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Gastrointestinal regulatory peptides in systemic sclerosis
Arthritis and Rheumatism
|May 1, 1993
Summary
Systemic sclerosis (SSc) patients show elevated gastrointestinal regulatory peptides, including corticotropin-releasing hormone (CRH), motilin, neuropeptide Y (NPY), and peptide YY (PYY). These peptide changes may contribute to gastrointestinal dysfunction in SSc.
Area of Science:
- Gastroenterology
- Endocrinology
- Rheumatology
Background:
- Gastrointestinal (GI) dysfunction is common in systemic sclerosis (SSc).
- The underlying pathogenesis of GI involvement in SSc remains unclear.
- Neurotransmitter release defects are implicated in SSc pathogenesis.
Purpose of the Study:
- To investigate the relationship between GI dysfunction and plasma concentrations of GI regulatory peptides in SSc patients.
- To explore potential mechanisms contributing to GI dysregulation in SSc.
Main Methods:
- Studied 43 SSc patients (18 diffuse, 25 limited cutaneous).
- Measured plasma levels of corticotropin-releasing hormone (CRH), gastrin, motilin, neuropeptide Y (NPY), and peptide YY (PYY) using radioimmunoassay and HPLC.
- Assessed GI function including esophageal hypomotility, acid output, and fat malabsorption (triolein breath test).
Main Results:
- Plasma concentrations of CRH, motilin, NPY, and PYY were significantly elevated in SSc patients compared to controls.
- HPLC analysis revealed distinct fragment patterns for motilin, NPY, and PYY in SSc.
- Increased CRH and NPY correlated with higher acid output; increased motilin and PYY were associated with more frequent fat malabsorption.
Conclusions:
- Elevated plasma peptide concentrations are common in SSc patients.
- These regulatory peptides play a role in GI motility, secretion, and absorption.
- Further characterization of the neuroendocrine system in SSc may elucidate the mechanisms of GI dysfunction.