Relaxation Patterns of Human Gastric Corporal Smooth Muscle by Cyclic Nucleotides Producing Agents

Abstract

To elucidate the mechanism of cyclic nucleotides, such as adenosine 3',5'-cyclic monophosphate (cAMP) and guanosine 3',5' -cyclic monophosphate (cGMP), in the regulation of human gastric motility, we examined the effects of forskolin (FSK), isoproterenol (ISO) and sodium nitroprusside (SNP) on the spontaneous, high K⁺ and acetylcholine (ACh)-induced contractions of corporal circular smooth muscle in human stomach. Gastric circular smooth muscle showed regular spontaneous contraction, and FSK, ISO and SNP inhibited its phasic contraction and basal tone in a concentration-dependent manner. High K⁺ (50 mM) produced sustained tonic contraction, and ACh (10 µM) produced initial transient contraction followed by later sustained tonic contraction with superimposed phasic contractions. FSK, ISO and SNP inhibited high K⁺-induced tonic contraction and also ACh-induced phasic and tonic contraction in a reversible manner. Nifedipine (1 µM), inhibitor of voltage-dependent L-type calcium current (VDCC_L), almost abolished ACh-induced phasic contractions. These findings suggest that FSK, ISO and SNP, which are known cyclic nucleotide stimulators, inhibit smooth muscle contraction in human stomach partly via inhibition of VDCC_L.

INTRODUCTION

Spontaneous rhythmical activity of gastrointesinal (GI) smooth muscle is originated from interstitial cells of Cajal (ICC_MY) in myenteric region of GI tract, and regulates GI motility via spreading its pacemaker potential to smooth muscle (Huizinga et al., 1995; Sanders, 1996). In general, GI motility is regulated by various intrinsic and/or extrinsic factors of neurohormones. Among these factors, muscarinic cholinergic contraction and β-adrenergic relaxation as well as production of nitric oxide (NO) are well known (Schultz et al., 1977; Ozaki et al., 1992; Jin et al., 1993; Smith et al., 1993; Severi et al., 2006). Isoproterenol (ISO) and nitric oxide (NO) produce membrane hyperpolarization, decrease slow wave, and then inhibit contraction via activation of adenylate and guanylate cyclase in GI tract (Ozaki et al., 1992; Jin et al., 1993; Smith et al., 1993; Severi et al., 2006). Especially, NO is recognized as a neurotransmitter of non-adrenergic non-cholinergic (NANC) nerves in the myenteric plexus throughout the GI tract and is responsible for gastric receptive relaxation (Ozaki et al., 1992; Jin et al., 1993; Smith et al., 1993; Tonini et al., 2000). In addition, sodium nitroprusside (SNP), known NO-releasing compound, is reported to stimulate guanylate cyclase and then increase intracellular guanosine 3',5'-cyclic monophosphate (cGMP) levels, while forskolin (FSK) to stimulate adenylate cyclase and then adenosine 3',5'-cyclic monophosphate (cAMP) levels in many smooth muscles, including GI tract (Katsuki et al., 1977; Huizinga et al., 1991; Ozaki et al., 1992; Jin et al., 1993; Smith et al., 1993; Severi et al., 2006). Therefore, the resultant activation of cAMP-dependent protein kinase A (PKA) and cGMP-dependent protein kinase G (PKG) seems to be linked to the inhibitory effects of FSK, ISO and SNP (Schultz et al., 1977; Jin et al., 1993; Smith et al., 1993).

The mechanisms of inhibition of gastric contraction by stimulators of cyclic nucleotides are still under investigations. Hyperpolarization, activation of small and middle conductance Ca²⁺ activated K⁺ (K_Ca) channel, activation of spontaneous transient outward current (STOCs), inhibition of voltage-dependent L-type calcium current (VDCC_L), and activation of Ca²⁺/calmodulin-dependent protein kinase II (CaMKII) have been suggested to be involved in the inhibition mechanism of cAMP and cGMP (Koh and Sanders, 1996; Geeson et al., 2002; Yu et al., 2003; Zhu et al., 2005; Kim and Perrino, 2007). Therefore, Ca²⁺ regulation of cAMP- and cGMP-dependent pathways seems to be important in smooth muscle motility. Recently, VDCC_L has been described even in human staomach and seems to play an essential role in the regulation of intracellular Ca²⁺ ([Ca²⁺]_i) (Katzka and Morad, 1989; Koh and Sanders, 1996; Kim et al., 1997; Kim et al., 2000; Zhu et al., 2005). However, there are some controversies on the inhibition pathways of smooth muscle motility through the regulation of VDCC_L and cyclic nucleotides. Hot issues to be considered are: 1) whether the effect is to increase or decrease VDCC_L, and 2) whether there are interactions between cAMP- and cGMP-dependent pathways (Ohya et al., 1987; Ishikawa et al., 1993; Koh and Sanders, 1996; Ruiz-Velasco et al., 1998; Zhu et al., 2005).

