BACKGROUND Visceral hypersensitivity is considered to play a vital role in the pathogenesis of irritable bowel syndrome(IBS). Neurotrophins have drawn much attention in IBS recently. Brain-derived neurotrophic factor(...BACKGROUND Visceral hypersensitivity is considered to play a vital role in the pathogenesis of irritable bowel syndrome(IBS). Neurotrophins have drawn much attention in IBS recently. Brain-derived neurotrophic factor(BDNF) was found to mediate visceral hypersensitivity via facilitating sensory nerve growth in pre-clinical studies. We hypothesized that BDNF might play a role in the pathogenesis of diarrhea-predominant IBS(IBS-D).AIM To investigate BDNF levels in IBS-D patients and its role in IBS-D pathophysiology.METHODS Thirty-one IBS-D patients meeting the Rome IV diagnostic criteria and 20 ageand sex-matched healthy controls were recruited. Clinical and psychological assessments were first conducted using standardized questionnaires. Visceral sensitivity to rectal distension was tested using a high-resolution manometry system. Colonoscopic examination was performed and four mucosal pinch biopsies were taken from the rectosigmoid junction. Mucosal BDNF expression and nerve fiber density were analyzed using immunohistochemistry. Mucosal BDNF mRNA levels were quantified by quantitative real-time polymerase chain reaction. Correlations between these parameters were examined.RESULTS The patients had a higher anxiety score [median(interquartile range), 6.0(2.0-10.0) vs 3.0(1.0-4.0), P = 0.003] and visceral sensitivity index score [54.0(44.0-61.0)vs 21.0(17.3-30.0), P < 0.001] than controls. The defecating sensation threshold[60.0(44.0-80.0) vs 80.0(61.0-100.0), P = 0.009], maximum tolerable threshold[103.0(90.0-128.0) vs 182.0(142.5-209.3), P < 0.001] and rectoanal inhibitory reflex threshold [30.0(20.0-30.0) vs 30.0(30.0-47.5), P = 0.032] were significantly lower in IBS-D patients. Intestinal mucosal BDNF protein [3.46 E-2(3.06 E-2-4.44 E-2) vs3.07 E-2(2.91 E-2-3.48 E-2), P = 0.031] and mRNA [1.57(1.31-2.61) vs 1.09(0.74-1.42), P = 0.001] expression and nerve fiber density [4.12 E-2(3.07 E-2-7.46 E-2) vs1.98 E-2(1.21 E-2-4.25 E-2), P = 0.002] were significantly elevated in the patients.Increased BDNF expression was展开更多
目的：实验证明神经节苷脂对中枢神经系统疾病，如颅内出血、HIE、脑梗死等有确切疗效。本试验是为进一步观察和分析早期使用神经节苷脂对新生儿室管膜下囊肿（SEC）的疗效。方法系统回顾2010年-2013年间200例经头颅 B 超诊断为室管膜...目的：实验证明神经节苷脂对中枢神经系统疾病，如颅内出血、HIE、脑梗死等有确切疗效。本试验是为进一步观察和分析早期使用神经节苷脂对新生儿室管膜下囊肿（SEC）的疗效。方法系统回顾2010年-2013年间200例经头颅 B 超诊断为室管膜下囊肿的足月新生儿，随机抽取200例进行分析。取其中100例患儿为治疗组，于确诊当天使用神经节苷脂营养脑治疗7～14天，另外100例无治疗患儿为对照组，分别对两组患儿在3、6、12个月时进行跟踪随访，检查内容包括头颅 B 超检查、体格测试、智能测试、脑干听觉诱发电位检查。内容包括头颅 B超检查、体格测试、智能测试、脑干听觉诱发电位检查。结果治疗组患儿3、6、12个月的体格发育指数与对照组无差异（P ＞0.05），而头颅 B 超观察囊肿吸收时间、脑干听觉诱发电位恢复正常时间及智能发育则优于对照组（P ＜0.05）。结论新生儿早期使用营养脑细胞药物对室管膜下囊肿的愈后有改善，值得推广使用。展开更多
