Vasoactive Intestinal Peptide (VIP) and VIP Receptors-Elucidation of Structure and Function for Therapeutic Applications

Vasoactive intestinal peptide (VIP) is a 28-amino acid polypeptide first isolated from swine duodenum. VIP is a neurotransmitter that is extensively distributed in tissues. According to published reports, VPAC1 and VPAC2 act as VIP receptors and are widely present in the central nervous system and peripheral tissues. VIP exerts diverse actions on the cardiovascular system, pancreas, digestive tract, respiratory system, and urological system. Recent reports indicated that VIP has immunological and neuroprotective effects and also affects cell growth. While primary investigations for developing therapeutic applications for various pathological conditions and diseases are underway, the structure and function of VIP should be analyzed in more detail.

Vasoactive intestinal polypeptide (VIP) corrects chronic inflammatory response syndrome (CIRS) acquired following exposure to water-damaged buildings

Exposure in water-damaged buildings (WDB) to airborne bioaerosols including metabolic products of toxigenic fungi, bacteria and actinomycetes;and inflammagens, can lead to a persistent innate immune inflammatory illness. This illness, termed a chronic inflammatory response syndrome (CIRS-WDB), is systemic with symptoms acquired from multiple organ systems. Treatment of CIRS-WDB has progressed rapidly as a better understanding of the inflammatory pathophysiology has led to targeted, sequential therapies. The fundamental basis of uncontrolled innate immune responses, the humoral deficiency of regulatory neuropeptides melanocyte stimulating hormone (MSH) or vasoactive intestinal polypeptide (VIP), seen in over 98% of pa tients, has not consistently responded to any treatment modality. Use of replacement VIP has been attempted anecdotally;VIP replacement therapies show promise in short term studies but longer therapies have not been attempted. Here we report an open label trial of 20 patients with refractory CIRS-WDB illness who took replacement VIP in a nasal spray for at least 18 months with confirmation of durable efficacy and absence of significant side effects. These 20 patients were similar in symptoms and lab find- ings to three previously published cohorts in- volving 1829 patients and 169 controls. Dosage of VIP was titrated downwards from four to zero doses a day to determine minimum effective dose, and retitrated upwards for maximum improvement over time. The trial showed that VIP therapy safely 1) reduced refractory symptoms to equal controls;2) corrected inflammatory parameters C4a, TGF beta-1, VEGF, MMP9;3) corrected estradiol, testosterone and 25-OH Vitamin D;4) returned pulmonary artery systolic pressure (PASP) during exercise to normal;and 5) enhanced quality of life in 100% of trial patients. Subsequent identification of correction of T-regulatory cell levels supports the potential role of VIP in both innate and adaptive immune function.

Role of vasoactive intestinal peptide and nitric oxide in the modulation of electroacupucture on gastric motility in stressed rats

AIM: To investigate the effects and mechanisms of vasoactive intestinal peptide (VIP) and nitric oxide (NO) in the modulation of electroacupucture (EA) on gastric motility in restrained-cold stressed rats. METHODS: An animal model of gastric motility disorder was established by restrained-cold stress. Gastric myoelectric activities were recorded by electrogastroent erography (EGG). VIP and NO concentrations in plasma and gastric mucosal and bulb tissues were detected by radioimmunoassay (RIA). VIP expression in the gastric walls was assayed using avidin-biotin-peroxidase complex (ABC) and image analysis. RESULTS: In cold restrained stressed rats, EGG was disordered and irregular. The frequency and amplitude of gastric motility were higher than that in control group (P < 0.01). VIP and NO contents of plasma, gastric mucosal and bulb tissues were obviously decreased (P < 0.01). Following EA at “Zusanli” (ST36), the frequency and amplitude of gastric motility were obviously lowered (P < 0.01), while the levels of VIP and NO in plasma, gastric mucosal and bulb tissues increased strikingly (P < 0.01, P < 0.05) and expression of VIP in antral smooth muscle was elevated significantly (P < 0.01) in comparison with those of model group. CONCLUSION: VIP and NO participate in the modulatory effect of EA on gastric motility. EA at “Zusanli” acupoint (ST36) can improve gastric motility of the stressed rats by increasing the levels of VIP and NO.

