Molecular mechanisms underlying guanylin-induced transcellular Cl- secretion into the intestinal lumen of seawater-acclimated eels.

Guanylin (GN) stimulates Cl- secretion into the intestinal lumen of seawater-acclimated eels, but the molecular mechanisms of transepithelial Cl- transport are still unknown. In Ussing chamber experiments, we confirmed that mucosal application of eel GN reversed intestinal serosa-negative potential difference, indicating Cl- secretion. Serosal application of DNDS or mucosal application of DPC inhibited the GN effect, but serosal application of bumetanide had no effect. Removal of HCO3- from the serosal fluid also inhibited the GN effect. In intestinal sac experiments, mucosal GN stimulated luminal secretion of both Cl- and Na+, which was blocked by serosal DNDS. These results suggest that Cl- is taken up at the serosal side by DNDS-sensitive anion exchanger (AE) coupled with Na+-HCO3- cotransporter (NBC) but not by Na+-K+-2Cl- cotransporter 1 (NKCC1), and Cl- is secreted by unknown DPC-sensitive Cl- channel (ClC) at the mucosal side. The transcriptomic analysis combined with qPCR showed low expression of NKCC1 gene and no upregulation of the gene after seawater transfer, while high expression of ClC2 gene and upregulation after seawater transfer. In addition, SO42- transporters (apical Slc26a3/6 and basolateral Slc26a1) are also candidates for transcellular Cl- secretion in exchange of luminal SO42. Na+ secretion could occur through a paracellular route, as Na+-leaky claudin15 was highly expressed and upregulated after seawater transfer. High local Na+ concentration in the lateral interspace produced by Na+/K+-ATPase (NKA) coupled with K+ channels (Kir5.1b) seems to facilitate the paracellular transport. In situ hybridization confirmed the expression of the candidate genes in the epithelial enterocytes. Together with our previous results, we suggest that GN stimulates basolateral NBCela/AE2 and apical ClC2 to increase transcellular Cl- secretion in seawater eel intestine, which differs from the involvement of apical CFTR and basolateral NKCC1 as suggested in mammals and other teleosts.

Robot-assisted extraperitoneal para-aortic lymphadenectomy (RAePAL) performed with the bipolar cutting method.

OBJECTIVE: In comparison with laparoscopic transperitoneal para-aortic lymphadenectomy, the advantages of laparoscopic extraperitoneal para-aortic lymphadenectomy (ePAL) are that the operative field is not obstructed by bowel and the Trendelenburg position is not required [1]. The ePAL technique has been adopted to the robotic surgery with the da Vinci Xi. There are only a few reports demonstrating the technical feasibility of robot-assisted ePAL (RAePAL) [2 3]. This report describes the new surgical technique of RAePAL with the bipolar cutting method. METHODS: The patient was a 53-year-old woman diagnosed as ovarian clear cell carcinoma (CCC) after left salpingo-oophorectomy. As the re-staging surgery, robot-assisted right salpingo-oophorectomy, hysterectomy, omentectomy, and pelvic lymphadenectomy were planned following ePAL. The patient was placed in the supine position and tilted 5 degrees to the right. Three da Vinci arms were docked at the patient's left side (Fig. 1). The bipolar cutting method was performed by with the surgeon's right hand. An AirSeal® port (ConMed, Utica, NY, USA) was placed on the side near the assistant. After the para-aortic space was expanded, lymphadenectomy was performed up to the renal veins with the bipolar cutting method. RESULTS: The PAL operative time was 155 minutes, estimated blood loss was 25 mL. The patient developed no perioperative complications, and the postoperative diagnosis was stage IC1 ovarian CCC with no pelvic (n=0/42) and para-aortic lymph nodes (n=0/59) metastasis. CONCLUSION: RAePAL with the bipolar cutting method was technically feasible. Performing lymphadenectomy between the aorta and the vena cava was facilitated by the articulated robotic arm.

Molecular mechanisms for intestinal HCO3- secretion and its regulation by guanylin in seawater-acclimated eels.

