Gastric Activity and Gut Peptides in Patients With Functional Dyspepsia: Postprandial Distress Syndrome Versus Epigastric Pain Syndrome.
OBJECTIVE
The goals of the study were to investigate in both postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS) the gastric electrical activity and the gastric emptying (GE) time together with the circulating concentrations of motilin, somatostatin, corticotrophin-releasing factor, and neurotensin, and to establish whether the genetic variability in the neurotensin system genes differs between these 2 categories of functional dyspepsia (FD).


BACKGROUND
The current FD classification is based on symptoms and it has been proven not to be completely satisfying because of a high degree of symptom overlap between subgroups.


METHODS
Gastric electrical activity was evaluated by cutaneous electrogastrography: the GE time by C-octanoic acid breast test. Circulating concentrations of gut peptides were measured by a radioimmunoassay. NTS 479 A/G and NTSR1 rs6090453 SNPs were evaluated by PCR and endonuclease digestion.


RESULTS
Fifty-four FD patients (50 female/4 male) were studied. Using a symptom questionnaire, 42 patients were classified as PDS and 12 as EPS, although an overlap between the symptom profiles of the 2 subgroups was recorded. The electrogastrographic parameters (the postprandial instability coefficient of dominant frequency, the dominant power, and the power ratio) were significantly different between the subgroups, whereas the GE time did not differ significantly. In addition, EPS was characterized by a different gut peptide profile compared with PDS. Finally, neurotensin polymorphism was shown to be associated with neurotensin levels. This evidence deserves further studies in consideration of an analgesic role of neurotensin.


CONCLUSIONS
Analysis of gut peptide profiles could represent an interesting tool to enhance FD diagnosis and overcome limitations due to a distinction based solely on symptoms.
*Laboratory of Nutritional Pathophysiology, National Institute for Digestive Diseases I.R.C.C.S. "Saverio de Bellis," Castellana Grotte †Department of Biosciences, Biotechnology and Biopharmaceutics, University of Bari, Bari, Italy.
Francesco
F
Russo
Guglielmina
G
Chimienti
Caterina
C
Clemente
Giuseppe
G
Riezzo
Benedetta
B
D'Attoma
Manuela
M
Martulli
D015746:Abdominal Pain / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D000324:Adrenocorticotropic Hormone / Q000097:blood / Q000235:genetics; D000328:Adult; D000368:Aged; D002210:Caprylates / Q000032:analysis; D003937:Diagnosis, Differential; D004415:Dyspepsia / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D004553:Electric Conductivity; D005260:Female; D005746:Gastric Emptying / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009037:Motilin / Q000097:blood / Q000235:genetics; D009496:Neurotensin / Q000097:blood / Q000235:genetics; D010455:Peptides / Q000097:blood*; D011110:Polymorphism, Genetic; D019518:Postprandial Period / Q000502:physiology*; D013004:Somatostatin / Q000097:blood / Q000235:genetics; D013270:Stomach / Q000503:physiopathology; D063189:Symptom Assessment / Q000379:methods*; D013577:Syndrome; D013997:Time Factors
D002210:Caprylates; D010455:Peptides; D009496:Neurotensin; D013004:Somatostatin; D009037:Motilin; D000324:Adrenocorticotropic Hormone