Altered hypothalamic cholinergic responses in patients with nonulcer dyspepsia: a study of pyridostigmine-stimulated growth hormone release.
OBJECTIVE
Acetylcholine plays a central and peripheral role in regulating gastric motility. In the hypothalamus, it is a key neuroendocrine modulator; acting through somatostatin, it brings about the release of growth hormone (GH). We measured hypothalamic cholinergic receptor sensitivity in patients with nonulcer dyspepsia (NUD) by examining GH release in response to cholinergic challenge.


METHODS
Forty patients with NUD and 40 healthy comparison subjects were administered pyridostigmine (the acetylcholinesterase inhibitor, 120 mg), and GH release over a 3-h period was monitored.


RESULTS
Calculating response as the maximum GH relative to baseline (delta GH), the mean +/- SEM response in the patients was 11.9 +/- 1.9 U/L and in the healthy subjects 6.7 +/- 0.7 mU/L (t = 2.1, df = 78, p = 0.03). Helicobacter pylori status had no appreciable impact on GH response with H. pylori-positive patients having a mean response of 10.5 +/- 2.1 mU/L and negative patients a mean response of 13.2 +/- 3.4 mU/L. Overall, patients with NUD release more GH in response to pyridostigmine challenge than healthy subjects.


CONCLUSIONS
Patients with NUD may have a pathophysiological disturbance involving central cholinergic systems.
Department of Pharmacology and Therapeutics, University College Cork, Ireland.
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Dinan
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Scott
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Brady
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McNamara
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Keeling
D000328:Adult; D000704:Analysis of Variance; D019540:Area Under Curve; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002800:Cholinesterase Inhibitors / Q000494:pharmacology*; D004415:Dyspepsia / Q000382:microbiology / Q000503:physiopathology*; D005260:Female; D005498:Follicular Phase; D013006:Growth Hormone / Q000097:blood / Q000378:metabolism*; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis; D016480:Helicobacter pylori; D006801:Humans; D007031:Hypothalamus / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D011729:Pyridostigmine Bromide / Q000494:pharmacology*; D012636:Secretory Rate / Q000187:drug effects
D002800:Cholinesterase Inhibitors; D013006:Growth Hormone; D011729:Pyridostigmine Bromide