To date, the effect of cAMP and/or cGMP which is associated with regulation of VDCC_L has not yet been evaluated in human gastric smooth muscle. Therefore, we investigated the effects of cAMP and cGMP on human gastric smooth muscle, focusing on the regulation mechanism of VDCC_L.

METHODS

Tissue preparation

Strips were isolated from the muscle of corpus of human gastric tissues which were obtained from 13 gastric cancer patients. This experimental protocol using human stomach was approved by the Institutional Review Board for Clinical Research of Chungbuk National University College of Medicine, Korea. Specimens were removed from macroscopically normal tissue, immediately after surgical operation far from neoplastic area. The mucosal layers in Krebs-Ringer bicarbonate (KRB) solution were removed by scissors. For the measurement of mechanical contractions, muscle strips (0.5×2 cm, 0.5 cm thickness) from the corpus tissue with circular direction were prepared. In this process, a pathologist identified each muscle layers including circular smooth muscles, from human tissue using HE staining, and we also checked these muscles by dissecting under microscope. For the measurement of mechanical contractions, circular muscle strip from the human stomach was mounted to vertical (25 ml and 75 ml) chambers in isometric contractile measuring system. In this system, one end of tissue was tied tightly to fixed holder, and the other side was connected by hook type of holder to force transducer (Harvard, USA). Force transducer was connected to PowerLab-Data Acquisition System and Charter v5.5 software (ADinstruments, Colorado, USA) with IBM compatible computer for measuring isometric contraction. Each strip was stretched passively to resting tension after 1.5~2 hours of equilibration. Then, contractile responses of the strip to high K⁺ (50 mM) were repeated two or three times until the responses were reproducible before main experiment.

Solution and drugs

KRB solution (CO₂/bicarbonate-buffered Tyrode) contained (in mM): NaCl 122, KCl 4.7, MgCl₂ 1, CaCl₂ 2, NaHCO₃ 15, KH₂PO₄ 0.93, and glucose 11 (pH 7.3~7.4, bubbled with 5% CO₂/95% O₂). Equimolar concentration of Na⁺ was replaced by K⁺ for making high K⁺ (50 mM) solution. The external solution was changed by solutions which had previously been incubated (bubbled with 5% CO₂/95% O₂, 36℃) in water bath before the application. All drugs used in this study were purchased from Sigma.

Statistics

The data are expressed as means±SEM. Statistical significance was estimated by Student's t-test. p<0.05 was considered to be statistically significant.

RESULTS

Isometric contraction of human gastric smooth muscle

Isometric contractile response of human gastric corporal circular smooth muscle was studied. Human stomach showed spontaneous contraction of 0.3±0.07 g with a frequency of 4.2±0.32 cycles/min (n=13, respectively; Fig. 1A). As shown in Fig. 2, high K⁺ (50 mM) reversibly produced tonic contraction. High K⁺ (50 mM) produced phasic and sustained tonic contraction of 5.3±1.54 g and 5.5±1.95 g, respectively (n=7 and 11, respectively; Fig. 1B). Application of ACh (10 µM) also produced initial transient contraction and then phasic and sustained tonic contractions of 4.5±1.16 g, 0.7±0.22 g and 1.6±0.34 g, respectively (n=11, 9 and 11, respectively; Fig. 1C). The inhibitory effect of nifedipine (1 µM), which is known to inhibit voltage-dependent L-type calcium current (VDCC_L) on ACh-induced phasic contraction, was also studied. Nifedipine (1 µM) inhibited ACh-induced phasic contraction to 1.7±1.71% of the control (n=4, p<0.05). Post-application of 1 and 2 µM nifedipine inhibited phasic contractions from 1.2±0.45 g to 0.03±0.03 g and 0.05±0.03 g, respectively (n=6, 4 and 6, respectively; data not shown). ACh-induced sustained tonic contraction was decreased by nifedipine, however, not completely blocked. Nifedipine (1 and 2 µM) inhibited ACh-induced tonic contraction to 54.5±11.32% and 57.7±11.72% of the control (n=4, respectively; p<0.05; data not shown).