Differences and significance of motilin,vasoactive intestinal peptide and gastrin in blood and gallbladder tissues of patients with gallstones

BACKGROUND: The disorders of gallbladder motility may play an important role in the formation of gallstones. Many neural and hormonal factors and their interactions regulate gallbladder motility and bile flow into the duodenum. Further study in these factors may help to reveal the etiology of gallbladder diseases. This study was undertaken to assess the relationship of the levels of motilin, vasoactive intestinal peptide (VIP) and gastrin in blood and gallbladder tissues with the formation of cholelithiasis. METHODS: The levels of motilin, gastrin and VIP in blood and gallbladder tissues of 36 patients with gallbladder stones, 14 patients with gallbladder polyps, 10 healthy volunteers and 10 patients with common bile duct stones were measured by radioimmunoassay. RESULTS: The level of motilin in plasma and gallbladder tissues of the gallbladder stone group was higher than that of the control and gallbladder polyp groups (P<0.05). The levels of plasma VIP and serum gastrin were much higher than those of the other three groups (P<0.01). The level of VIP in gallbladder tissues was higher than that of the control and gallbladder polyp groups (P<0.01). CONCLUSIONS: The abnormal excretion of hormonal factors is closely related to gallstone formation. The high level of VIP in gallbladder tissues may be an important cause of gallbladder hypomotility. The abnormal level of serum gastrin may be related to the gastrointestinal symptoms of patients with gallstones.

Recombinant expressed vasoactive intestinal peptide analogue ameliorates TNBS-induced colitis in rats

AIM To investigate the modulatory effect of recombinantexpressed vasoactive intestinal peptide(VIP) analogue(rVIPa) on trinitrobenzene sulfonic acid(TNBS)-induced colitis in rats. METHODS Forty-eight rats were randomized into six groups: normal control group(Control), model control group(TNBS), ethanol treatment group(ETOH), and VIP treatment groups with different dosage(rVIPa_(1nmol), rVIPa_(2nmol), rVIPa_(4nmol)). Diarrhea and bloody stool were observed. Colonic damage was evaluated histologically. The levels of tumor necrosis factor-α( TNF-α), interleukin-10(Il-10), myeloperoxidase(MPO) and endotoxin in colonic tissue and serum were determined by enzyme-linked immunosorbent assay(ElISA). The expression of occludin, ZO-1, Toll-like receptor 4(TlR4),and nuclear factor-kappa B p65(NF-κBp65), IκBα, and p-IκBα were detected by Western blot. RESULTS Administration with 2 nmol rVIPa prevented TNBSinduced necrosis, hyperemia, swelling, inflammation, etc., pathologic changes observed in the inner surface of colon in experimental rats. Moreover, rVIPa significantly decreased colonic TNF-α level(P < 0.001), MPO activity(P < 0.001) and serum endotoxin level(P < 0.01), and remarkably increased colonic Il-10 content(P < 0.001) in rats with TNBS-induced colitis. Furthermore, compared to the TNBS-induced colitis group, 2 nmol rVIPa treatment up-regulated the levels of occludin(P < 0.05) and ZO-1(P < 0.05), NF-κB p65(P < 0.01) and IκBα(P < 0.001), and down-regulated the levels of TlR4. CONCLUSION rVIPa ameliorates TNBS-induced colonic injury and inflammation and effectively protected the intestinal mucosal barrier function in rats. The mechanism may be related to TlR4/NF-κB-mediated signaling pathway. rVIPa could be used as a new alternative therapy for intestinal inflammatory disorders.

Roles of sphincter of Oddi motility and serum vasoactive intestinal peptide,gastrin and cholecystokinin octapeptide

AIM: To investigate roles of sphincter of Oddi (SO) motility played in pigment gallbladder stone formation in model of guinea pigs.

Vasoactive intestinal peptide,a promising agent for myopia?

