Smith-Edwards, Kristen M

The intestinal epithelium is exposed to diverse combinations of microbiota-derived compounds; however, the mechanisms by which the host integrates these signals remain poorly defined. Studying two highly abundant microbial metabolites, we identified the purine metabolite hypoxanthine as an effector metabolite that directly drives signaling and the short-chain fatty acid butyrate as a regulatory metabolite that conditions host responsiveness. Specifically, hypoxanthine activates the adenosine A1 receptor–TRPC4 axis in enterochromaffin (EC) cells, triggering calcium influx and serotonin release resulting in accelerated gastrointestinal transit locally and increased platelet activation systemically. In contrast, butyrate epigenetically upregulates specific G protein–coupled receptors and ion channels to enhance response to hypoxanthine and the neurotransmitters norepinephrine and dopamine. These findings define a cooperative signaling framework and highlight the role of EC cells as a distinct epithelial signaling hub that senses and integrates microbial metabolite signals to drive physiological responses. Our findings provide a mechanistic foundation for therapeutic strategies that leverage combinatorial microbial signaling.

Abstract Interstitial cells of Cajal (ICC) regulate gastrointestinal motility by generating electrical slow waves that orchestrate downstream calcium (Ca 2 + ) waves and coordinate smooth muscle contractions. A reduced ICC number has been reported in diabetic gastroparesis patients and in mouse models of delayed gastric emptying (DGE). However, functional changes in ICC propagating across the gastric regions in intact stomach are not well understood. The aim of this study was to develop an imaging approach to visualize ICC Ca 2+ waves in mouse stomach and determine spatiotemporal changes in mice with DGE. Tamoxifen‐treated B6.GCaMP5‐KitCreERT2 female mice were used as non‐diabetic controls (Non‐Db), while mice treated with streptozocin to induce diabetes were categorized as having normal (Db‐NGE) or delayed (Db‐DGE) gastric emptying based on emptying of solids. The ICC Ca 2+ network was imaged from excised intact mouse stomachs and subsequently opened along the lesser curvature and pinned flat. ICC Ca 2+ waves typically propagated along the greater curvature from the fundus–corpus line toward the antrum. The propagation length of ICC Ca 2+ activity was significantly decreased in Db‐DGE compared to Non‐Db and Db‐NGE and correlated to longer GE times. There was also a decrease in frequency, and the velocity was significantly faster in stomachs from Db‐DGE compared to Non‐Db and Db‐NGE. All experimental groups exhibited similar proportions of aberrant Ca 2+ propagation patterns (e.g., retrograde waves), but ectopic initiation only occurred in Db‐DGE stomachs. Thus, DGE is possibly driven by dysfunction in Ca 2+ activity in the ICC network that propagates rapidly over short distances, resulting in uncoordinated, non‐phasic muscle activity. image Key points Dysfunction of the interstitial cells of Cajal (ICC) has been implicated in diabetic gastroparesis but the changes in spatiotemporal properties of ICC network activity are not known. We developed an ex vivo Ca 2+ imaging approach to visualize ICC network activity across the entire stomach and determined changes in ICC Ca 2+ activity in a diabetic mouse model of delayed gastric emptying (GE). Decreased frequency and increased velocity of ICC Ca 2+ activity was observed in stomachs of diabetic mice with delayed GE. Ectopic initiation was a key feature associated with delayed GE. The propagation length of ICC Ca 2+ activity was inversely correlated to GE times and significantly reduced in stomach preparations from diabetic mice with delayed GE.