Fig. 1.

Characterization of gastric corporal circular muscle motility in human. (A) Human gastric smooth muscle shows regular contraction with 0.3 g and 4.2 cycles/min (n=13). (B, C) High K⁺ and ACh produce tonic and phasic contraction in human stomach (n=7~11).

Fig. 2.

Inhibitory effect of forskolin (FSK), isoproterenol (ISO) and sodium nitroprusside (SNP) on spontaneous contraction of human stomach. (A) SNP (3 and 5 µM) inhibited spontaneous contraction and decreased basal tone of human stomach. FSK also inhibited spontaneous contraction and the inhibitory effects of FSK and SNP are summarized in (B). Inhibitory effect of ISO on spontaneous contraction of human stomach is also summarized in (C). Asterisks show a statistical significance (p<0.05).

Effect of forskolin (FSK), isoproterenol (ISO) and sodium nitroprusside (SNP) on spontaneous contraction of human gastric corporal circular smooth muscle

As shown in Fig. 2, FSK, ISO and SNP produced relaxation of human stomach in a reversible manner. The spontaneous contractions were inhibited to 40.9±12.87% and 26.1±11.98% of the control at 3 and 5 µM FSK, respectively (n=7 and 6, respectively; p<0.05; Fig. 2B),while basal tone was decreased by 5.0±0.14 g and 0.8±0.26 g, respectively (n=7 and 6, respectively; p<0.05; data not shown). Even though data not shown, 0.1 and 10 µM FSK inhibited spontaneous contraction to 88.5±1.30% and 0% of the control, respectively (n=3 and 2, respectively; p<0.05), while basal tone was decreased by 0.2±0.07 g and 0.32±0.01 g, respectively (n=3 and 2, respectively; p<0.05; data not shown). As shown in Fig. 2C, ISO also inhibited gastric contraction: 2, 6 and 10 µM ISO inhibited spontaneous contractions to 37.0±5.36%, 32.7±4.83% and 24.6±3.44% of the control (n=8, 7 and 3, respectively; p<0.05; Fig. 2C), while basal tone was decreased by 0.4±0.08 g, 0.6±0.12 g and 0.6±0.4 g, respectively (n=8, 7 and 3, respectively; p<0.05; data not shown). In two cases, 0.5 µM ISO also inhibited spontaneous contraction and basal tone to 43.6±4.01% of the control and by 0.3±0.19 g, respectively (data not shown). SNP (3 and 5 µM) also inhibited spontaneous contractions to 47.9±10.42% and 47.0±11.33% of the control respectively (n=8 and 3, respectively; p<0.05; Fig. 2A and B) and basal tone was decreased by 0.7±0.16 g and 1.1±0.24 g, respectively (n=8 and 3, respectively; p<0.05; data not shown). SNP (0.1 µM) also inhibited spontaneous contraction and basal tone to 82.2±8.93% of the control and by 0.1±0.01 g, respectively (n=2; data not shown).

Effect of FSK and SNP on high K⁺ (50 mM)-induced contraction in human stomach

As shown in Fig. 3, FSK, ISO and SNP inhibited high K⁺ (50 mM)-induced contraction in human stomach. In general, high K⁺ (50 mM) produced initial peak, followed by sustained tonic contraction of 5.3±1.54 g and 5.5±1.95 g (n=7 and 11, respectively). FSK (3, 5 and 10 µM) inhibited high K⁺ (50 mM)-induced contraction to 52.8±10.97%, 51.2±15.30% and 23.2±15.65% of the control, respectively (n=3, 4 and 4, respectively; Fig. 3A and 3C). SNP (3, 5 and 10 µM) inhibited high K⁺ (50 mM)-induced contraction to 64.5±11.72%, 54.4±7.28% and 45.7±9.04% of the control, respectively (n=4, 5 and 4, respectively; Fig. 3B and 3D). As shown in Fig 3E, 1, 2, 6 and 10 µM ISO also inhibited high K⁺ (50 mM)-induced contraction to 72.9±8.76%, 79.6±8.40%, 68.5±9.06% and 80.7±9.76% of the control, respectively (n=3, 5, 3 and 4, respectively; p<0.05).

Fig. 3.