The intestine of marine teleosts secretes HCO3- into the lumen and precipitates Ca2+ and Mg2+ in the imbibed seawater as carbonates to decrease luminal fluid osmolality and facilitate water absorption. However, the hormonal regulation of HCO3- secretion is largely unknown. Here, mucosally added guanylin (GN) increased HCO3- secretion, measured by pH-stat, across isolated seawater-acclimated eel intestine bathed in saline at pH 7.4 (5% CO2). The effect of GN on HCO3- secretion was slower than that on the short-circuit current, and the time course of the GN effect was similar to that of bumetanide. Mucosal bumetanide and serosal 4,4'-dinitrostilbene-2,2'-disulfonic acid (DNDS) inhibited the GN effect, suggesting an involvement of apical Na+-K+-2Cl- cotransporter (NKCC2) and basolateral Cl-/HCO3- exchanger (AE)/Na+-HCO3- cotransporter (NBC) in the GN effect. As mucosal DNDS failed to inhibit the GN effect, apical DNDS-sensitive AE may not be involved. To identify molecular species of transporters involved in the GN effect, we performed RNA-seq analyses followed by quantitative real-time PCR after transfer of eels to seawater. Among the genes upregulated after seawater transfer, AE genes (draa, b, and pat1a, c) on the apical membrane, and NBC genes (nbce1a, n1, n2a) and an AE gene (sat-1) on the basolateral membrane were candidates involved in HCO3- secretion. Judging from the slow effect of GN, we suggest that GN inhibits NKCC2b on the apical membrane and decreases cytosolic Cl- and Na+, which then activates apical DNDS-insensitive DRAs and basolateral DNDS-sensitive NBCs to enhance transcellular HCO3- flux across the intestinal epithelia of seawater-acclimated eels.

Guanylin activates Cl(-) secretion into the lumen of seawater eel intestine via apical Cl(-) channel under simulated in vivo conditions.

Guanylin (GN) action on seawater eel intestine was examined under simulated in vivo conditions, where isotonic luminal fluid has low NaCl and high MgSO4 (MgSO4 Ringer). In Ussing chamber, MgSO4 Ringer induced serosa-negative potential difference (PD) even after bumetanide treatment, which is due to the higher paracellular Na(+) permeability over Cl(-), as confirmed by the replacement by MgCl2 (no Cl(-) gradient) or Na2SO4 Ringer (no Na(+) gradient). Luminal GN reversed serosa-negative PD, probably by enhancing Cl(-) secretion into the lumen, as the GN effect was blocked by apical Cl(-) channel blockers [diphenylamine-2-carboxylic acid (DPC), 5-nitro-2-(3-phenylpropylamino) benzoic acid, glibenclamide but not cystic fibrosis transmembrane regulator (CFTR)inh-172] or replacement of luminal fluid by MgCl2 Ringer. The blockers' effect was undetectable when normal Ringer was on both sides. In the sac preparation, NaCl secretion occurred into the lumen (Na(+) > Cl(-)), and GN further enhanced Cl(-) secretion (Cl(-) > Na(+)), resulting in water secretion. These GN effects were also blocked by DPC. Quantitative analyses showed that isotonic NaCl is absorbed when luminal fluid is normal Ringer, but, when luminal fluid is MgSO4 Ringer, hypertonic NaCl, almost equivalent to seawater, is secreted into the lumen after GN. These results indicate that GN stimulates the secretion of hypertonic NaCl into the lumen of seawater eel intestine, like rectal gland of marine elasmobranchs, to get rid of excess NaCl although marine teleost intestine is thought to have only absorptive-type cells with a unique Na-K-Cl cotransport system. The secreted NaCl may activate the cotransport system and further help absorb water in the final segment of seawater eel intestine.

Mechanisms of guanylin action on water and ion absorption at different regions of seawater eel intestine.

