肠道通透性
促肾上腺皮质激素释放激素
内科学
内分泌学
肥大细胞
激素
乳果糖
医学
甘露醇
化学
免疫学
生物化学
作者
Tim Vanuytsel,Sander Van Wanrooy,Hanne Vanheel,Christophe Vanormelingen,Sofie Verschueren,Els Houben,Shadea Salim Rasoel,Joran Tóth,Lieselot Holvoet,Ricard Farré,Lukas Van Oudenhove,Guy E. Boeckxstaens,Kristin Verbeke,Jan Tack
出处
期刊:Gut
[BMJ]
日期:2013-10-23
卷期号:63 (8): 1293-1299
被引量:429
标识
DOI:10.1136/gutjnl-2013-305690
摘要
Intestinal permeability and psychological stress have been implicated in the pathophysiology of IBD and IBS. Studies in animals suggest that stress increases permeability via corticotropin-releasing hormone (CRH)-mediated mast cell activation. Our aim was to investigate the effect of stress on intestinal permeability in humans and its underlying mechanisms.Small intestinal permeability was quantified by a 2 h lactulose-mannitol urinary excretion test. In a first study, 23 healthy volunteers were subjected to four different conditions: control; indomethacin; public speech and anticipation of electroshocks. In a second study, five test conditions were investigated in 13 volunteers: control; after pretreatment with disodium cromoglycate (DSCG); administration of CRH; DSCG+CRH and DSCG+public speech.Indomethacin, as a positive comparator (0.071±0.040 vs 0.030±0.022; p<0.0001), and public speech (0.059±0.040; p<0.01), but not the shock protocol increased intestinal permeability. Similarly, salivary cortisol was only increased after public speech. Subgroup analysis demonstrated that the effect of public speech on permeability was only present in subjects with a significant elevation of cortisol. CRH increased the lactulose-mannitol ratio (0.042±0.021 vs 0.028±0.009; p=0.02), which was inhibited by the mast cell stabiliser DSCG. Finally, intestinal permeability was unaltered by public speech with DSCG pretreatment.Acute psychological stress increases small intestinal permeability in humans. Peripheral CRH reproduces the effect of stress and DSCG blocks the effect of both stress and CRH, suggesting the involvement of mast cells. These findings provide new insight into the complex interplay between the central nervous system and GI function in man.
科研通智能强力驱动
Strongly Powered by AbleSci AI