Potential of Intestinal Electrical Stimulation for Obesity: A Preliminary Canine Study*

Veterans Research and Education Foundation, Veterans Administration Medical Center, Oklahoma City, Oklahoma, USA.
Obesity (Impact Factor: 3.73). 05/2007; 15(5):1133-8. DOI: 10.1038/oby.2007.615
Source: PubMed


The aims of this study were to investigate the therapeutic potential of intestinal electrical stimulation (IES) for obesity. Experiments were performed to investigate the effects of IES on food intake, gastric tone, gastric accommodation, and its possible pathway.
Ten normal dogs and six dogs with truncal vagotomy were used in this study. Each dog was equipped with a gastric cannula for the measurement of gastric tone and accommodation by barostat and one pair of duodenal serosal electrodes for IES. The experiment on food intake was composed of both control session without IES and IES session after a 28-hour fast. The experiment on gastric tone and accommodation was performed in the fasting and fed states and composed of three sessions: control, IES, and IES with N(G)-nitro-l-arginine.
IES significantly reduced food intake in the normal dogs (459.0 vs. 312.6 grams, p < 0.001). The food intake was negatively correlated with the fasting gastric volume during IES. IES significantly decreased fasting gastric tone in the normal dogs reflected as a decrease in gastric volume (89.1 vs. 261.3 mL, p < 0.01), which was abolished by vagotomy and N(G)-nitro-l-arginine.
IES reduces food intake and inhibits gastric tone in the fasting state. The inhibitory effect of IES on gastric tone is mediated by both vagal and nitrergic pathway.

1 Follower
4 Reads
  • Source
    • "In humans, the barostat method is the gold standard to measure gastric tone and accommodation (Mundt et al., 2002; Tomita et al., 2013). Most of the well-known studies on fundus relaxation are using barostat in the canine (Azpiroz and Malagelada, 1985; De Ponti et al., 2003; Lei et al., 2005; Yin et al., 2007), but rat (Graca et al., 2002; Monroe et al., 2004; Romer et al., 2005; Zhao et al., 2005), ferret (Blackshaw et al., 1987) and feline (Mayrand et al., 1994; Janssen et al., 2004) are also known in vivo models. There are 2 kinds of end points evaluating fundus relaxation in the canine barostat model: accommodation and compliance (Azpiroz and Malagelada, 1985; De Ponti et al., 2003). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Motilitone(®) (DA-9701) is a new herbal drug that was launched for the treatment of functional dyspepsia in December 2011 in Korea. The heterogeneous symptom pattern and multiple causes of functional dyspepsia have resulted in multiple drug target strategies for its treatment. DA-9701, a compound consisting of a combination of Corydalis Tuber and Pharbitidis Semen, has being developed for treatment of functional dyspepsia. It has multiple mechanisms of action such as fundus relaxation, visceral analgesia, and prokinetic effects. Furthermore, it was found to significantly enhance meal-induced gastric accommodation and increase gastric compliance in dogs. DA-9701 also showed an analgesic effect in rats with colorectal distension induced visceral hypersensitivity and an antinociceptive effect in beagle dogs with gastric distension-induced nociception. The pharmacological effects of DA-9701 also include conventional effects, such as enhanced gastric emptying and gastrointestinal transit. The safety profi le of DA-9701 is also preferable to that of other treatments.
    Biomolecules and Therapeutics 05/2013; 21(3):181-189. DOI:10.4062/biomolther.2012.096 · 1.73 Impact Factor
  • Source
    • "The research pattern in this newly emerging area is very similar to its gastric predecessors—encouraging animal studies which as a rule are not placebo-controlled but claim effectiveness, while leaving the possible mechanism of action unclear [140–142], followed by several studies on a limited number of chronic patients, also not placebo-controlled and with unclear mechanism of action [36, 143]. Based on the less-than-glorious history of GES, such studies appear to be sufficient to attract the attention (and the investment) of major medical device manufacturers, which might lead to a CE certification, but whether an FDA approval would follow remains highly questionable. "
    [Show abstract] [Hide abstract]
    ABSTRACT: GROWING WORLDWIDE OBESITY EPIDEMIC HAS PROMPTED THE DEVELOPMENT OF TWO MAIN TREATMENT STREAMS: (a) conservative approaches and (b) invasive techniques. However, only invasive surgical methods have delivered significant and sustainable benefits. Therefore, contemporary research exploration has focused on the development of minimally invasive gastric manipulation methods featuring a safe but reliable and long-term sustainable weight loss effect similar to the one delivered by bariatric surgeries. This antiobesity approach is based on placing external devices in the stomach ranging from electrodes for gastric electrical stimulation to temporary intraluminal bezoars for gastric volume displacement for a predetermined amount of time. The present paper examines the evolution of these techniques from invasively implantable units to completely noninvasive patient-controllable implements, from a functional, rather than from the traditional, parametric point of view. Comparative discussion over the available pilot and clinical studies related to gastric electrical stimulation outlines the promises and the fallacies of this concept as a reliable alternative anti-obesity strategy.
    02/2013; 2013:434706. DOI:10.1155/2013/434706
  • [Show abstract] [Hide abstract]
    ABSTRACT: This review focuses on progress made in the field of gastric motility in the past year, emphasizing advances in understanding the motor physiology of the stomach in health and disease; noninvasive imaging technology and data on novel pharmacotherapeutics and other therapeutic interventions for gastroparesis. The differential conduction pattern in the interstitial cell of Cajal is responsible for the generation of the full spatio-temporal pattern of gastric peristalsis. The mitochondrial powerhouse provides the driving potential for the gastric slow waves. Females are more dependent on the nitrenergic system for gastric relaxation, which is predominantly affected in diabetes. The noninvasive modalities to evaluate gastric function have undergone substantial evolution in the past year. On the therapeutic front, a new generation of medications has been tested and holds promise for the near future. Gastric electrical stimulation is a viable option for medically refractory gastroparesis. Using dynamic imaging modalities, the pathophysiology of dyspepsia is becoming better understood and recognized as an end point of multifactorial dysfunction of the enteric neural circuitry. Mechanism-targeted drugs, stem cell transplantation and electrical stimulation options are becoming available.
    Current Opinion in Gastroenterology 12/2007; 23(6):625-30. DOI:10.1097/MOG.0b013e3282f0957c · 4.29 Impact Factor
Show more