Introduction: Inflammatory bowel disease is characterized by remitting and relapsing bouts of intestinal inflammation accompanied by sensory and motor dysfunction that persists beyond the active periods of inflammation. Evidence suggests that neural pathways of the Gut-Brain Axis, particularly the sensory and sympathetic nervous system, are involved in pathophysiology, but until recently technical restrictions have limited our understanding of the underlying neural circuit mechanisms. In this study, we examined how sensory-sympathetic circuits are modified by colitis and how these alterations contribute to dysfunction during both active inflammation and post-inflammatory recovery. Methods: E2a-GCaMP mice were treated with vehicle or 3% dextran sodium sulfate (DSS) for 5 days to induce experimental colitis and switched to normal drinking water. Mice were assessed at two time points: Day 7 (two days after ending DSS treatment), representing active inflammation, and Day 21 to represent recovery. Inflammation and mucosal damage were evaluated using disease activity index scores and hematoxylin and eosin (H&E) staining. Colon motility was assessed in vivo via colonic bead expulsion and ex vivo using whole-colon preparations. We performed Ca 2+ imaging of sympathetic motor neurons in prevertebral ganglia (PVG) and sensory neurons in dorsal root ganglia (DRG) neurons in ex vivo preparations that preserve extrinsic neural circuitry with the colon (intestinofugal-sympathetic and spinal cord-sympathetic pathways). Results: Histological analysis confirmed hallmark features of colitis, including colon shortening, immune infiltration, and mucosal damage at 7 days post-DSS (p< 0.05, n=3–4), which resolved after recovery. During active inflammation, in vivo colon transit time was significantly faster, and this persisted after recovery (p< 0.05, n=7-9). Ex vivo motility assays in isolated colons also revealed DSS-induced dysmotility during active inflammation, but the irregular colon motor complexes became normal after recovery (p< 0.05, n=7-9), suggesting that extrinsic neural pathways contribute to prolonged dysmotility. In preparations without the spinal cord, PVG neurons exhibited increased activity and increased responses to distension during active inflammation but returned to baseline after recovery (p< 0.05, n=3-4), suggesting alternative sensory-PVG pathways contribute to persistent dysmotility. In preparations with spinal circuits intact, thoracolumbar (TL), but not lumbosacral (LS), DRG sensory neurons were hypersensitive to colonic distension during inflammation (p< 0.05, n=8-9). Furthermore, TL spinal stimulation evoked more responses in PVG neurons during active inflammation, but this was associated with decreased inhibition of ENS motor circuits (p< 0.05, n=6-7) and increased Ca 2+ signaling in the epithelium (p< 0.05, n=5), suggesting shifts in TL spinal-sympathetic motor output. Preliminary studies show an increase in spontaneous activity of TL DRG neurons in recovery that does not occur at LS levels (p< 0.05, n=3-6), which suggests that thoracolumbar spinal pathways remain hyperexcitable after recovery.Conclusions: Our findings indicate that TL spinal pathways associated with sympathetic motor outflow contribute to pain and dysmotility during active inflammation and may contribute to the post-inflammatory recovery processes that seem to go awry in IBD patients with relapsing inflammation. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.

Background: As part of the bidirectional gut-brain communication system that influences gastrointestinal function, vagal pathways coordinate with the activity of interstitial cells of Cajal (ICC) to regulate gastric motility. Impairments in ICC slow wave activity and altered vagal tone have been implicated in diabetic gastroparesis and obesity, but technical limitations have restricted our ability to measure integrated and bidirectional activity in vagal-ICC pathways. Furthermore, the influence of physiological and meal-induced stimuli like gastric distension on these pathways is not well understood. We aimed to develop a calcium imaging approach in ex vivo nodose ganglion-vagus nerve-stomach preparations to investigate vagal-ICC pathways and test the effects of gastric distension on vagal activation, ICC network activity, and their functional interactions. Methods: Calcium imaging was performed in ex vivo preparations, in which the stomach and vagus nerves (with or without the ganglion) remain intact. EIIa-GCaMP6 (n=3) and cKit-GCaMP6 (n=3) mice were used to image Ca 2 + signals from both vagal neurons and ICC or ICC alone, respectively. Two-minute recordings were captured in the following stomach conditions: (1) Undistended; (2) Undistended + vagal nerve stimulation (VNS, 20 Hz, 1 s); (3) Distended (0.25 ml volume distension); (4) Distended + VNS. Ca 2 + signals in ICC and neurons, along with tissue displacement, were analyzed using Image J. Data from both GCaMP models were pooled for ICC. Results: Acute gastric distension significantly activated vagal sensory neurons in nodose ganglion compared to baseline (p=0.0193), and VNS evoked Ca 2 + responses in ICC and neurons, confirming intact nerve pathways. Both VNS and gastric distension altered the direction of ICC propagation, significantly increasing retrograde waves (p=0.0025 and p=0.0032, respectively), and VNS had no effect on retrograde waves in distended stomachs. VNS and distension also reduced length of propagation of anterograde ICC waves (p=0.019 and p=0.0004, respectively), and again, VNS effects were not observed during distension. VNS increased the velocity of ICC wave propagation, but only in undistended stomach (p=0.0283). Finally, VNS increased ICC pacemaker frequency regardless of the distension state (p=0.0123). Conclusion: Both acute gastric distension and VNS altered ICC network activity, with similar effects on network parameters. However, most of the VNS effects on ICC were blocked during distension. VNS increased the frequency of ICC network waves in both undistended and distended stomachs, suggesting that VNS can influence ICC pacemakers regardless of distension state. These findings have important implications for designing therapeutic strategies for gastroparesis. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.