Guanylin (GN) inhibited water absorption and short-circuit current (Isc) in seawater eel intestine. Similar inhibition was observed after bumetanide, and the effect of bumetanide was abolished by GN or vice versa, suggesting that both act on the same target, Na(+)-K(+)-2Cl(-) cotransporter (NKCC), which is a key player for the Na(+)-K(+)-Cl(-) transport system responsible for water absorption in marine teleost intestine. However, effect of GN was always greater than that of bumetanide: 10% greater in middle intestine (MI) and 40% in posterior intestine (PI) for Isc, and 25% greater in MI and 34% in PI for water absorption. After treatment with GN, Isc decreased to zero, but 20-30% water absorption still remained. The remainder may be due to the Cl(-)/HCO3 (-) exchanger and Na(+)-Cl(-) cotransporter (NCC), since inhibitors for these transporters almost nullified the remaining water absorption. Quantitative PCR analysis revealed the presence of major proteins involved in water absorption; the NKCC2ß and AQP1 genes whose expression was markedly upregulated after seawater acclimation. The SLC26A6 (anion exchanger) and NCCß genes were also expressed in small amounts. Consistent with the inhibitors' effect, expression of NKCC2ß was MI > PI, and that of NCCß was MI << PI. The present study showed that GN not only inhibits the bumetanide-sensitive Na(+)-K(+)-Cl(-) transport system governed by NKCC2ß, but also regulates unknown ion transporters different from GN-insensitive SLC26A6 and NCC. A candidate is cystic fibrosis transmembrane conductance regulator Cl(-) channel, as demonstrated in mammals, but its expression is low in eel intestine, and its role may be minor, as indicated by the small effect of its inhibitors.

A vagal nerve branch controls swallowing directly in the seawater eel.

By developing a new in vivo method to evaluate the esophageal closure, which reflects inhibition of swallowing, we demonstrate that the vagal X1 branch projected from the glossopharyngeal-vagal motor complex (GVC) controls the upper esophageal sphincter (UES) muscle directly. Although eel vagal nerve consisted of five branches, other branches (X2, X3, X4 and X5) did not influence the esophageal pressure. When the X1 nerve branch was stimulated electrically, the balloon pressure in the UES area increased with optimum frequency of 20 Hz. Since similar optimum frequency was observed both in the pithed eel and in the isolated UES preparation, such characteristic of X1 nerve is not due to anesthetic used during experiment. As the isolated UES preparation consists of muscle cells and nerve terminals, and as the optimum frequency of the nerve terminal is identical with that of the X1 branch, it is most likely that the X1 nerve branch is identical with the nerve terminals within the UES preparation. On the other hand, since the GVC neurons fire spontaneously at around 20 Hz, the optimum frequency of 20 Hz means that the eel UES is usually closed vigorously and relaxed only when the GVC neuron is inactivated. The effect of X1 stimulation was inhibited by curare, but not by atropine, indicating that the X1 nerve branch releases acetylcholine, which acts on the nicotinic receptor on the UES striated muscle. Beside vagal nerve X1 branch, spinal nerve SN2, SN3 and SN4 also contributed to the UES closure, but SN1 did not influence the UES movement. However, since the efficacy of these spinal nerve stimulations is about 1/10 of that by vagal X1 branch, the eel UES may be controlled primarily by a vagal nerve X1 branch, and secondarily by spinal nerves (SN2, SN3 and SN4).

Hormonal control of drinking behavior in teleost fishes; insights from studies using eels.

