Effect of vasoactive intestinal polypeptide (VIP) antagonism on rat jejunal fluid and electrolyte secretion induced by cholera and Escherichia coli enterotoxins

Background-The enteric nervous system is important in the pathophysiology o f intestinal fluid secretion induced by cholera toxin (CT), Escherichia col i heat labile (LT), and heat stable (STa) toxins. The neurotransmitters inv olved are not fully elucidated. Vasoactive intestinal polypeptide (VIP), a potent intestinal secretagogue present in the enteric nervous system, is in creased after exposure of the cat intestine to CT. Whether VIP is involved in the pathogenesis of cholera and other toxins in not known. Aim-To study in vivo the effect of VIP antagonism on jejunal fluid secretio n induced by CT, LT, and STa. Methods-CT, LT (25 mu g), or 0.9% NaCl was instilled in an isolated 25 cm s egment of rat jejunum, and the VIP antagonist (VIPa) [4Cl-D-Phe(6), Leu(17) ]-VIP (0.2 or 2 mu g/kg/min) or 0.9% NaCl was given intravenously. Two hour s later, single pass in vivo jejunal perfusion was performed to assess flui d movement. In STa experiments, intravenous VIPa or 0.9% NaCl was given and 30 minutes later the jejunal segment was perfused with a solution containi ng STa 200 mu g/l. Results-VIPa had no effect on basal intestinal fluid absorption. CT induced net fluid secretion (median -68 mu l/min/g dry intestinal weight (interqua rtile range -80 to -56)) which was dose dependently reversed by VIPa (6.2 ( -16 to 34) and 29 (17 to 42); p<0.01). Similarly, LT induced secretion (-63 (-73 to -30)) was attenuated by VIPa (0.2 mu g/kg/min) (-15 (-24 to -1); p <0.01) and totally reversed to normal levels by VIPa (2 mu g/kg/min) (37 (2 8-56); p<0.01 compared with LT and not significant compared with normal con trols). STa induced secretion (-17 (-19 to -2)) was also reversed by VIPa ( 12 (9-23) and 14 (0-26); p<0.01). Conclusion-VIP plays an important role in CT, LT, and STa induced intestina l secretion and may be the final putative neurotransmitter in the pathophys iology of these toxins.