and sympathetic circuits are activated before hypothalamic-pituitary-adrenal pathways, 2) plasma vasopressin levels correlate most closely with the temporal onset and resolution of nausea, and 3) peripheral gastric dysrhythmias may have a role in activating central vasopressinergic neurons.


2002 ◽  
Vol 283 (1) ◽  
pp. G8-G15 ◽  
Author(s):  
Chung Owyang ◽  
William L. Hasler

This review describes recent advances in our knowledge about the pathogenesis and therapeutic approaches to human gastric dysrhythmias. A number of clinical conditions has been found to be associated with gastric slow-wave rhythm disturbances that may relate to the induction of nausea and vomiting. Human and animal studies indicate that multiple neurohumoral factors are involved in the generation of gastric dysrhythmias. Antral distension and increased intestinal delivery of lipids may cause slow-wave disruption and development of nausea. This may be mediated by cholinergic and serotonergic pathways. Similarly, progesterone and estrogen may also disrupt gastric slow-wave rhythm in susceptible individuals. Prostaglandin overproduction in gastric smooth muscle appears to mediate slow-wave disruption in diabetes and with tobacco smoking. On the other hand, central cholinergic pathways play an important role in the genesis of gastric dysrhythmias associated with motion sickness. This may be mediated by vasopressin released from the pituitary. Although it is difficult to ascribe with certainty a causative role of slow-wave rhythm disturbances in the genesis of nausea and vomiting, the search has begun for novel antiemetic therapies based on their abilities to ablate or prevent gastric dysrhythmia formation. This includes the use of prostaglandin synthesis inhibitors, central muscarinic receptor antagonists, and dopamine receptor antagonists. Finally direct gastric electrical stimulation using a surgically implanted neurostimulator has shown promise in reducing emesis in patients with gastroparesis and gastric dysrhythmias.


1996 ◽  
Vol 270 (3) ◽  
pp. G506-G514 ◽  
Author(s):  
J. W. Walsh ◽  
W. L. Hasler ◽  
C. E. Nugent ◽  
C. Owyang

Women in pregnancy experience nausea, which correlates with gastric slow-wave rhythm disruption. Mediators of these dysrhythmias were explored. To quantitate slow-wave disruption, eight pregnant women with first-trimester nausea underwent electrogastrography after a 250-kcal meal. Results were compared with nonpregnant women with nausea during a prior pregnancy who received estradiol and/or progesterone to levels of the first trimester of pregnancy. Five pregnant women exhibited dysrhythmias, with increases in combined recording time in tachygastria plus bradygastria, as well as decreases in the percentage of electrogastrography signal power in the normal 3 cycle/min range (cpm), compared with nonpregnant women (P<0.05). Estradiol did not evoke dysrhythmias in nonpregnant women; however, progesterone induced increases in recording time in bradygastria plus tachygastria and increases in bradygastric signal power with corresponding decreases in signal power in the 3-cpm range (P<0.05). With estradiol and progesterone coadministration, an additive effect was observed at 3.3 +/- 0.8 h, with increased recording time in bradygastria alone and in bradygastria plus tachygastria with corresponding increases in bradygastric signal power and decreases in power in the 3-cpm range (P<0.05). In conclusion, women with nausea of pregnancy exhibit slow-wave rhythm disruption. Similar dysrhythmias are evoked in nonpregnant women by progesterone alone or in combination with estradiol in doses that reproduce levels in pregnancy. Thus gastric dysrhythmias in pregnancy may be due to a combination of elevated progesterone and estrogen levels.


2010 ◽  
Vol 299 (1) ◽  
pp. R298-R305 ◽  
Author(s):  
Hanaa S. Sallam ◽  
Hermes M. Oliveira ◽  
Suhuan Liu ◽  
Jiande D. Z. Chen

Delayed gastric emptying is common following severe large cutaneous burns; however, the mechanisms of burn-induced delayed gastric emptying remain unknown. The aim of this study was to explore the possible involvement of hyperglycemia and cyclooxygenase-2 receptors in the burn-induced gastric dysrhythmias. Gastric slow waves and gastric emptying were assessed in rats 6 h following sham or burn injury. Animals were randomized to one sham-burn and seven burn groups: untreated; two groups of saline treated (control); insulin treated (5 IU/kg); cyclooxygenase-2 inhibitor treated (10 mg/kg); ghrelin treated (2 nmol/rat); and gastric electrical stimulation treated. It was found that 1) severe burn injury impaired gastric slow waves postprandially and delayed gastric emptying; 2) the impairment in gastric slow waves included a decrease in the slow-wave frequency and in the percentage of normal slow waves, and an increase in the percentage of bradygastria ( P = 0.001, 0.01, and 0.01, respectively vs. preburn values). None of the gastric slow-wave parameters was significantly correlated with gastric emptying; 3) cyclooxygenase-2 inhibitor normalized burn-induced delayed gastric emptying ( P = 0.3 vs. sham-burn), but not gastric dysrhythmias ( P < 0.002 vs. sham), whereas insulin normalized both gastric emptying ( P = 0.4 vs. sham-burn) and gastric dysrhythmias ( P = 0.3 vs. sham-burn); 4) both gastric electrical stimulation and ghrelin accelerated burn-induced delayed gastric emptying ( P = 0.002 and 0.04, respectively, vs. untreated burn). In conclusion, hyperglycemia alters gastric slow-wave activity and delayed gastric emptying, while cyclooxygenase-2 inhibition delays gastric emptying without altering gastric slow-wave activity.


1985 ◽  
Vol 249 (3) ◽  
pp. R313-R316
Author(s):  
L. Share ◽  
J. T. Crofton ◽  
D. P. Brooks ◽  
C. M. Chesney

Dog platelets contain a substance immunologically similar to arginine vasopressin. In conscious and anesthetized dogs under basal conditions, platelet immunoreactive vasopressin accounts for approximately 40% of the total circulating immunoreactive vasopressin. When the plasma vasopressin concentration in the anesthetized dog was lowered 75% by intravenous infusion of isotonic dextrose solution for 2 h, the platelets failed to discharge a significant quantity of immunoreactive vasopressin. Subsequently, when the plasma vasopressin concentration was elevated to a level 10-fold greater than the initial levels by intravenous infusion of arginine vasopressin, there was no statistically significant increase in the estimated platelet vasopressin content measured 1 and 2 h after the start of the infusion, although there was the suggestion that the platelets had indeed taken up some vasopressin after 2 h of vasopressin infusion. Thus immunoreactive vasopressin in dog platelets does not appear to exchange readily with plasma vasopressin. The physiological role of platelet immunoreactive vasopressin remains to be determined.


2000 ◽  
Vol 118 (4) ◽  
pp. A851
Author(s):  
Zhishun Wang ◽  
Liwei Qian ◽  
Tatsuyuki Ueno ◽  
Hui Ouyang ◽  
Jiande Chen

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