Marine teleost fishes drink environmental seawater to compensate for osmotic water loss, and the amount of water intake is precisely regulated to prevent dehydration or hypernatremia. Unlike terrestrial animals in which thirst motivates a series of drinking behaviors, aquatic fishes can drink environmental water by reflex swallowing without searching for water. Hormones are key effectors for the regulation of drinking. In particular, angiotensin II and atrial natriuretic peptide are likely candidates for physiological regulators because of their potent dipsogenic and antidipsogenic activities, respectively. In the eel, these hormones act on the area postrema in the medulla oblongata, a circumventricular structure without blood-brain barrier, which then regulates the activity of the glossopharyngeal-vagal motor complex. These motor neurons in the hindbrain innervate the upper esophageal sphincter muscle and other swallowing-related muscles in the pharynx and esophagus for regulation of drinking. Thus, the neural circuitry for drinking in fishes appears to be confined within the hindbrain. This simple mechanism is much different from that of terrestrial animals in which thirst sensation is induced through hormonal actions on the subfornical organ and organum vasculosum of the lamina terminalis that are located in the forebrain. It seems that the neural and hormonal mechanism that regulates drinking behavior has evolved from fishes depending on the availability of water in their natural habitats.

Central regulation of the pharyngeal and upper esophageal reflexes during swallowing in the Japanese eel.

We investigated the regulation of the pharyngeal and upper esophageal reflexes during swallowing in eel. By retrograde tracing from the muscles, the motoneurons of the upper esophageal sphincter (UES) were located caudally within the mid-region of the glossopharyngeal-vagal motor complex (mGVC). In contrast, the motoneurons innervating the pharyngeal wall were localized medially within mGVC. Sensory pharyngeal fibers in the vagal nerve terminated in the caudal region of the viscerosensory column (cVSC). Using the isolated brain, we recorded 51 spontaneously active neurons within mGVC. These neurons could be divided into rhythmically (n = 8) and continuously (n = 43) firing units. The rhythmically firing neurons seemed to be restricted medially, whereas the continuously firing neurons were found caudally within mGVC. The rhythmically firing neurons were activated by the stimulation of the cVSC. In contrast, the stimulation of the cVSC inhibited firing of most, but not all the continuously firing neurons. The inhibitory effect was blocked by prazosin in 17 out of 38 neurons. Yohimbine also blocked the cVSC-induced inhibition in five of prazosin-sensitive neurons. We suggest that the neurons in cVSC inhibit the continuously firing motoneurons to relax the UES and stimulate the rhythmically firing neurons to constrict the pharynx simultaneously.

Post- and pre-synaptic action of isotocin in the upper esophageal sphincter muscle of the eel: its role in water drinking.

Isotocin is a fish analogue of the mammalian hormone oxytocin. To elucidate sites of action of isotocin (IT) in the upper esophageal sphincter (UES) muscle, a key muscle in swallowing, IT was applied after treatment with tetrodotoxin (TTX). Even after blocking nerve activity with TTX, IT relaxes the UES muscle in a concentration-dependent manner, suggesting that IT receptor(s) is present on the muscle cells. Similar relaxation was also obtained by application of 3-isobutyl-1-methylxanthine (IBMX), forskolin (FSK) and 8-bromo-adenosine, 3',5'-cyclic monophosphate (8BrcAMP) after pretreatment with TTX, suggesting that the relaxing effect (postsynaptic action) of IT may be mediated by cAMP. In contrast to such relaxing effect, IT enhanced the UES contraction induced by repetitive electrical field stimulation (EFS). Such enhancement was blocked by an IT receptor antagonist, suggesting that this effect is also mediated by IT receptor(s). Similar enhancement was also induced by IBMX, FSK and 8BrcAMP, suggesting the enhancing effect is also mediated by cAMP. However, no enhancing effect of IT was observed when the muscle was stimulated by carbachol, or after treatment with curare or TTX, denying the postsynaptic modulatory action of IT and suggesting presynaptic action for IT, i.e., accelerating acetylcholine release. Summarizing these results, role of IT in precisely regulating the drinking rate in the seawater eel is discussed.

Antagonistic effects of vasotocin and isotocin on the upper esophageal sphincter muscle of the eel acclimated to seawater.

