J Neurogastroenterol Motil.  2017 Jul;23(3):428-434. 10.5056/jnm16155.

Neuroendocrine Dysregulation in Irritable Bowel Syndrome Patients: A Pilot Study

Affiliations
  • 1Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy. cristina.stasi@gmail.com
  • 2Gastrointestinal Unit, Department of Gastroenterology, University of Pisa, Pisa, Italy.
  • 3Gastrointestinal Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
  • 4Cardiovascular Center, University Hospital, Zürich, Switzerland.

Abstract

BACKGROUND/AIMS
Irritable bowel syndrome (IBS) is a multifactorial disorder, involving dysregulation of brain-gut axis. Our aim was to evaluate the neuroendocrine activity in IBS.
METHODS
Thirty IBS and 30 healthy volunteers were enrolled. Psychological symptoms were evaluated by questionnaires. Urinary 5-hydroxyindoleacetic acid, plasma serotonin (5-hydroxytryptamine, 5-HT), endothelin, and neuropeptide Y (NPY), and plasma and urinary cortisol levels were evaluated. Fourteen IBS subjects underwent microneurography to obtain multiunit recordings of efferent postganglionic muscle sympathetic nerve activity (MSNA).
RESULTS
Prevalent psychological symptoms in IBS were maladjustment (60%), trait (40%) and state (17%) anxiety, obsessive compulsive-disorders (23%), and depressive symptoms (23%). IBS showed increased NPY (31.9 [43.7] vs 14.8 [18.1] pmol/L, P = 0.006), 5-HT (214.9 [182.6] vs 141.0 [45.5] pg/mL, P = 0.010), and endothelin [1.1 [1.4] vs 2.1 [8.1] pg/mL, P = 0.054], compared to healthy volunteers. Moreover, plasma NPY, endothelin, cortisol and 5-HT, and urinary 5-hydroxyindoleacetic acid were associated with some psychological disorders (P ≤ 0.05). Despite a similar resting MSNA, after cold pressor test, IBS showed a blunted increase in MSNA burst frequency (+4.1 vs +7.8 bursts/min, P = 0.048; +30.1% vs +78.1%, P = 0.023). Baseline MSNA tended to be associated with urinary cortisol (ρ = 0.557, P = 0.059). Moreover, changes in heart rate after mental stress were associated with urinary cortisol (ρ = 0.682, P = 0.021) and changes in MSNA after mental stress were associated with plasma cortisol (ρ = 0.671, P = 0.024)."
CONCLUSION
Higher concentrations of endothelin, NPY, and 5-HT were found to be associated with some psychological disorders in IBS patients together with an altered cardiovascular autonomic reactivity to acute stressors compared to healthy volunteers.

Keyword

Autonomic nervous system; Endothelin-1; Irritable bowel syndrome; Neuropeptide Y; Serotonin

MeSH Terms

Anxiety
Autonomic Nervous System
Depression
Endothelin-1
Endothelins
Healthy Volunteers
Heart Rate
Humans
Hydrocortisone
Irritable Bowel Syndrome*
Neuropeptide Y
Pilot Projects*
Plasma
Serotonin
Endothelin-1
Endothelins
Hydrocortisone
Neuropeptide Y
Serotonin
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