Effect of FSK, ISO and SNP on high K⁺-induced contraction in human stomach. (A) High K⁺ (50 mM) produced tonic contraction in human stomach, and it was inhibited by 3, 5 and 10 µM FSK to 53%, 51% and 23% of the control, respectively (n=3~4). (B) 3, 5 and 10 µM SNP inhibited high K⁺ (50 mM)-induced contraction to 65%, 54% and 46% of the control, respectively (n=4~5). Inhibitory effects of FSK, SNP and ISO on high K⁺ (50 mM)-induced contraction of human stomach are summarized in (C~E). Asterisks show a statistical significance (p<0.05).

Effect of FSK and SNP on acethylcholine (ACh)-induced contraction in human stomach

FSK, ISO and SNP inhibited ACh-induced contraction in a concentration-dependent manner. ACh-induced phasic contraction was inhibited to 58.3±11.46%, 44.7±1.00% and 0% of the control at 3, 5 and 10 µM of FSK, respectively (n=3, respectively; p<0.05; Fig. 4A and 4B). Furthermore, ACh-induced sustained tonic contraction was inhibited to 46.2±14.25%, 19.2±13.84% and 11.3±13.66% of the control at 3, 5 and 10 µM of FSK (n=5, 5 and 4, respectively; p<0.05; Fig. 4A and 4B). ISO and SNP also inhibited ACh-induced phasic contraction: 2, 6 and 10 µM ISO inhibited ACh-induced phasic contraction to 41.5±13.81%, 45.2±10.09% and 42.3±11.96% of the control, respectively (n=5, 4 and 4, respectively; p<0.05; Fig. 4C). In the case of ACh-induced sustained tonic contraction, 2, 6 and 10 µM ISO inhibited the contraction to 49.4±11.20%, 40.3±13.77% and 55.9±7.70% of the control (n=5, 4 and 4, respectively; p<0.05; Fig 4C). Meanwhile, SNP (3 µM) significantly inhibited ACh-induced phasic contraction to 11.3±8.25% and -0.5±0.09 g, respectively (n=6; p<0.05; Fig. 4D). In the absence of SNP, ACh-induced phasic and tonic contraction were 0.8±0.32 g and 0.4±0.15 g (n=6, respectively). Post-application of SNP inhibited phasic and tonic contraction to 0.03±0.02 g and -0.5±0.09 g, respectively (n=6; p<0.05; Fig. 4D).

Fig. 4.

Effects of FSK, ISO and SNP on acethylcholine (ACh)-induced contraction in human stomach. FSK, ISO and SNP inhibited ACh-induced contraction in a concentration-dependent manner. (A) FSK (3, 5 and 10 µM) inhibited ACh-induced phasic and tonic contraction (n=3~5). Inhibitory effect of FSK on ACh-induced contraction is summarized in (B). Similar inhibitory effect on ACh-induced contraction by both SNP and ISO was observed, as shown in (C) and (D). Asterisks show a statistical significance (p<0.05).

DISCUSSION

In the present study, we found that FSK, ISO and SNP, known to increase cyclic nucleotides (cAMP and cGMP), inhibited spontaneous contraction of the corporal circular smooth muscle in human stomach. In addition, FSK, ISO and SNP inhibited high K⁺- and ACh-induced contraction which has been shown to be activated by Ca²⁺ influx through VDCC_L. These findings suggest that FSK-, ISO- and SNP-induced inhibition of human stomach smooth muscle contractions is associated partly with the inhibition of VDCC_L. To our best knowledge, this study is the first report to show that inhibition of VDCC_L is responsible for FSK-, ISO- and SNP-induced inhibition of human gastric smooth muscle contractions.

Most mechanical and electrical properties in human GI tract have been investigated using electrogastrograph (EGG) and ultrasonography (Hocke et al., 2009; Matsumoto et al., 2009), although several in vitro GI motility studies have been reported (Tonini et al., 2000; Farrelly et al., 2003; Severi et al., 2006; Wang et al., 2007). In this in vitro study, we first characterized mechanical properties. As shown in Fig. 1A and 1B, isolated circular muscle contracted rhythmically, and sustained tonic contraction was induced by high K⁺ (50 mM) (Ozaki et al., 1992). Furthermore, 10 µM ACh also induced initial transient contraction, followed by sustained tonic contraction later with superimposed phasic contractions (Fig. 1C) (Sato et al., 1994). Phasic component was blocked by 1 µM nifedipine (data not shown), however, ACh-induced sustained tonic contraction was partially inhibited: 55% and 58% of the control by 1 and 2 µM nifedipine, respectively.

