U of L Clinical Center to Investigate the Pathogenesis, Etiology, and Treatment of Gastroparesis through the NIDDK Gastroparesis Consortium

洛杉矶大学临床中心通过 NIDDK 胃轻瘫联盟研究胃轻瘫的发病机制、病因和治疗

• 批准号: 10319759
• 负责人: Thomas Lyman Abell
• 金额: --
• 依托单位: UNIVERSITY OF LOUISVILLE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-15 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10319759
• 关键词: Abdominal Pain; Affect; Anatomy; Autoimmune; Botulinum Toxins; Caring; Characteristics; Chronic; Clinical; Clinical Research; Databases; Devices; Digestive System Disorders; Disease; Electric Stimulation; Electrolytes; Enrollment; Esophagus; Ethnic Origin; Etiology; Feces; Functional disorder; Gastric Emptying; Gastrointestinal Diseases; Gastroparesis; Gender; Genomics; Goals; Health; Health Services Accessibility; Homeostasis; Hormonal; Inflammatory; Intervention Studies; Knowledge; Life; Liquid substance; Malnutrition; Measures; Methods; Microscopic; Mission; Motor; Motor Activity; National Institute of Diabetes and Digestive and Kidney Diseases; Natural History; Nausea; Nausea and Vomiting; Nortriptyline; Nutritional Support; Nutritional status; Outcome; Pain; Pathogenesis; Patient-Focused Outcomes; Patients; Peripheral; Pharmacology Study; Physical Function; Physicians; Physiological; Physiology; Protocols documentation; Psychological Impact; Publishing; Quality of life; Questionnaires; Race; Randomized; Recommendation; Registries; Research; Resolution; Sensory; Series; Severities; Signal Transduction; Stomach; Symptoms; Syndrome; Therapeutic; Time; Tissue Sample; United States National Institutes of Health; Visceral; Vomiting; Weight; Work; clinical center; disability; early satiety; effective therapy; evidence base; frailty; gastrointestinal function; gut-brain axis; improved; metabolomics; motor disorder; neuromuscular; novel; novel strategies; nutrition; persistent symptom; psychologic; recruit; response; social; therapeutically effective; treatment strategy; young woman

Gastroparesis is a disorder of gastric function characterized by delay in gastric emptying, frequently associated with chronic nausea and vomiting, early satiety, postprandial fullness, abdominal pain, and malnutrition that may require nutritional support. Gastroparesis has a devastating impact on quality of life and predominantly affects younger women. In the past 5 years, the Gastroparesis Clinical Research Consortium (GpCRC) has made a series of important contributions (see below) to improve our understanding of this disorder and advancing the goals of patients, physicians and the NIH for management of gastroparesis. Yet, much remains to be learned about its etiology, natural history, treatment strategies, and clinical course, which is the rationale behind our response to the Continuation of the Gastroparesis Consortium. The biggest barrier to effective therapeutic approaches to gastroparesis is our lack of knowledge about either its pathogenesis or its pathophysiology. Further, the correlation between the major symptoms such as nausea, vomiting, pain, and current methods to measure change in gastric function (electrical, motor activity, meal emptying times) is poor at best. Finally, we do not understand the long-term outcomes of these patients and whether outcomes differ on the basis of etiology, symptom severity, and degree of emptying abnormalities. Consequently, our approach to these patients is erratic and treatment has been empirical and only partially effective, if at all, in relieving the major symptoms. The mission of the GpCRC is completely aligned with the recommendations of the National Commission on Digestive Diseases: specifically, Research Goal 2.6 relates to gastroparesis and states: "Understand the noxious visceral signaling causing nausea and vomiting related to gastric neuro-electrical and/or motor dysfunction and the bi-directional brain-gut interactions. Gastroparesis provides an archetypal disease for investigative inquiry. Chronic vomiting, a debilitating and socially isolating digestive symptom, creates potentially life-threatening disruptions in fluid and electrolyte homeostasis and compromises nutritional status. Chronic nausea remains a significant hidden disability. Nausea and vomiting usually occur in tandem and overlay with other Gl symptoms as well as presenting in numerous digestive diseases. More effective treatments for nausea and vomiting would improve quality of life and physical functioning in a vast array of illnesses. A paucity of research exists for defining peripheral noxious signaling of nausea and vomiting related to primary Gl motor/sensory disturbances." The Specific Aims of this proposal are to: 1. Complete the current GpCRC registry (Registry Three); 2. Extend the GpCRC core lab, responsible for anatomic and related studies on tissue samples of patients with Gp syndromes; 3. Perform pharmacologic studies on patients with Gp syndromes.; 4. Perform a new device/pyloric intervention study protocol for patients with the Gp syndromes; and 5. Utilize several novel approaches to some of the unmet needs in patients with gastroparesis symptoms, which could be incorporated in new studies of the Consortium.

胃轻瘫是一种以胃排空延迟为特征的胃功能紊乱，常与 慢性恶心和呕吐，早饱，餐后饱腹感，腹痛和营养不良 可能需要营养支持。胃瘫对生活质量有毁灭性的影响，主要是 影响年轻女性。在过去的5年里，胃轻瘫临床研究联盟(GpCRC) 做出了一系列重要的贡献(见下文)，以提高我们对这种疾病的理解和 促进患者、医生和美国国立卫生研究院管理胃瘫的目标。然而，仍然有很多东西 了解其病因、自然病史、治疗策略和临床病程。 是我们对胃瘫联盟继续做出回应的理由。最大的障碍 对胃瘫的有效治疗方法是我们对其发病机制或 它的病理生理学。此外，恶心、呕吐、疼痛等主要症状与 目前测量胃功能变化(电、运动、排空时间)的方法很差。 最多也就是。最后，我们不了解这些患者的长期结果，以及结果是否不同。 根据病因、症状严重程度和排空异常程度。因此，我们的方法 对这些患者的治疗是不稳定的，治疗是经验性的，如果真的有效的话，在缓解 主要症状。GpCRC的使命与国家儿童基金会的建议完全一致 消化疾病委员会：具体而言，研究目标2.6涉及胃瘫，并指出： “了解引起恶心和呕吐的有害内脏信号与胃神经电有关。 和/或运动功能障碍和大脑-肠道的双向相互作用。胃轻瘫提供了一种原型 疾病用于调查调查。慢性呕吐，一种使人虚弱和与社会隔离的消化症状， 造成液体和电解质动态平衡的潜在威胁生命的破坏，并损害营养 状态。慢性恶心仍然是一种严重的隐性残疾。恶心和呕吐通常是同时发生的 并与其他Gl症状叠加，以及在许多消化系统疾病中表现。更有效 恶心和呕吐的治疗将改善生活质量和身体功能 疾病。对于定义与恶心和呕吐相关的外周有害信号的研究还很少 这项建议的具体目标是：1.完成当前的 GpCRC登记处(登记处三)；2.扩大GpCRC核心实验室，负责解剖和相关研究 GP综合征患者的组织标本；3.对GP患者进行药理学研究 对患有GP综合征的患者进行一项新的设备/幽门介入研究方案； 以及5.利用几种新的方法来解决胃瘫症状患者的一些未得到满足的需求， 这可以被纳入该联盟的新研究中。