Cholinergic control of gastric acid secretion in man.

In this report I briefly review the neural mechanisms of gastric acid secretion in man focussing particularly on muscarinic control of the oxyntic glands and the G-cells during the cephalic and gastric phases. Cephalic phase which is mediated by vagal nerves appears to be almost entirely due to cholinergic activation of the oxyntic glands without significant role of vagally released gastrin. Distention, which is a major component of gastric phase activates cholinergic reflexes with afferents to both oxyntic glands and the G-cells. Using highly selective antimuscarinic agent, pirenzepine, the evidence is presented that gastrin release during vagal activation or gastric distention is exerted by cholinergic transmission without involvement of cholinergic inhibitory pathway suggested previously. The possible role of histamine in neural control of gastric secretion is also discussed.