Department of Clinical Sciences, Gastroenterology Division, Skånes University Hospital, Lund University, Malmö, Sweden.
Neurogastroenterol Motil. 2011 Nov;23(11):1000-6, e459. doi: 10.1111/j.1365-2982.2011.01744.x. Epub 2011 Jun 30.
The etiology of irritable bowel syndrome (IBS) and dysmotility is in most cases unknown. Organic, pathognomonic changes have not been described. We have previously demonstrated sporadic expressions of antibodies against gonadotropin-releasing hormone (GnRH) in serum from these patients. The aim of this study was to screen for the presence of GnRH antibodies in healthy subjects and patients with gastrointestinal (GI) diseases.
Consecutive patients suffering from either IBS, idiopathic dysmotility, GI complaints secondary to diabetes mellitus, celiac disease or inflammatory bowel disease (IBD) were included. Healthy blood donors served as controls. Blood samples were taken for analyzing IgM and IgG antibodies against GnRH using an ELISA method. Medical records were scrutinized with respect to duration of symptoms, co-existing diseases, drug treatments, hereditary factors, and laboratory analyses.
Healthy controls expressed low levels of GnRH IgM antibodies in a prevalence of 23%. The prevalence of GnRH IgM antibodies in IBS and dysmotility patients was 42% (P = 0.008), and the levels were higher (P = 0.000). Patients with diabetes mellitus expressed GnRH IgM antibodies in the same prevalence as controls (25%), but in higher levels (P = 0.02). Patients with celiac disease or IBD had the same or lower levels of antibodies. There were no associations between antibodies, other co-existing diseases or laboratory analyses.
CONCLUSIONS & INFERENCES: Higher levels of GnRH IgM antibodies were detected in patients with IBS and dysmotility, but not organic GI diseases, compared with healthy controls. These findings suggest that IBS and dysmotility to some extent may be of an autoimmune origin.
大多数情况下,肠易激综合征(IBS)和运动障碍的病因尚不清楚。尚未描述明确的器质性病变。我们之前已经证明,这些患者的血清中存在散在表达的促性腺激素释放激素(GnRH)抗体。本研究的目的是筛选健康受试者和胃肠道(GI)疾病患者中 GnRH 抗体的存在情况。
连续纳入患有 IBS、特发性运动障碍、继发于糖尿病、乳糜泻或炎症性肠病(IBD)的 GI 疾病的患者。健康献血者作为对照。采集血样,采用 ELISA 法分析针对 GnRH 的 IgM 和 IgG 抗体。仔细查阅病历,记录症状持续时间、并存疾病、药物治疗、遗传因素和实验室分析结果。
健康对照者的 GnRH IgM 抗体呈低水平表达,流行率为 23%。IBS 和运动障碍患者的 GnRH IgM 抗体流行率为 42%(P = 0.008),且水平更高(P = 0.000)。糖尿病患者的 GnRH IgM 抗体流行率与对照组相同(25%),但水平更高(P = 0.02)。乳糜泻或 IBD 患者的抗体水平相同或更低。抗体与其他并存疾病或实验室分析之间无关联。
与健康对照组相比,IBS 和运动障碍患者的 GnRH IgM 抗体水平更高,但与其他器质性 GI 疾病患者无差异。这些发现提示 IBS 和运动障碍在一定程度上可能具有自身免疫性起源。