肠易激综合征肠黏膜SP、VIP、CGRP变化的研究

Changes of colonic substance P,vasoactive intestinal polypeptide and calcitonin gene-related peptide in irritable bowel syndrome

目的 :探讨肠易激综合征 (IBS)患者结肠黏膜 P物质 (SP)、血管活性肠肽 (VIP)和降钙素基因相关肽 (CGRP)的变化 ,以及它们在 IBS中的可能作用和临床意义。 方法 :黏膜标本取自 17例正常人、16例腹泻型 IBS(D- IBS)患者和 12例便秘型 IBS(C- IBS)患者的回盲部、乙状结肠 ,应用免疫组织化学染色法和放射免疫测定法分别检测 SP、VIP、CGRP。结果 :IBS患者结肠黏膜 SP、VIP含量均较正常对照组显著升高 (P<0 .0 1) ;IBS患者结肠黏膜 SP、VIP免疫反应阳性神经纤维较正常对照组增多、增粗、阳性增强 (P<0 .0 1) ;IBS患者与正常对照组结肠黏膜的 CGRP含量和 CGRP免疫反应阳性神经纤维的强度、面积、密度差异无统计学意义 (P>0 .0 5 )。 结论 :SP、VIP可能参与了 IBS的病理生理过程。

Objective: To investigate the changes of substance P(SP),vasoactive intestinal polypeptide(VIP),calcitonin gene related peptide(CGRP) ergic terminals in ileocecal junction(ICJ) and the sigmoid colon mucosa in irritable bowel syndrome(IBS),and to study their possible roles.Methods:The biopsies of the ICJ and the sigmoid colon were measured by radioimmunoassay and the neuropeptide positive terminals were studied by immunohistochemistry in 15 controls and 28 patients with IBS.The results of immunohistochemistry were investigated qualitatively and quantitatively by color image analyzer.Results: Significant increase of SP and VIP were found in IBS of colon compared to the controls ( P <0.01).Simultaneously,in the colon biopsies from IBS patients,the terminals of VIP and SP in the lamina propria were markedly increased in density and in degree of immunostaining compared to that of the controls ( P <0.01).The concentration of CGRP in the IBS patients were similar to those in the controls( P >0.05).Conclusion: VIP and SP are involved in the pathophysiological mechnism of IBS in certain ways,while the CGRP in sigmoid mucosa has no great significance in IBS.The possible role of VIP or SP in the colon suggests that further studies of the alterations of this gut peptide may be useful in the understanding IBS pathophysiology.