AIM： To investigate the role of vasoactive intestinal peptide（VIP） in form-deprivation myopia（FDM）.METHODS： FDM was created in three groups of eight chicks by placing a translucent diffuser on their right eyes.Intravitreal injections of saline and VIP were applied once a day into the occluded eyes of groups 2 and 3,respectively.Retinoscopy and axial length（AL） measurements were performed on the first and 8^th days of diffuser wear.The retina mR NA levels of the VIP receptors and the ZENK protein in right eyes of the three groups and left eyes of the first group on day 8 were determined using real time polymerase chain reaction（PCR）.RESULTS： The median final refraction（D） in right eyes were-13.75（-16.00,-12.00）,-11.50（-12.50,-7.50）,and-1.50（-4.75,-0.75） in groups 1,2,and 3,respectively（P〈0.001）.The median AL（mm） in right eyes were 10.65（10.00,11.10）,9.90（9.70,10.00）,and 9.20（9.15,9.25） in groups 1,2,and 3,respectively（P〈0.001）.The median delta-delta cycle threshold（CT） values for the VIP2 receptors were 1.07（0.82,1.43）,1.22（0.98,1.65）,0.29（0.22,0.45） in right eyes of groups 1,2,and 3,and 1.18（0.90,1.37） in left eyes of group 1,respectively（P=0.001）.The median delta-delta CT values for the ZENK protein were 1.07（0.63,5.03）,3.55（2.20,5.55）,undetectable in right eyes of groups 1,2,and 3 and 1.89（0.21,4.73） in left eyes of group 1,respectively（P=0.001）.CONCLUSION： VIP has potential inhibitory effects in the development of FDM.

Research advances of vasoactive intestinal peptide in the pathogenesis of ulcerative colitis by regulating interleukin-10 expression in regulatory B cells

Ulcerative colitis(UC)is a chronic relapsed intestinal disease with an increasing incidence around the world.The pathophysiology of UC remains unclear.However,the role of the interaction between the enteric nervous system and the immune system in the pathogenesis of UC has been the focus of attention and has become a research hotspot.Vasoactive intestinal peptide(VIP)is a kind of endogenous neuropeptide with regulatory activity on intestinal immunity.It has been shown to regulate immune disorders in animal and human experiments and has become an effective anti-inflammatory and immune modulator that affects the innate immune system and adaptive immune system.Regulatory B cells(Bregs)are a new group of B cells that negatively regulate the immunity and have received extensive attention in immune circles.Bregs can regulate immune tolerance by producing interleukin(IL)-10,IL-35,and transforming growth factor-β,suppressing autoimmune diseases or excessive inflammatory responses.The secretion of IL-10 by Bregs induces the development of T helper(Th)0 and Th2 cells.It also induces Th2 cytokines and inhibits Th1 cytokines,thereby inhibiting Th1 cells and the Th1/Th2 balance.With further clarity on the mechanism of the regulation of IL-10 expression by VIP in Bregs in colitis patients,we believe that Bregs can provide a novel strategy for the clinical treatment of UC.Thus,we aim to review the current literature on this evolving topic.

Effect of vasoactive intestinal peptide on the wound healing of alkali-burned corneas

AIM： To study the effect of vasoactive intestinal peptide （VIP） on wound healing in experimental alkali burns of the cornea. METHODS： Twenty-seven albino rabbits, weighing 3.2 -0.75 kg were used. Alkali burns were induced on corneas by applying 10 mm Whatman paper No：50 soaked in 1 mol/L NaOH. They have further classified into 5 groups as follows： 1） control group given no treatment （n=5）; 2） VIP given subconjunctivally （n=6）; 3） VIP injected into anterior chamber （n=6）; 4） NaCI 0.9% given subconjunctivally （n=5）; 5） NaCI 0.9% given into the anterior chamber （n=5）. All treatment protocols except control group were followed by topical eye drops composed of VIP at two hourly intervals for one week from 8 a.mo to 6 p.m, RESULTS： VIP treated groups of rabbits with alkali burns were found to have better wound healing findings histo-pathologically when compared to those of control group who have received no treatment on day 30. No differences were observed between groups in respect to degree of polymorphonuclear leukocytes （PMNL） infiltration and degree of loss of amorphous substrate on day 15. However, PMNL infiltration and degree of loss of amorphous substrate were lower in Groups 2 and 3 when compared to that of control group on day 30 （P〈0.05）. CONCLUSION： We have shown that VIP has positive effects on alkali induced corneal burns. VIP may inhibit PMNL migration to cornea through an immunomodulatory effect. Inhibition of PMNL migration might reduce the release of collagenaees and this might prevent the extracellular amorphous substance loss.

