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Peptide histidine methionine (PHM) increases ileostomy output
J Calam1, Y Yiangou, B Chrysanthou
1Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, U.K.
Regulatory Peptides
|October 1, 1988
Summary
Peptides histidine methionine (PHM) significantly increased ileal output and chloride concentration in patients. This suggests PHM may contribute to watery diarrhea syndrome and control ileal water and electrolyte transport.
Area of Science:
- Gastroenterology
- Endocrinology
- Neuroscience
Background:
- The human vasoactive intestinal peptide (VIP) gene also encodes peptides histidine methionine (PHM).
- Both VIP and PHM are found in human ileal nerve fibers and elevated in watery diarrhea syndrome.
- PHM shares sequence homology with VIP, suggesting potential functional overlap.
Purpose of the Study:
- To investigate the effect of PHM infusion on human ileal output.
- To determine if PHM contributes to the pathophysiology of watery diarrhea syndrome.
- To explore the role of neuronal PHM in regulating ileal water and electrolyte transport.
Main Methods:
- Infusion of PHM (23 pmol/kg/min) into 5 patients with ileostomies.
- Measurement of plasma PHM levels before and during infusion.
- Quantification of ileal output, solid content, and chloride concentration in ileal effluent.
Main Results:
- Plasma PHM levels increased significantly from baseline to 6013 +/- 874 pM during infusion.
- Ileal output rose dramatically from 16 +/- 3 to 177 +/- 27 g/30 min (P < 0.0001).
- PHM infusion led to a decrease in ileal solid content and an increase in chloride concentration.
Conclusions:
- Elevated plasma PHM levels during infusion mimicked those seen in watery diarrhea syndrome.
- PHM may play a role in causing diarrhea in this condition.
- Neuronal PHM likely influences physiological control of ileal water and electrolyte transport.