The gastrointestinal tract is made up of specialized organs that work in tandem to facilitate digestion. The colon regulates the final steps in this process where complex motor patterns in proximal regions facilitate the formation of fecal pellets that are propelled along the distal colon via self-sustaining neural peristalsis and temporarily stored before defecation. Historically, our understanding of colonic motility has focused primarily on distal regions, and the intrinsic reflex circuits of the enteric nervous system involved in neural peristalsis have been defined, but we do not yet have a clear grasp on the mechanisms orchestrating motor function in proximal regions. New approaches have brought to the forefront the unique structural, neurochemical, and functional characteristics that exist in distinct regions of the mouse and human colon. In this mini-review, we highlight key differences along the proximal-distal colonic axis and discuss how these differences relate to region-specific motor function.

Irritable bowel syndrome is a globally prevalent disorder categorized into constipation, diarrhea or mixed (IBS‐C, IBD‐D, IBS‐M) based on the predominant stool form/frequency. While the gut microbiome is recognized as an important factor underlying the pathophysiology of IBS, the specific mechanisms remain an area of active investigation. In our recent longitudinal multi‐omics study in IBS patients, we found bacteria‐derived hypoxanthine was significantly decreased in stool from IBS‐C patients. The aim of this study was to determine if IBS‐C relevant molecular pathways are affected by hypoxanthine. We hypothesized that hypoxanthine acts on enterochromaffin (EC) cells to stimulate serotonin (5‐HT) release, where 5‐HT is an important determinant of gastrointestinal (GI) transit time. We used Ca 2+ imaging in QGP cells (EC model), T84 cells (colonocyte model), primary cells and organoids from NeuroD1‐cre;GCaMP5‐tdTomato mice [NeuroD1 is a marker for enteroendocrine cells (EECs) which express calcium indicator GCaMP in these mice] in the absence or presence of receptor antagonists, and in ex vivo colon preparations with intact innervation from E2aCre:GCaMP6s mice (GCaMP is expressed in neuronal and non‐neuronal cells), to test the effect of hypoxanthine. The physiologic relevance of hypoxanthine signaling was assessed by measuring whole gut transit time. We found hypoxanthine increased Ca 2+ influx in QGP cells [using Cal520 (qualitative) and Fura‐2AM (quantitative)], primary EECs and EECs within organoids (previous research showed that the majority of these EECs are EC cells), but not in T84 cells. Hypoxanthine‐evoked Ca 2+ response was absent in Ca 2+ ‐free medium (n=6‐8, t‐test, P <0.0001), inhibited by G αi/o ‐GPCR antagonist (pertussis toxin; n=8‐14, t‐test, P <0.01)), Transient Receptor Potential Cation Channel Subfamily C Member 4 (TRPC4) antagonist (ML204; n=14‐15, t‐test, P <0.0001) and TRPC4 siRNA (n=5‐21, t‐test, P <0.01), and was accompanied by increased 5‐HT release (measured using 5‐HT biosensor). In ex vivo experiments, luminal application of hypoxanthine activated a subset of epithelial cells (likely EC cells) followed by subsets of neurons (latency to response onset, n=4, Mann‐Whitney, P <0.0001), as well as movement of the imaging field, which indicates smooth muscle contraction/relaxation. Our in vitro findings were confirmed by in vivo experiments showing that germ‐free mice colonized with hypoxanthine‐producing bacteria had faster whole gut transit and higher stool 5‐HT level compared to hypoxanthine‐consuming bacteria (n=7‐8, t‐test, P <0.05). In summary, hypoxanthine increases Ca 2+ influx specifically in EC cells by activating a signaling cascade involving a G αi/o ‐GPCR and TRPC4 channels, which results in 5‐HT release. The delay in activation of myenteric neurons and motor activity suggests that EC cell 5‐HT release likely induces neurogenic motor patterns and may underlie the shorter GI transit time seen with increased bacterial hypoxanthine production. While the current empirically designed probiotics have proven ineffective in IBS, our findings will allow development of novel mechanism‐based probiotic therapies for IBS‐C using hypoxanthine‐producing bacteria.