Octreotide reverses shock due to vasoactive intestinal peptide-secreting adrenal pheochromocytoma: A case report and review of literature

Vasoactive intestinal peptide-producing tumors （VIP-oma） usually originate in the pancreas and are chara-cterized by diarrhea, hypokalemia, and achlorhydria （WDHA syndrome）. In adults, nonpancreatic VIPoma is very rare. Herein, we report an unusual case of VIP-producing pheochromocytoma marked by persistent shock, fushing, and watery diarrhea and high sensitivity to octreotide. A 53-year-old woman was hospitalized for sudden-onset hypertension with convulsions, which then rapidly evolved to persistent shock, fushing, and watery diarrhea. Abdominal computed tomography indicated a left adrenal mass, accompanied by bleeding;and marked elevations of both plasma catecholamine and VIP concentrations were documented via laboratory testing. Surprisingly, all clinical symptoms responded swiftly to octreotide treatment. Once surgically treated, hormonal levels normalized in this patient, and the clinical symptoms dissipated. Postoperative pathological and immunohistopathological studies confrmed a VIP-secreting pheochromocytoma with strong, diffuse positivity for somatostatin receptor type 2. During a 6-mo follow-up period, she seemed in good health andwas symptom-free.

Role of vasoactive intestinal peptide in Aspergillus fumigatus-infected cornea

AIM： To investigate the anti-inflammatory role of vasoactive intestinal peptide（VIP） in Aspergillus fumigatus（A. fumigatus） ketatitis.METHODS： Expression of VIP was tested by polymerase chain reaction（PCR） in C57BL/6 and BALB/c normal and A. fumigatus infected corneas. C57BL/6 mice were pretreated with recombinant（r） VIP, while BALB/c mice were pretreated with VIP antagonist, and then infected with A. fumigatus. Clinical score was recorded. Expression of pro-and anti-inflammatory cytokines, toll-like receptor 4（TLR4）, lectin-like oxidized low-density lipoprotein receptor 1（LOX-1）, and neutrophil infiltration were tested by PCR, enzyme-linked immunosorbent assay（ELISA）, and myeloperoxidase（MPO） assay.RESULTS： VIP mR NA expression in BALB/c cornea was higher than C57BL/6 cornea at 1 and 3 d post infection（p.i.）. rV IP treatment of C57BL/6 mice showed alleviated disease and down-regulated expression of interleukin-1β（IL-1β） and tumor necrosis factor-α（TNF-α）, while IL-10 expression was up-regulated. Neutrophil infiltration and TLR4, IL-17 expression were decreased after rVIP treatment, while LOX-1 expression was up-regulated in C57BL/6. VIP antagonist pretreatment showed increased disease and higher IL-1β, TNF-α, TLR4, IL-17 and MPO levels, while IL-10 and LOX-1 levels were down-regulated in BALB/c mice.CONCLUSION： rVIP alleviate disease response of C57BL/6 mice. VIP antagonist resulted in worsened disease of BALB/c mice. VIP proposed anti-inflammatory role in A. fumigatus keratitis.

Vasoactive intestinal peptide secreting tumour:An overview

Vasoactive intestinal peptide(VIP)secreting tumour(VIPoma)is a rare functional neuroendocrine tumour that typically arises from pancreatic islet cells.These present as sporadic,solitary pancreatic neoplasias with an estimated incidence of one in ten million individuals per year.Only around 5%of VIPomas are associated with multiple endocrine neoplasia type I syndrome.Excessive VIP secretion produces a clinical syndrome characterized by refractory watery diarrhoea,hypokalemia and metabolic acidosis.These coupled with elevated plasma levels of VIP are diagnostic.The majority of VIPomas are malignant and have already metastasized at the time of diagnosis(60%).Metastases occur most frequently in the liver,or regional lymph nodes,lungs,kidneys and bones.Some reports of skin metastases have been documented.Complete surgical resection continues to be the only potentially curative treatment.However,when the neoplasia cannot be excised completely,surgical debulking may provide palliative benefit.Other palliative options have included recently the peptide receptor radionuclide therapy which has shown to be effective and well-tolerated.This article will review all aspects of pancreatic VIPomas highlighting aspects such as clinical presentation,diagnosis and management.

