Alterations of neuropeptides in the human gut during peritonitis.
OBJECTIVE
Gastrointestinal motility is reduced during sepsis but the pathomechanism involved is poorly understood. We investigated the expression of substance P (SP) and vasoactive intestinal peptide (VIP) in the myenteric plexus during peritonitis in human small bowel.


METHODS
Tissue samples of the small bowel were gathered from healthy patients and from patients with peritonitis. Immunohistochemistry for myeloperoxidase (MPO), SP, and VIP was performed in whole mount sections. To determine the level of inflammation, MPO-positive cells were counted in the circular muscle layer. SP and VIP immunoreactivity was analyzed in myenteric plexus neurons. The area of positive immunoreactivity for either neuropeptide within the plexus was analyzed and set in relation to the total area of the plexus and consecutively expressed as percentage.


RESULTS
During peritonitis, MPO-positive cells significantly increased by approximately fourfold as compared to healthy tissue. The immunoreactivity for SP was significantly reduced by approximately 80% in myenteric plexus neurons during peritonitis. In contrast, the immunoreactivity for VIP significantly increased by nearly twofold during peritonitis.


CONCLUSIONS
During peritonitis, the inflammatory reaction within the gut is increased. The neuropeptide expression in myenteric plexus neurons was observed as shifting towards increased expression of VIP, known to inhibit intestinal motility, and towards decreased expression of the prokinetic neuropeptide SP.
Jacob
P
P
Department of General and Transplantation Surgery, University Hospital of Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany. petra.jacob@uni-tuebingen.de
Mueller
M H
MH
Hahn
J
J
Wolk
I
I
Mayer
P
P
Nagele
U
U
Hennenlotter
J
J
Stenzl
A
A
Konigsrainer
A
A
Glatzle
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D007421:Intestine, Small / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009197:Myenteric Plexus / Q000378:metabolism*; D009474:Neurons / Q000378:metabolism*; D010538:Peritonitis / Q000378:metabolism* / Q000503:physiopathology; D009195:Peroxidase / Q000378:metabolism; D013373:Substance P / Q000378:metabolism*; D014660:Vasoactive Intestinal Peptide / Q000378:metabolism*
D013373:Substance P; D014660:Vasoactive Intestinal Peptide; D009195:Peroxidase