The effects of isotocin (IT) and vasotocin (VT), which are fish analogues of mammalian oxytocin and vasopressin respectively, were examined in the isolated upper esophageal sphincter (UES) muscle. IT relaxed and VT constricted the UES muscle in a concentration-dependent manner. The relaxation by IT and the contraction by VT were completely blocked by H-9405 (an oxytocin receptor antagonist) and by H-5350 (a V(1)-receptor antagonist), respectively, suggesting that the eel UES possesses both IT and VT receptors. Truncated fragments of VT did not show any significant effects, indicating that all nine residues are essential for the VT and IT actions. IT may relax the UES muscle through enhancing cAMP production, since similar relaxation was also observed after treatment with 3-isobutyl-1-methylxantine, forskolin and 8-bromoadenosine, 3', 5'-cyclic mono-phosphate (8BrcAMP). Although 8-bromoguanosine, 3', 5'-cyclic monophosphate also relaxed the UES, its effect was less than 1/3 of that 8BrcAMP, suggesting minor contribution of nitric oxide (NO) in the relaxation of the UES muscle. Both peptides seem to act directly on the UES muscle, not through release of other substances from the epithelial cells, since similar relaxation and contraction were observed even in the scraped UES preparations. When IT and VT were intravenously administrated (in vivo experiments), the drinking rate of the seawater eel was enhanced by IT and was inhibited by VT. These effects correspond to the in vitro results described above, relaxation by IT and contraction by VT in the UES muscle. The significance of the relaxing effect by IT is discussed with respect to controlling the drinking behavior of the eel.

Catecholamines inhibit neuronal activity in the glossopharyngeal-vagal motor complex of the Japanese eel: significance for controlling swallowing water.

To clarify neuronal networks controlling swallowing water, inhibitory neurotransmitters were searched on the glossopharyngeal-vagal motor complex (GVC) of the medulla oblongata (MO), which is proposed as a motor nucleus controlling swallowing. Spontaneous firing (20-30 Hz) in the GVC was inhibited by adrenaline (AD), noradrenaline (NA) and dopamine (DA). The inhibitory effects of these catecholamines (CAs) were dose-dependent, and the effects of AD and NA were completely blocked by phenoxybenzamine or yohimbine, indicating that at least these two CAs act on the same receptor, presumably on alpha(2)-adrenoceptor. Even after blocking the alpha(2)-adrenoceptor with yohimbine, the inhibitory effect of DA still remained, indicating separate action of DA from AD or NA. Although DA receptor type was not determined in the present study, these results suggest existence of CA receptors in the GVC neurons. Almost 70% GVC neurons were inhibited by CAs. The CA-sensitive neurons were specifically restricted in the middle part of the GVC area. There were many tyrosine hydroxylase (TH)-immunoreactive somata and fibers in the eel MO. Among these TH-immunoreactive nuclei, the area postrema (AP) and the commissural nucleus of Cajal (NCC) appeared to project to the GVC morphologically. Significance of the catecholaminergic inhibition in the GVC activity is discussed in relation to controlling swallowing water.

"Blood-contacting neurons" in the brain of the Japanese eel Anguilla japonica.

To discriminate "blood-contacting neurons" within the brain of the eel, Evans blue (EB) was injected intraperitoneally. After five days, six brain areas were externally stained blue with the dye; the saccus dorsalis (SD), the epiphysis (E), the area postrema (AP), the posterior part of the magnocellular preoptic nucleus (PM), the pituitary (Pit), and the saccus vasculosus (SV). Among the EB-positive area, some cells in the PM, the anterior tuberal nucleus (NAT) and the AP were discriminated as the "blood-contacting neurons" histologically, whereas EB-positive neurons were not detected in the SD, the E, the Pit and the SV regions. In the PM, most EB-positive neurons (90 %) were immunoreactive to vasotocin (AVT) antibody, indicating that these neurons are vasotocinergic. The remaining EB-positive neurons (10 %) were not immunoreactive to ANG II and tyrosine hydroxylase (TH) antibodies. Although some neurons in the PM were immunoreactive to ANG II antibody, they were EB-negative. In contrast, almost all EB-positive neurons in the AP showed TH-like immunoreactivity (-lir), indicating that these neurons utilize catecholamine(s) as a neurotransmitter. The EB-positive neurons in the NAT were not immunoreactive to AVT, ANG II and TH antibodies, whereas some neurons without EB-staining showed ANG II-lir. Possible roles of these neurons in regulating drinking behavior in eels are discussed.

