title: The gut peptide neuropeptide Y and post-traumatic stress disorder.
abstract: OBJECTIVE
  This article reviews the role of neuropeptide Y (NPY) in the pathophysiology of post-traumatic stress disorder (PTSD) and gastrointestinal disorders such as irritable bowel syndrome (IBS) with which PTSD is highly comorbid. NPY is low in the cerebrospinal fluid and plasma of male combat veterans with PTSD and correlates negatively with sympathetic nervous system (SNS) hyperreactivity, PTSD symptoms and time to recovery. NPY regulation has not yet been evaluated in women with PTSD.
  
  
  RESULTS
  NPY levels in bowel tissue are low in IBS with diarrhea (IBS-D) versus IBS with constipation. The density of ghrelin containing cells of the gastric oxyntic mucosa is markedly increased in IBS-D. PTSD-related SNS hyperreactivity may interact with this substrate to increase ghrelin release, which activates receptors in the lumbosacral spinal cord and basolateral amygdala to increase colonic motility and amygdala hyperreactivity, respectively. Loss of function gene polymorphisms in adrenergic α2-autoreceptors and increased corticotropin-releasing hormone, as observed in PTSD, are also thought to contribute to IBS-D.
  
  
  CONCLUSIONS
  Knowledge of shared underlying NPY system-related neurobiological factors that contribute to the comorbidity of PTSD and gastrointestinal disorders may help guide research, development and prescription of targeted and more effective individualized therapeutic interventions.
authors.affiliation: aNational Center for PTSD, Women's Health Science Division, Department of Veterans Affairs bVA Boston Healthcare System cBoston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Rasmusson
mesh_terms: D003130:Combat Disorders / Q000097:blood / Q000134:cerebrospinal fluid; D015897:Comorbidity; D003248:Constipation; D003967:Diarrhea; D005260:Female; D005753:Gastric Mucosa / Q000737:chemistry; D054439:Ghrelin / Q000032:analysis; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D009478:Neuropeptide Y / Q000097:blood / Q000134:cerebrospinal fluid / Q000502:physiology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000503:physiopathology*; D014728:Veterans
chemical_list: D054439:Ghrelin; D009478:Neuropeptide Y