Many studies have suggested ISO and vasoactive intestinal peptide (VIP) as mediators of relaxation in several types of smooth muscle (Schultz et al., 1977; Jin et al., 1993; Smith et al., 1993; Severi et al., 2006). β-Adrenergic nerve and VIP containing neurons in myenteric plexus, which project to the smooth muscle layers, have been reported to exist in the gut, and their stimulation inhibits slow wave and contraction via increasing cAMP and/or cGMP (Andersson and Nilsson, 1972; Jin et al., 1993; Smith et al., 1993). Furthermore, FSK and SNP, cyclic nucleotide (cAMP and cGMP) activators, have also been shown to inhibit electrical and contractile activity of GI smooth muscle (Huizinga et al., 1991; Ozaki et al., 1992; Jin et al., 1993; Smith et al., 1993; Kim et al., 2006; Severi et al., 2006). In the present study, we found the inhibitory effect of ISO in human stomach: ISO inhibited spontaneous contraction and basal tone in a reversible manner (Fig. 2C). Even if data not shown, 2 and 6 µM ISO inhibited the frequency of contraction, however, it was not significant (n=7 and 6, respectively; p>0.05). FSK (3 and 5 µM) and SNP (3 and 5 µM) also inhibited the frequency of contraction (n=6, 5, 8 and 3, respectively; p>0.05). And ISO significantly inhibited high K⁺-induced contraction and ACh-induced phasic contraction (Fig. 3E and 4C, respectively). It is generally known that increased cAMP and cGMP by FSK and SNP produced relaxation via activation of PKA and PKG in smooth muscle, respectively (Schultz et al., 1977; Jin et al., 1993; Smith et al., 1993). As shown in Fig. 2A and 2B, FSK and SNP inhibited spontaneous contraction of human gastric corporal smooth muscle in a reversible manner: FSK (3 and 5 µM) inhibited spontaneous contraction to 41% and 26% of the control, respectively (Fig. 2B), while decreasing basal tone by 0.5 g and 0.8 g, respectively. Meanwhile, SNP (3 and 5 µM) also inhibited spontaneous contraction to 48% and 47% of the control (Fig. 2B), while decreasing basal tone by 0.7 g and 1.1 g, respectively. Since these stimulators are known to inhibit slow wave and produce hyperpolarization, then suppressing contraction, it inhibits phasic contraction and basal tone in GI tract (Andersson and Nilsson, 1972; Jin et al., 1993; Smith et al., 1993). These findings imply that cyclic nucleotide activators such as FSK and SNP play an inhibitory role for basal tone as well as spontaneous contraction in human stomach (Huizinga et al., 1991; Ozaki et al., 1992; Jin et al., 1993; Smith et al., 1993; Kim et al., 2006; Kim and Perrino, 2007).

To date, several mechanisms have been suggested to explain cAMP and/or cGMP-induced relaxation of smooth muscles. For the cAMP-induced relaxation: 1) decrease of Ca²⁺ influx (Bulbring and Tomita, 1980; Ozaki et al., 1992; Smith et al., 1993; Koh and Sanders, 1996; Zhu et al., 2005), and 2) regulation of sarcoplasmic reticulum (SR) Ca²⁺ uptake and Ca²⁺ extrusion (Casteels and Raeymakers, 1979; Meisheri and van Breemen, 1982; Nishimura and van Breemen, 1989). For the cGMP-mediated relaxation: 1) decrease of Ca²⁺ influx (Ozaki et al., 1992; Quignard et al., 1997; Ruiz-Velasco et al., 1998; Geeson et al., 2002; Zhu et al., 2005), 2) increase of sarcoplasmic reticulum (SR) Ca²⁺ uptake, 3) involvement of protein kinase (Kim et al., 2006; Kim and Perrino, 2007), and 4) increase of calcium activated K⁺ current (IK_Ca) (Yu et al., 1993; Geeson et al., 2002; Kim et al., 2006). Therefore, the inhibitory effect of cAMP and/or cGMP on smooth muscle motility seems to be associated with regulation of Ca²⁺ homeostasis. In general, phasic contraction of GI tract produces peristaltic contraction of stomach which is responsible for gastric function such as gastric emptying (Kelly and Code, 1971). Since slow wave from ICC_MY activates VDCC_L and generates phasic contraction of smooth muscle, the investigation of VDCC_L regulation pathway appears to be basic for understanding gastric functions (Kelly and Code, 1971). VDCC_L has recently been described in GI smooth muscles (Katzka and Morad, 1989; Zhu et al., 2005), and seems to play an essential role in the regulation of intracellular Ca²⁺ ([Ca²⁺]_i) (Kim et al., 1997).