基金Supported by the National Key Technology Support Program during "12th Five-Year Plan"Period of China,No.2014BAI08B00the Leapforward Development Program for Beijing Biopharmaceutical Industry(G20),No.Z171100001717008
文摘BACKGROUND Visceral hypersensitivity is considered to play a vital role in the pathogenesis of irritable bowel syndrome(IBS). Neurotrophins have drawn much attention in IBS recently. Brain-derived neurotrophic factor(BDNF) was found to mediate visceral hypersensitivity via facilitating sensory nerve growth in pre-clinical studies. We hypothesized that BDNF might play a role in the pathogenesis of diarrhea-predominant IBS(IBS-D).AIM To investigate BDNF levels in IBS-D patients and its role in IBS-D pathophysiology.METHODS Thirty-one IBS-D patients meeting the Rome IV diagnostic criteria and 20 ageand sex-matched healthy controls were recruited. Clinical and psychological assessments were first conducted using standardized questionnaires. Visceral sensitivity to rectal distension was tested using a high-resolution manometry system. Colonoscopic examination was performed and four mucosal pinch biopsies were taken from the rectosigmoid junction. Mucosal BDNF expression and nerve fiber density were analyzed using immunohistochemistry. Mucosal BDNF mRNA levels were quantified by quantitative real-time polymerase chain reaction. Correlations between these parameters were examined.RESULTS The patients had a higher anxiety score [median(interquartile range), 6.0(2.0-10.0) vs 3.0(1.0-4.0), P = 0.003] and visceral sensitivity index score [54.0(44.0-61.0)vs 21.0(17.3-30.0), P < 0.001] than controls. The defecating sensation threshold[60.0(44.0-80.0) vs 80.0(61.0-100.0), P = 0.009], maximum tolerable threshold[103.0(90.0-128.0) vs 182.0(142.5-209.3), P < 0.001] and rectoanal inhibitory reflex threshold [30.0(20.0-30.0) vs 30.0(30.0-47.5), P = 0.032] were significantly lower in IBS-D patients. Intestinal mucosal BDNF protein [3.46 E-2(3.06 E-2-4.44 E-2) vs3.07 E-2(2.91 E-2-3.48 E-2), P = 0.031] and mRNA [1.57(1.31-2.61) vs 1.09(0.74-1.42), P = 0.001] expression and nerve fiber density [4.12 E-2(3.07 E-2-7.46 E-2) vs1.98 E-2(1.21 E-2-4.25 E-2), P = 0.002] were significantly elevated in the patients.Increased BDNF expression was
文摘目的：实验证明神经节苷脂对中枢神经系统疾病，如颅内出血、HIE、脑梗死等有确切疗效。本试验是为进一步观察和分析早期使用神经节苷脂对新生儿室管膜下囊肿（SEC）的疗效。方法系统回顾2010年-2013年间200例经头颅 B 超诊断为室管膜下囊肿的足月新生儿，随机抽取200例进行分析。取其中100例患儿为治疗组，于确诊当天使用神经节苷脂营养脑治疗7～14天，另外100例无治疗患儿为对照组，分别对两组患儿在3、6、12个月时进行跟踪随访，检查内容包括头颅 B 超检查、体格测试、智能测试、脑干听觉诱发电位检查。内容包括头颅 B超检查、体格测试、智能测试、脑干听觉诱发电位检查。结果治疗组患儿3、6、12个月的体格发育指数与对照组无差异（P ＞0.05），而头颅 B 超观察囊肿吸收时间、脑干听觉诱发电位恢复正常时间及智能发育则优于对照组（P ＜0.05）。结论新生儿早期使用营养脑细胞药物对室管膜下囊肿的愈后有改善，值得推广使用。