Effect of vasoactive intestinal peptide on proliferation of hepatoma cells

It has been found that vasoactive intestinal peptide (VIP) stimulates the growth ofseveral kinds of tumor cells.There is no report so far about the effect of VIP on the growth ofhepatoma cells.Using the tetrazolium colorimetric assay (MTT assay) and cell countingmethod,it was investigated that the effect of VIP on the growth of a cultured rat hepatomaFSK-7902 cells.The results showed that VIP stimulated the proliferation of the rat hepatomacells obviously.The addition of 1μmol/L VIP caused a significant increase in the number of thecultured rat hepatoma cells on 3rd day and maximal increase occured on 4th day and 5th day ( P【0.01).The growth promoting effect was greater as the concentration of VIP increased.Thelowest effective concentration of VIP was 0.5μmol/L.Exposure to VIP for 12 h followed by re-moval of the peptide resulted in sustained growth for several days.

EFFECTSOFVASOACTIVEINTESTINALPEPTIDEONACTIVITIESOFSUCCINICDEHYDROGENASEANDALKALINEPHOSPHATASEINRATHEPATOMACELLS

Using cytochemical method,microspectrophotometry and image analysis,effects of va-soactive intestinal peptide(VIP)on activities of succinic dehydrogenase(SDH)and alkalinephosphatase(ALP)in rat hepatoma cells were studied in vitro.The results showed that thehepatoma cell expressed potent positive reactions of SDH and ALP,the positive positionswere located at the cell membranes and/or cytoplasm.Having been treated with VIP,ALPdecreased obviously in activity(P【0. 01,compared with hepatoma cells untreated by VIP).The sites of ALP activty were chiefly located at the cell membranes,particularly at the cell-cell contacts.Cultured rat hepatoma cells had intensive SDH activity in their cytoplasm.Compared with untreated eclls,there was no marked difference in the intensity of SDH activ-ity in VIP-treated hepatoma cells(P】0.05).

RELAXANT EFFECTS OF VASOACTIVE INTESTINAL PEPTIDE ON PULMONARY ARTERY IN CHRONICALLY HYPOXIC RATS

The object of this study is to investigate the effect of VIP on pulmonary artery of chronically hypoxic rats. It was shown that chronic hypoxia depressed significantly pulmonary artery relaxation induced by VIP as compared with those of control (P<0. 001). The vascular relaxation of both groups was correlated with concentration of VIP. In addition, the relaxant effect of VIP on pulmonary arteries in rats was endothelium─independent, and was not prevented by indomethacin or nordihydroguaiaretic acid, but was abolished completely by methylene blue. These results suggest that the lower relaxation of pulmonary artery in rats might not be due to the endothelial injury caused by chronic hypoxia, and chronic hypoxia may inhibit directly the soluble guanylate cyclase in vascular smooth muscle cells invloved in synthesis of cGMP and thus reduced the sensitivity and reactivity of pulmonary artery to VIP.

THE AUTOCRINE REGULATORY EFFECT OF VASOACTVE INTESTINAL PEPTIDE ON THE GROWTH OF HUMAN PANCREATIC CARCINOMA CELLS

In the present study, the effects of VIP on the growth of two human pancreatic carcinoma cell lines PU-PAN-l and PANC-I were determined using tritiated thymidine incorporation. VIP receptors. intracellular cAMP and polyamines were investigated. The results indicated that VIP at a concentration of 10-8 mol/L to 10-7 mol/L can significantly stimulate the growth of PU-PAN-I cells but not PANC-1 cells. This effect is dose-dependent and abolished by VIP receptor antagonist, [4-C1-Phe6 . Leu17] VIP, suggesting VIP receptors in PU-PAN-I cells may mediate this effect. VIP can markedly elevate the levels of intracellular cAMP and polyamines in PU-PAN-I cells.indicating that the growth-promoting effect stimulated by VIP may be via a rapid increase in the biosyntheses of cAMP and polyamines. In addition, the VIP-antibody inhibited the growth of PU-PAN-I cells in serum-free culture mediurn. The results above suggested that VIP has an autocrine regulatory effect on this pancreatic carcinoma cell line (PU-PAN-1).