At present, regulation mechanism of VDCC_L by cAMP and/or cGMP in GI smooth muscle seems complicated. In canine colon, cGMP pathway inhibited VDCC_L, whereas cAMP at low concentration increased VDCC_L and decreased VDCC_L at high concentration. Thus, 'cross-activation of kinase hypothesis' was proposed, by which cAMP affects also cGMP-dependent pathway (Koh and Sanders, 1996; Ruiz-Velasco et al., 1998). In fact, it was reported that cAMP and cGMP were activated by VIP, and that cAMP increasd VDCC_L in vascular smooth muscle (Ishikawa et al., 1993; Taguchi et al., 1997). Recently, however, separate cAMP-PKA- and cGMP-PKG-dependent VDCC_L inhibition pathways have been reported (Ohya et al., 1987; Muraki et al., 1993; Zhu et al., 2005), whereas dehydropyridine-sensitive VDCC_L has already been isolated in human gastric smooth muscle cells in 2000 (Kim et al., 2000). Neveetheless, the relationship between VDCC_L and cAMP/cGMP in human stomach has not yet been evaluated. In the present study, therefore, we studied the effects of cAMP and/or cGMP on human gastric motility, based on the regulation mechanism of VDCC_L (Fig. 3). However, we did not study the direct effect of cAMP and/or cGMP on VDCC_L in human stomach in this study. Therefore, we plan to elucidate this mechanism in future.

In the present study, the relationship between FSK-, ISO- and SNP-induced relaxation and inhibition of Ca²⁺ influx was studied by high K⁺- and ACh-induced contractions. FSK (Fig. 3A and 3C), SNP and ISO (Fig. 3B, 3D and 3E) significantly inhibited high K⁺ (50 mM)-induced contraction. Since high K⁺ produces contraction through membrane depolarization which is ascribed to the activation of VDCC_L, the inhibition of VDCC_L seems to be one of the plausible mechanism to explain relaxation by FSK, SNP and ISO in human gastric corporal smooth muscle. In GI smooth muscle, VDCC_L is known to be linked to ACh-induced phasic contraction, and ACh is known also to regulate Ca²⁺ current in GI smooth muscle (Sato et al., 1994). As shown in Fig. 1C, ACh produced typical contraction patterns, which were composed of initial transient contraction, followed by sustained tonic contraction later with superimposed phasic contractions. Nifedipine (1 µM) inhibited ACh-induced phasic contraction to 1.7% of the control (data not shown), implying that the activation of Ca²⁺ influx via VDCC_L during muscarinic stimulation is responsible for ACh-induced phasic contraction in human stomach (Sato et al., 1994). As shown in Fig. 4, FSK, SNP and ISO inhibited ACh-induced phasic contraction. These findings strongly suggest that the inhibition of Ca²⁺ influx via VDCC_L by FSK, ISO and SNP might be one of the important regulation mechanisms of human gastric motility.

In summary, our present results indicated that FSK, ISO and SNP, which are known as cyclic nucleotide activators, have an inhibitory effect on human gastric corporal smooth muscle contractility through inhibiting VDCC_L.

ABBREVIATIONS

cAMP

3',5'-cyclic monophosphate

cGMP

guanosine 3',5'-cyclic monophosphate

FSK

forskolin

ISO

isoproterenol

SNP

sodium nitroprusside

ACh

acetylcholine

VDCC_L

voltage-dependent L-type calcium current

GI tract

gastrointestinal tract

ICC_MY

interstitial Cells of Cajal in myenteric region

NO

nitric oxide

NANC

non-adrenergic non-cholinergic

PKA

protein kinase A

PKG

protein kinase G

K_Ca channel

Ca²⁺ activated K⁺ channel

STOC

spontaneous transient outward current

CaMKII

Ca²⁺/calmodulin-dependent protein kinase II

[Ca²⁺]_i

intracellular Ca²⁺

KRB

Krebs-Ringer bicarbonate

EGG

electrogastrograph

VIP

vasoactive intestinal peptide

SR

sarcoplasmic reticulum

IK_Ca

calcium activated K⁺ current