Gastric perception thresholds are low and sensory neuropeptide levels high in helicobacter pylori-positive functional dyspepsia.
OBJECTIVE
In functional dyspepsia (FD) decreased perception levels can be shown on gastric distension. Substance P (SP) and calcitonin gene-related peptide (CGRP) are involved in the sensitization of afferent neuronal pathways due to chronic inflammation. The role of Helicobacter pylori-induced gastric mucosal inflammation in the pathogenesis of FD is controversial. The aim of this study was to assess whether FD patients have altered mucosal concentrations of CGRP and SP, and to investigate whether this is associated with visceral hypersensitivity or H. pylori infection.


METHODS
Gastrointestinal symptoms, H. pylori status, perception thresholds at gastric balloon distension, and gastric mucosal concentrations of CGRP and SP were determined in 13 FD patients and 18 healthy controls (HC).


RESULTS
In H. pylori-positive FD patients discomfort and pain thresholds on gastric distension were lower compared to other groups. Antral mucosal levels of CGRP and SP were higher in H. pylori-positive subjects. In FD significantly negative correlations between discomfort and pain thresholds and antral mucosal concentrations of CGRP and SP were observed.


CONCLUSIONS
In FD low perception thresholds on gastric distension are associated with high levels of CGRP and SP in the antrum, suggesting that sensory neuropeptides are involved in FD pathophysiology.
Mönnikes
Hubert
H
Department of Medicine, Division of Hepatology and Gastroenterology, Charité, Campus Virchow-Klinikum, Humboldt-Universitat zu Berlin, Germany. hubert.moennikes@charite.de
van der Voort
Ivo R
IR
Wollenberg
Birgit
B
Heymann-Monnikes
Ingeborg
I
Tebbe
Johannes J
JJ
Alt
Wibke
W
Arnold
Rudolf
R
Klapp
Burghard F
BF
Wiedenmann
Bertram
B
McGregor
Gerard P
GP
D000293:Adolescent; D000328:Adult; D015740:Calcitonin Gene-Related Peptide / Q000032:analysis; D016022:Case-Control Studies; D004415:Dyspepsia / Q000382:microbiology / Q000503:physiopathology*; D005260:Female; D005753:Gastric Mucosa / Q000737:chemistry; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori / Q000472:pathogenicity*; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010465:Perception; D013270:Stomach / Q000033:anatomy & histology / Q000294:innervation / Q000502:physiology*; D013373:Substance P / Q000032:analysis
D013373:Substance P; D015740:Calcitonin Gene-Related Peptide