Effect of Vasocation Intestinal Peptide on Immune Privilege of the Rat Testis

Objective To study the effect of vasocation intestinal peptide （VIP） on immune privilege of the rat testis. Methods The UU infected SD rats and Leydig cells were intervened by VIP, the secretion of TGF-β and the expression of FasL in rat Leydig cells were compared between VIP-intervened group and control group to test the effect of VIP on immune privilege of the rat testis in vitro and in vivo. Results In vitro, the secretion of TGF-β in Leydig cells could be increased by low dosage of VIP while inhibitited by high dosage of VIP; expression of FasL mRNA in Leydig cells could be decreased by VIP In vivo, increased expression of TGF-β mRNA and decreased FasL mRNA were observed in VIP group in 2-3 weeks after infected by UU. In addition, the apoptosis of Jurkat cells mediated by Leydig cells could be prevented by VIP Conclusion When Leydig cells or testis infected by UU, VIP could regulate the immune function of rat Leydig cells and participate in the regulation of immune privilege of testis through the regulation of TGF-β secretion and FasL expression pattern of Leydig cells.

养荣润肠舒合剂对慢性传输型便秘SD大鼠结肠5-HT、VIP的影响

目的探讨慢性传输型便秘大鼠结肠黏膜5-羟色(5-hydroxytryptophan,5-HT)、血管活性肠多肽(vasoactive intestinal polypeptide,VIP)的含量,以明确中药制剂养荣润肠舒合剂对大鼠结肠5-HT、VIP表达的调节作用。方法将60只健康的SD大鼠随机分为空白组10只,造模组50只(模型组10只、莫沙必利组10只、养荣润肠舒合剂高、中、低剂量组各10只)。应用复方地芬诺酯灌胃(2 mL/200 g体质量)以复制慢性传输型便秘大鼠模型(每天1次,连续10 d)。期间记录大鼠首次排便时间,并收集粪便、测量粪便剂量、含水量以判断造模是否成功。复制模型成功后进行药物治疗,每天1次,连续10 d。然后采用间接酶联免疫吸附试验(Enzyme Linked Immunosorbent Assay,ELISA)观测大鼠结肠5-HT、VIP的光密度(optical density,OD)值。结果①与空白组比较,模型组SD大鼠的首次排便时间延后,且新鲜粪便的剂量、含水量减少,差异有显著统计学意义(P<0.01)。②与模型组比较,莫沙必利组和养荣润肠合剂低、中、高剂量组治疗后大鼠的首次排便时间均提前,且粪便的含水率、重量除使用养荣润肠低组外均有所增长(P<0.01)。③与莫沙必利组比较,养荣润肠舒合剂中组剂量组大鼠的一般状况最好,首次排便时间最接近莫沙必利组且较短于莫沙必利组,差异无统计学意义(P>0.05),新鲜粪便剂量最接近莫沙必利组且较重于莫沙必利组,差异无统计学意义(P>0.05),含水量明显优于莫沙必利组,差异有统计学意义(P<0.05);养荣润肠舒合剂高剂量组大鼠排便状况与莫沙必利组相差不大,差异无统计学意义(P>0.05);莫沙必利组大鼠排便状况明显优于养荣润肠舒合剂低剂量组,差异有显著统计学意义(P<0.01)。④养荣润肠舒合剂中剂量组的大鼠一般状况更佳,而低剂量组的大鼠状况较差,新鲜粪便的剂量、含水量较小。⑤与空白组比较,模型组大鼠近端结肠组织5-HT、VIP的含量显著降低,OD值缩小(P<0.01)。⑥治疗后与模型组比较,莫沙必利组及养荣润肠舒合剂低、中、高剂量SD大鼠结肠5-HT、VIP含量显著升高,OD值增加,差异有明显统计学意义(P<0.01)。⑦治疗后与莫沙必利组比较,养荣润肠舒合剂中剂量大鼠结肠的5-HT、VIP含量及OD值增加,最接近莫沙必利组且较高于莫沙必利组,差异无统计学意义(P>0.05);养荣润肠舒合剂高剂量组大鼠状况及大鼠结肠5-HT、VIP含量与莫沙必利组相差不大,差异无统计学意义(P>0.05)。⑧与养荣润肠舒合剂高剂量组比较,养荣润肠舒合剂中剂量组大鼠结肠5-HT、VIP含量更高,OD值差异无统计学意义(P>0.05),而养荣润肠舒合剂低剂量组大鼠结肠的5-HT、VIP含量相对较低,与养荣润肠舒合剂中剂量组相比OD值也较低,具有统计学意义(P<0.01)。结论5-HT作为脑—肠轴的关键神经递质,VIP作为存在于中枢神经和肠神经系统中的神经递质,在慢性传输型便秘的发病中起着重要的作用;中药方剂养荣润肠舒合剂能有效提高慢性传输型便秘大鼠结肠5-HT、VIP含量,增强5-HT、VIP的表达有关;因此,作者认为养荣润肠舒合剂可能是通过这一机制改善慢性传输型便秘的临床症状,从而达到“以补治秘”的目的。