Water metabolism in the eel acclimated to sea water: from mouth to intestine.

Eels seem to be a suitable model system for analysing regulatory mechanisms of drinking behavior in vertebrates, since most dipsogens and antidipsogens in mammals influence the drinking rate in the seawater eels similarly. The drinking behavior in fishes consists of swallowing alone, since they live in water and water is constantly held in the mouth for respiration. Therefore, contraction of the upper esophageal sphincter (UES) muscle limits the drinking rate in fishes. The UES of the eel was innervated by the glossopharyngeal-vagal motor complex (GVC) in the medulla oblongata (MO). The GVC neurons were immunoreactive to an antibody raised against choline acetyltransferase (ChAT), an acetylcholine (ACh) synthesizing enzyme, indicating that the eel UES muscle is controlled cholinergically by the GVC. The neuronal activity of the GVC was inhibited by adrenaline or dopamine, suggesting catecholaminergic innervation to the GVC. The AP and the commissural nucleus of Cajal (NCC) in the MO projected to the GVC and were immunoreactive to an antibody raised against tyrosine hydroxylase (TH), rate limiting enzyme to produce catecholamines from tyrosine. Therefore, it is likely that activation in the AP or the NCC may inhibit the GVC and thus relaxes the UES muscle, which allows for water to enter into the esophagus. During passing through the esophagus, the imbibed sea water (SW) was desalted to approximately 1/2 SW, which was further diluted in the stomach and arrived at the intestine as approximately 1/3 SW, almost isotonic to the plasma. Finally, from the diluted SW, the eel intestine absorbed water following the Na(+)-K(+)-2Cl(-) cotransport (NKCC2) system. The NaCl and water absorption across the intestine was regulated by various factors, especially by peptides such as atrial natriuretic peptide (ANP) and somatostatin (SS-25 II). During desalination in the esophagus, however, excess salt enters into the blood circulation, which is liable to raise the plasma osmolarity. However, the eel heart was constricted powerfully by the hyperosmolarity, suggesting that the hyperosmolarity enhances the stroke volume to the gill, where excess salt was extruded powerfully via Na(+)-K(+)-2Cl(-) cotransport (NKCC1) system.

Central effects of various ligands on drinking behavior in eels acclimated to seawater.

Intracranial injection of eel angiotensin II (eANG II, 5x10(-13)-5x10(-8) mol), acetylcholine (ACh, 5x10(-12)-5x10(-9) mol), substance P (5x10(-10) mol) and isoproterenol (a beta-adrenoceptor agonist, 5x10(-11)-5x10(-9) mol) enhanced water intake in the seawater eel. The effects of eANG II, ACh and isoproterenol were dose-dependent. By contrast, water intake was inhibited by intracranial injection of eel atrial natriuretic peptide (eANP, 5x10(-13)-5x10(-10) mol), serotonin (5-HT, 5x10(-12)-5x10(-8) mol), ghrelin (5x10(-12)-5x10(-10) mol), gamma-amino butyric acid (GABA, 5x10(-11)-5x10(-8) mol), prolactin (PRL, 5x10(-10)-5x10(-9) mol), arginine vasotocin (AVT, 5x10(-12) mol), vasoactive intestinal peptide (VIP, 5x10(-11) mol), noradrenaline (5x10(-9) mol l(-1)) and phenylephrine (alpha-adrenoceptor agonist, 5x10(-11)-5x10(-9) mol). The inhibitory effects of eANP, 5-HT, ghrelin, GABA, PRL and phenylephrine were dose-dependent. The intracranial stimulatory effect of eANG II was relatively long-lasting compared with the intravenous effect. The stimulatory effect of intravenous eANG II disappeared immediately, and was followed by an inhibition, which could be well explained by an increase in eANP secretion from the atrium.