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Ammonia modifies enteric neuromuscular transmission through glial gamma-aminobutyric acid signaling.

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AJP Gastrointestinal and Liver Physiology

Published online on

Abstract

Objective: Impaired gut motility may contribute, at least in part, to the development of systemic hyperammonemia and systemic neurological disorders in inherited metabolic disorders, or in severe liver and renal disease. It is not known whether enteric neurotransmission regulates intestinal luminal and hence systemic ammonia levels by induced changes in motility. Design: Here, we propose and test the hypothesis that ammonia acts through specific enteric circuits to influence gut motility. We tested our hypothesis by recording the effects of ammonia on neuromuscular transmission in tissue samples from mice, pigs and humans, and investigated specific mechanisms using novel mutant mice, selective drugs, cellular imaging and enzyme-linked immunosorbent assays. Results: Exogenous ammonia increased neurogenic contractions and decreased neurogenic relaxations in segments of mouse, pig and human intestine. Enteric glial cells responded to ammonia with intracellular Ca2+ responses. Inhibition of glial glutamine synthetase and the deletion of glial connexin-43 channels in hGFAP::CreERT2+/–/connexin43f/f mice potentiated the effects of ammonia on neuromuscular transmission. The effects of ammonia on neuromuscular transmission were blocked by GABAA receptor antagonists and ammonia drove substantive GABA release as did the selective pharmacological activation of enteric glia in GFAP::hM3Dq transgenic mice. Conclusion: We propose a novel mechanism whereby local ammonia is operational through GABAergic glial signaling to influence enteric neuromuscular circuits that regulate intestinal motility. Therapeutic manipulation of these mechanisms may benefit a number of neurological, hepatic and renal disorders manifesting hyperammonemia.