Temple University Gastroparesis Clinical Center

项目总结 胃瘫患者经常出现慢性胃肠道症状，而这些症状得不到充分治疗。 由于对潜在的病理生理学缺乏了解，也缺乏有效的治疗方法。这个 天普大学作为临床中心参与NIDDK胃轻瘫临床研究 财团和拟议的研究将有助于实现广泛的长期目标，即改善 胃轻瘫患者的认识和治疗。派和坦普尔大学完全有资格 继续成为该联盟的临床中心之一。坦普尔大学拥有临床专业知识和 积极研究胃瘫患者的评估和治疗方案。这样做的目的是 胃瘫协会的更新有三倍。第一，为了更好地了解黄斑狼疮的病理基础 继续提供胃瘫患者的胃全层活检标本。 我们现在正在收集胃窦部的标本，并获得新鲜的冰冻组织用于RNA表达。 第二，为了更好地了解慢性阻塞性肺疾病患者的临床表现和病理生理 通过维护和扩展胃轻瘫注册表来实现胃瘫。我们的目标是拥有四年的 对病人的跟踪，这将需要维持登记处和持续定期的后续访问。 我们建议继续招募新病人。对现有调查问卷和 病理生理学方法，以及新的方法，将使我们能够回答与 慢性阻塞性肺疾病患者的发病机制、严重程度分级、并发症、治疗反应和临床结果 胃瘫。第三，对胃轻瘫进行新的多中心研究，探讨其病理生理学， 诊断和治疗。我们的申请提出了三个研究，每个研究的目的都是为了理解 胃轻瘫症状的病理生理学及治疗。改进的测试将会更好 将病理生理学与胃瘫症状联系起来，最终实现对胃瘫的靶向治疗 潜在的胃部病理生理异常。我们的第一项研究将确定5HT-1受体的作用 丁螺环酮激动剂对早饱和胃内膳食分布的影响 胃瘫。我们的第二项研究是对胃瘫患者腹痛的评估，确定 慢性胰腺炎的患病率和治疗反应。最后，我们的第三项研究将评估临床 胃轻瘫患者接受胃镜下幽门肌切开术的结果，观察反应和 这一新疗法临床改善的预测因素。这三项研究最终将使 内科医生更好地靶向治疗慢性阻塞性肺疾病患者的潜在病理生理异常 胃瘫。坦普尔公司参与了美国国立卫生研究院胃瘫临床联合会，并承诺 坦普尔建议的研究将有助于实现财团的目标，因为它将促进我们对 对症状性胃轻瘫患者的病理生理和开发适当的治疗方法。

PROJECT SUMMARY Patients with gastroparesis often suffer with chronic gastrointestinal symptoms that are not adequately treated due to both a lack of understanding of the underlying pathophysiology and lack of effective treatments. The participation of Temple University as a clinical center in the NIDDK Gastroparesis Clinical Research Consortium and the proposed studies will help achieve the broad, long term objectives of improving the understanding and treatment of patients with gastroparesis. The PI and Temple University are well qualified to continue to be one of the clinical centers in this consortium. Temple University has clinical expertise and an active research program in the evaluation and treatment of patients with gastroparesis. The aims for this renewal of the Gastroparesis Consortium are threefold. First, to better understand the pathologic basis of gastroparesis by continuing to provide gastric full thickness biopsy specimens from patients with gastroparesis. We are now collecting specimens from the antrum and obtaining freshly frozen tissue for RNA expression. Second, to better understand the clinical manifestations and pathophysiology of patients with symptoms of gastroparesis by maintaining and expanding the Gastroparesis Registry. Our goal is to have four years of follow-up on patients which will require maintenance of the Registry and continued periodic follow-up visits. We propose to continue recruitment of new patients. Refinements to existing questionnaires and pathophysiologic measures, as well as new ones, will allow us to answer questions related to the pathogenesis, severity grading, complications, treatment responses, and clinical outcomes in patients with gastroparesis. Third, to conduct new multicenter studies of gastroparesis investigating the pathophysiology, diagnosis, and treatment. Our application proposes three studies, each aimed at the understanding of the pathophysiology of symptoms and treatment of symptoms from gastroparesis. Improved testing will better associate pathophysiology with gastroparesis symptoms and ultimately enable targeted therapy to the underlying gastric pathophysiologic abnormality. Our first study will determine the effect of the 5HT-1 receptor agonist, buspirone, on early satiety and intragastric meal distribution in patients with symptoms of gastroparesis. Our second study is an evaluation of abdominal pain in gastroparesis, determining the prevalence of and response to treatment for chronic pancreatitis. Finally, our third study will assess the clinical outcome of patients undergoing endoscopic pyloromyotomy for gastroparesis, looking at the response and predictive factors for clinical improvement with this novel treatment. These three studies will ultimately enable physicians to better target therapy to the underlying pathophysiologic abnormalities in patients with gastroparesis. Temple's participation in the NIH Gastroparesis Clinical Consortium and the undertaking of Temple's proposed studies will help achieve the goal of the consortium by advancing our understanding of the pathophysiology and developing appropriate treatments for patients with symptomatic gastroparesis.