血清DAO、VIP、PCT水平与急性肠梗阻病情相关性及其联合检测对绞窄性肠梗阻的诊断价值

目的探究急性肠梗阻患者血清二胺氧化酶(DAO)、血管活性肠肽(VIP)、降钙素原(PCT)水平与病情的相关性,分析其对绞窄性肠梗阻的诊断价值。方法回顾性选取2019年5月至2023年5月医院收治的102例急性肠梗阻患者为研究组,同期于医院体检的34例健康志愿者为对照组,检测并比较两组血清DAO、VIP、PCT水平。研究组接受肠切除术治疗,依据术中肠管缺损情况分为轻损伤者(60例)、重损伤者(42例),比较其入院时、术后1 d、术后3 d血清DAO、VIP、PCT水平。依据术后诊断将研究组患者分为单纯性肠梗阻(53例)、绞窄性肠梗阻(49例),比较其临床资料及入院时血清DAO、VIP、PCT水平。多因素logistic回归分析绞窄性肠梗阻发生的影响因素。采用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析入院时血清DAO、VIP、PCT水平对绞窄性肠梗阻的诊断价值。结果研究组血清DAO、VIP、PCT水平高于对照组(P<0.05);入院时、术后1 d、术后3 d肠管重损伤者血清DAO、VIP、PCT水平高于轻损伤者,且随着术后时间延长各血清水平呈下降趋势(P<0.05);绞窄性肠梗阻者入院时血清DAO、VIP、PCT水平高于单纯性肠梗阻者(P<0.05);腹部手术史及入院时血清DAO、VIP、PCT水平为绞窄性肠梗阻发生的独立危险因素(P<0.05);入院时血清DAO、VIP、PCT水平联合检测绞窄性肠梗阻的AUC大于任意两项指标联合检测,且大于单项指标检测(P<0.05)。结论急性肠梗阻患者血清DAO、VIP、PCT水平升高,联合检测其水平对绞窄性肠梗阻具有一定诊断价值,并可能作为评估病情严重程度的辅助指标。

调神健脾针法结合穴位贴敷治疗肠易激综合征疗效及对血清5-HT、VIP水平的影响

目的:观察调神健脾针法结合穴位贴敷治疗肠易激综合征(IBS)疗效及对血清5-羟色胺(5-HT)、血管活性肠肽(VIP)水平的影响。方法:选取2020年11月~2022年11月本院收治的110例IBS患者,遵随机数字表法分为55例对照组(常规西药治疗)和55例观察组(对照组基础上+调神健脾针法+穴位贴敷)。比较两组间疗效,比较两组治疗前后中医症状积分,IBS症状严重程度评分(IBS-SSS)和内脏敏感指数评分(VSI),直肠容量刺激感觉指标(排便阈值、疼痛阈值、感觉阈值)及血清5-HT和VIP水平,记录两组不良反应发生情况。结果:治疗后,观察组总有效率为96.36%,显著高于对照组的85.45%(P<0.05);治疗后,两组中医症状积分(腹痛即泻、急躁易怒、纳呆、两胁胀满和身倦乏力)均明显降低(P<0.05),且观察组显著低于对照组(P<0.05);治疗后,两组IBSSSS和VSI评分均明显降低(P<0.05),且观察组显著低于对照组(P<0.05);治疗后,两组排便阈值、感觉阈值和疼痛阈值均明显升高(P<0.05),且观察组显著高于对照组(P<0.05);治疗后,两组5-HT和VIP水平均明显降低(P<0.05),且观察组显著低于对照组(P<0.05);两组在治疗过程中均未发生明显不良反应。结论:调神健脾针法结合穴位贴敷治疗IBS患者疗效确切,能有效改善患者腹痛、腹泻等临床症状,调节机体5-HT和VIP水平,值得应用。