Relationship between sympathoadrenal and pituitary-adrenal response during colorectal distention in the presence of corticotropin-releasing hormone in patients with irritable bowel syndrome and healthy controls.
Relationship between sympathoadrenal and pituitary-adrenal response during colorectal distention in the presence of corticotropin-releasing hormone in patients with irritable bowel syndrome and healthy controls.
复制标题
DOI：
10.1371/journal.pone.0199698
复制
发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Fukudo S
中科院分区：
文献类型：
--
作者：
Tanaka Y;Kanazawa M;Kano M;Tashiro M;Fukudo S
促肾上腺皮质激素释放激素（CRH）在脑 - 肠轴中调节应激反应。给予CRH可调节大脑激活，例如通过控制自主神经系统以应对结直肠扩张。在此，我们研究了肠易激综合征（IBS）患者对结直肠扩张的交感肾上腺和下丘脑 - 垂体 - 肾上腺（HPA）反应之间的关系。我们招募了32例IBS患者（16名女性和16名男性）以及32名健康受试者（16名女性和16名男性），并将他们随机分配到CRH和生理盐水注射组。患者随机接受无（0 mmHg）、轻度（20 mmHg）或重度（40 mmHg）的结直肠扩张。然后通过注射给予CRH（2μg/kg）或生理盐水，并重复扩张操作。使用心电图分析心率（HR）和心率变异性（HRV；计算为低频[LF]与高频[HF]峰值比，LF/HF）。在每次扩张时测量血浆去甲肾上腺素、肾上腺素、促肾上腺皮质激素（ACTH）和皮质醇水平。通过结构方程模型分析显示，在扩张期间注射CRH的健康对照者中，血浆肾上腺素水平与血浆ACTH水平相关。在扩张期间注射安慰剂的IBS患者中，这两个参数之间的关联比注射CRH的患者更紧密。广义估计方程分析显示，HF功率存在显著的扩张×组×药物交互作用。此外，在对照组中注射CRH时，肾上腺素与HRV之间有很强的相关性，但在IBS患者中没有。结直肠扩张期间HPA - 交感肾上腺反应与CRH水平之间的关系在IBS患者和对照组之间存在差异。肾上腺对ACTH刺激的活性调节可能有助于IBS的脑 - 肠病理生理学特征。
Corticotropin-releasing hormone (CRH) mediates stress responses in the brain-gut axis. Administration of CRH modulates brain activation, for example by controlling the autonomic nervous system in response to colorectal distention. Here, we investigated the relationship between sympathoadrenal and hypothalamic-pituitary-adrenal (HPA) responses to colorectal distention in patients with irritable bowel syndrome (IBS). We enrolled 32 patients with IBS (16 women and 16 men) and 32 healthy subjects (16 women and 16 men), and randomly divided them between CRH and saline injection groups. The patients randomly underwent no (0 mmHg), mild (20 mmHg), or strong (40 mmHg) colorectal distension. CRH (2 μg/kg) or saline was then administered via injection, and the distention protocol was repeated. The heart rate (HR) and HR variability (HRV; calculated as the low [LF] to high frequency [HF] peak ratio, LF/HF) were analyzed using electrocardiography. Plasma noradrenaline, adrenaline, adrenocorticotropic hormone (ACTH), and cortisol levels were measured at the time of each distention. Plasma adrenaline levels were shown to be associated with plasma ACTH levels in HCs injected with CRH during distention using structural equation modeling analysis. Patients with IBS injected with placebo during distention displayed a closer association between these two parameters than those injected with CRH. Generalized estimating equation analysis revealed a significant distention × group × drug interaction for HF power. Moreover, there was a strong correlation between adrenaline and HRV upon CRH injection in controls, but not patients with IBS. The relationship between HPA-sympathoadrenal responses and CRH levels during colorectal distention differs between patients with IBS and controls. Modulation of adrenal gland activity in response to ACTH stimulation may contribute to the brain-gut pathophysiology characteristic of IBS.
登录
查看更多内容
影响因子：
16.2
作者：
McCall JG;Al-Hasani R;Siuda ER;Hong DY;Norris AJ;Ford CP;Bruchas MR
通讯作者：
Bruchas MR
影响因子：
24.5
作者：
Sagami, Y;Shimada, Y;Fukudo, S
通讯作者：
Fukudo, S
影响因子：
56.9
作者：
AKSELROD, S;GORDON, D;COHEN, RJ
通讯作者：
COHEN, RJ
影响因子：
4.8
作者：
DEMEERSMAN, RE
通讯作者：
DEMEERSMAN, RE
影响因子：
24.5
作者：
Fukudo, S;Nomura, T;Hongo, M
通讯作者：
Hongo, M