DAVID J. DE CARLE, M.B.; JAMES CHRISTENSEN, M.D.
To the editor: Dr. Castell, in his recent review of lower esophageal sphincter physiology and disease (1), pointed out that relaxation of the lower esophageal sphincter is mediated by nonadrenergic, noncholinergic nerves. He repeated the suggestion of others that the inhibition is via the "purinergic nervous system," and that adenosine triphosphate (ATP) may be the neurotransmitter involved (1).
The evidence that purines act as neurotransmitters in the gastrointestinal tract is derived almost entirely from studies using the guinea pig taenia coli (2). There is no evidence to support adenosine triphosphate or other purines as eurotransmitters in the esophagus. We have
DE CARLE DJ, CHRISTENSEN J. "Purinergic" Neurotransmitters in the Esophagus?. Ann Intern Med. ;84:220–221. doi: 10.7326/0003-4819-84-2-220
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Published: Ann Intern Med. 1976;84(2):220-221.
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