目的检测酸敏感离子通道3(ASIC3)在胃食管反流大鼠食管黏膜及背根神经节(DRG)中的表达变化,探讨其在胃食管反流病(GERD)发病中的作用。方法将Sprague-Dawley雄性大鼠随机分为实验组(G组)和对照组(S组)。实验组采用限制幽门及结扎胃底方...目的检测酸敏感离子通道3(ASIC3)在胃食管反流大鼠食管黏膜及背根神经节(DRG)中的表达变化,探讨其在胃食管反流病(GERD)发病中的作用。方法将Sprague-Dawley雄性大鼠随机分为实验组(G组)和对照组(S组)。实验组采用限制幽门及结扎胃底方法建立GERD大鼠模型。于造模后15 d处死两组大鼠,通过HE染色对大鼠食管黏膜进行组织病理学检测,通过蛋白质印迹法(Western blotting)和实时定量聚合酶链反应(RT-PCR)检测大鼠食管黏膜及DRG中ASIC3蛋白及mRNA表达变化。结果HE染色显示G组大鼠食管黏膜慢性炎症改变,S组大鼠食管黏膜无异常;Western blotting显示G组大鼠DRG中ASIC3蛋白表达高于S组(6.75±0.74 vs 5.07±0.72)(P<0.05),食管黏膜中ASIC3蛋白表达高于S组(8.04±0.67 vs 7.31±0.740)(P<0.05);RT-PCR同样显示,G组大鼠DRG中ASIC3 mRNA表达高于S组(0.00030±0.00003 vs 0.00013±0.00002)(P<0.05),食管黏膜中ASIC3 mRNA表达高于S组(0.01073±0.00231 vs 0.00088±0.0007)(P<0.05)。结论 ASIC3在DRG及食管黏膜上表达上调可能是导致GERD食管内脏高敏感的原因之一。展开更多
Background &Aims: Esophageal hypersensitivity is thought to be important in the generation and maintenance of symptoms in noncardiac chest pain (NCCP). In this study, we explored the neurophysiologic basis of esop...Background &Aims: Esophageal hypersensitivity is thought to be important in the generation and maintenance of symptoms in noncardiac chest pain (NCCP). In this study, we explored the neurophysiologic basis of esophageal hypersensitivity in a cohort of NCCP patients. Methods: We studied 12 healthy controls (9 women; mean age, 37.1 ±8.7 y) and 32 NCCP patients (23 women; mean age, 47.2 ±10 y). All had esophageal manometry, esophageal evoked potentials to electrical stimulation, and NCCP patients had 24-hour ambulatory pH testing. Results: The NCCP patients had reduced pain thresholds (PT) (72.1 ±19.4 vs 54.2 ±23.6, P = .02) and increased P1 latencies (P1 = 105.5 ±11.1 vs 118.1 ±23.4, P = .02). Subanalysis showed that the NCCP group could be divided into 3 distinct phenotypic classifications. Group 1 had reduced pain thresholds in conjunction with normal/reduced latency P1 latencies (n = 9). Group 2 had reduced pain thresholds in conjunction with increased (> 2.5 SD) P1 latencies (n = 7), and group 3 had normal pain thresholds in conjunction with either normal (n = 10) or increased (> 2.5 SD, n = 3) P1 latencies. Conclusions: Normal esophageal evoked potential latencies with reduced PT, as seen in group 1 patients, is indicative of enhanced afferent transmission and therefore increased esophageal afferent pathway sensitivity. Increased esophageal evoked potential latencies with reduced PT in group 2 patients implies normal afferent transmission to the cortex but heightened secondary cortical processing of this information, most likely owing to psychologic factors such as hypervigilance. This study shows that NCCP patients with esophageal hypersensitivity may be subclassified into distinct phenotypic subclasses based on sensory responsiveness and objective neurophysiologic profiles.展开更多
文摘目的检测酸敏感离子通道3(ASIC3)在胃食管反流大鼠食管黏膜及背根神经节(DRG)中的表达变化,探讨其在胃食管反流病(GERD)发病中的作用。方法将Sprague-Dawley雄性大鼠随机分为实验组(G组)和对照组(S组)。实验组采用限制幽门及结扎胃底方法建立GERD大鼠模型。于造模后15 d处死两组大鼠,通过HE染色对大鼠食管黏膜进行组织病理学检测,通过蛋白质印迹法(Western blotting)和实时定量聚合酶链反应(RT-PCR)检测大鼠食管黏膜及DRG中ASIC3蛋白及mRNA表达变化。结果HE染色显示G组大鼠食管黏膜慢性炎症改变,S组大鼠食管黏膜无异常;Western blotting显示G组大鼠DRG中ASIC3蛋白表达高于S组(6.75±0.74 vs 5.07±0.72)(P<0.05),食管黏膜中ASIC3蛋白表达高于S组(8.04±0.67 vs 7.31±0.740)(P<0.05);RT-PCR同样显示,G组大鼠DRG中ASIC3 mRNA表达高于S组(0.00030±0.00003 vs 0.00013±0.00002)(P<0.05),食管黏膜中ASIC3 mRNA表达高于S组(0.01073±0.00231 vs 0.00088±0.0007)(P<0.05)。结论 ASIC3在DRG及食管黏膜上表达上调可能是导致GERD食管内脏高敏感的原因之一。
文摘Background &Aims: Esophageal hypersensitivity is thought to be important in the generation and maintenance of symptoms in noncardiac chest pain (NCCP). In this study, we explored the neurophysiologic basis of esophageal hypersensitivity in a cohort of NCCP patients. Methods: We studied 12 healthy controls (9 women; mean age, 37.1 ±8.7 y) and 32 NCCP patients (23 women; mean age, 47.2 ±10 y). All had esophageal manometry, esophageal evoked potentials to electrical stimulation, and NCCP patients had 24-hour ambulatory pH testing. Results: The NCCP patients had reduced pain thresholds (PT) (72.1 ±19.4 vs 54.2 ±23.6, P = .02) and increased P1 latencies (P1 = 105.5 ±11.1 vs 118.1 ±23.4, P = .02). Subanalysis showed that the NCCP group could be divided into 3 distinct phenotypic classifications. Group 1 had reduced pain thresholds in conjunction with normal/reduced latency P1 latencies (n = 9). Group 2 had reduced pain thresholds in conjunction with increased (> 2.5 SD) P1 latencies (n = 7), and group 3 had normal pain thresholds in conjunction with either normal (n = 10) or increased (> 2.5 SD, n = 3) P1 latencies. Conclusions: Normal esophageal evoked potential latencies with reduced PT, as seen in group 1 patients, is indicative of enhanced afferent transmission and therefore increased esophageal afferent pathway sensitivity. Increased esophageal evoked potential latencies with reduced PT in group 2 patients implies normal afferent transmission to the cortex but heightened secondary cortical processing of this information, most likely owing to psychologic factors such as hypervigilance. This study shows that NCCP patients with esophageal hypersensitivity may be subclassified into distinct phenotypic subclasses based on sensory responsiveness and objective neurophysiologic profiles.
