Beta-endorphin in silent duodenal ulcer.
OBJECTIVE
To investigate whether duodenal ulcer patients with painful active peptic ulcer and those with silent active ulceration have different plasma beta-endorphin levels.


METHODS
Forty-five patients (28 men and 17 women), aged 38-50 years, with at least a 5-year history of duodenal ulceration. Twenty-two patients had painful symptoms, while 23 had silent active duodenal ulcer.


METHODS
Beta-endorphin plasma levels (pmol/l) were measured during an acute episode of duodenal ulcer, before and after antisecretory therapy with omeprazole. In three patients we measured the concentration of beta-endorphin in gastric juice before and after pentagastric (6 micrograms/kg subcutaneous) stimulation.


RESULTS
The basal values of beta-endorphin in both patients with asymptomatic and those with symptomatic duodenal ulcer showed no difference before or after 30 days of antisecretory treatment. Plasma beta-endorphin levels (median values in the normal range < 12 pmol/l) were significantly higher (Student's t-test, P < 0.005) in the asymptomatic than in symptomatic patients, both before (9.07 +/- 4.8 versus 5.6 +/- 2.5 pmol/l) and after (8.7 +/- 4.1 versus 5.7 +/- 2.4 pmol/l) omeprazole treatment. The highest levels of beta-endorphin were found in four patients with a negative history for any pain symptom (visual analogue scale score 0).


CONCLUSIONS
Our data suggest that the opioid system, particularly beta-endorphin, is involved in the perception of pain in duodenal ulcer disease, which explains the silent clinical characteristics of some peptic ulcers. In addition, the concentration of beta-endorphin found in gastric juice indicates a possible peripheral effect of this opiate.
Tonnarini
G F
GF
Institute of Clinical Medicine II, University of Rome La Sapienza, Italy.
Delle Fave
G
G
Chianelli
M
M
Mariani
P
P
Negri
M
M
D000328:Adult; D004381:Duodenal Ulcer / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009619:Nociceptors / Q000502:physiology; D009853:Omeprazole / Q000627:therapeutic use; D010146:Pain; D001615:beta-Endorphin / Q000097:blood* / Q000502:physiology
D001615:beta-Endorphin; D009853:Omeprazole