Harnett KM. ATP: a mediator for HCl-induced TRPV1 activation in esophageal mucosa. Am J Physiol Gastrointest Liver Physiol 301: G1075-G1082, 2011. First published September 29, 2011 doi:10.1152/ajpgi.00336.2011In esophageal mucosa, HCl causes TRPV1-mediated release of calcitonin gene-related peptide (CGRP) and substance P (SP) from submucosal neurons and of platelet-activating factor (PAF) from epithelial cells. CGRP and SP release was unaffected by PAF antagonists but reduced by the purinergic antagonist suramin. ATP caused CGRP and SP release from esophageal mucosa, confirming a role of ATP in the release. The human esophageal epithelial cell line HET-1A was used to identify epithelial cells as the site of ATP release. HCl caused ATP release from HET-1A, which was reduced by the TRPV1 antagonist 5-iodoresiniferatoxin. Real-time PCR demonstrated the presence of mRNA for several P2X and P2Y purinergic receptors in epithelial cells. HCl also increased activity of lyso-PAF acetyl-CoA transferase (lyso-PAF AT), the enzyme responsible for production of PAF. The increase was blocked by suramin. ATP caused a similar increase, confirming ATP as a mediator for the TRPV1-induced increase in enzyme activity. Repeated exposure of HET-1A cells to HCl over 2 days caused upregulation of mRNA and protein expression for lyso-PAF AT. Suramin blocked this response. Repeated exposure to ATP caused a similar mRNA increase, confirming ATP as a mediator for upregulation of the enzyme. Thus, HCl-induced activation of TRPV1 causes ATP release from esophageal epithelial cells that causes release of CGRP and SP from esophageal submucosal neurons and activation of lyso-PAF AT, the enzyme responsible for the production of PAF in epithelial cells. Repeated application of HCl or of ATP causes upregulation of lyso-PAF AT in epithelial cells. purinergic receptors; vanilloid receptors; platelet-activating factor; calcitonin gene-related peptide; substance P ESOPHAGITIS WAS THOUGHT TO develop from a chemical injury starting at the luminal surface of the squamous epithelium, progressing through epithelium and lamina propria into the submucosa and resulting in acid-induced death of surface cells and stimulation of a proliferative response in the basal cells (20). Epithelial cells were viewed as bystanders in the process of inflammation, functioning primarily as a protective barrier to infiltration of noxious chemicals and bacteria into the underlying tissue. Recent evidence, however, in the urinary bladder (5) and in the esophagus suggests that these cells function as primary transducers of physical and chemical stimuli and communicate with underlying cells, including nerves (14), smooth muscle (11,12), and even inflammatory cells (26).We propose that acid-induced inflammation of the esophagus begins with activation of acid-sensitive vanilloid receptors (TRPV1) in the mucosa. TRPV1 activation induces synthesis and release of the sensory neurotransmitters calcitonin generelated peptide (CGRP) and substance P (SP) from submucosal neurons and of the...