Prostaglandin E1 effects on resting and cholinergically stimulated lower esophageal sphincter pressure in cats

Intraluminal esophageal manometry with a sleeve catheter was used to compare the magnitude of decrease in lower esophageal spincter (LES) pressure produced by an arterial or venous infusion of prostaglandin E₁ in cats. Arterial PGE₁ produced significantly lower LES pressures than venous PGE₁ (p < 0.05). Maximal decrease of 75% in basal LES pressure occurred with an associated 15% decrease in systolic blood pressure. The site of action of PGE₁ in producing LES hypotension was studied by injection of either edrophonium, or bethanechol during the maximal PGE₁ effects. Bethanechol, which acts directly on sphincteric smooth muscle, produced an increase in LES pressure during both saline and PGE₁ infusion, while the increases in LES pressure seen with edrophonium during saline infusion were blocked during the PGE₁ infusion. From these studies, we conclude that PGE₁ produces LES hypotension in the cat by an inhibitory effect on the cholinergic pathway responsible for maintaining LES tone. These studies pharmacologically reproduce the LES pressure abnormality previously reported in the cat during acid-induced esophagitis and support the hypothesis that PGE₁ may be involved in the pathogenesis of acute acid-induced lower esophageal sphincter abnormalities.