Sand Elin, Roth Bodil, Weström Björn, Bonn Peter, Ekblad Eva, Ohlsson Bodil
Department of Clinical Sciences, Division of Internal Medicine Skåne University Hospital, Lund University, Inga Marie Nilssons street 32, S-205 02, Malmö, Sweden.
Department of Experimental Medical Science, Neurogastroenterology Unit, BMC B11, Lund University, 221 84, Lund, Sweden.
BMC Gastroenterol. 2014 Dec 11;14:209. doi: 10.1186/s12876-014-0209-7.
Women treated with gonadotropin-releasing hormone (GnRH) analogs may develop enteric neuropathy and dysmotility. Administration of a GnRH analog to rats leads to similar degenerative neuropathy and ganglioneuritis. The aim of this study on rat was to evaluate the early GnRH-induced enteric neuropathy in terms of distribution of neuronal subpopulations and gastrointestinal (GI) function.
Forty rats were given the GnRH analog buserelin (20 μg, 1 mg/ml) or saline subcutaneously, once daily for 5 days, followed by 3 weeks of recovery, representing one treatment session. Two weeks after the fourth treatment session, the animals were tested for GI transit time and galactose absorption, and fecal weight and fat content was analyzed. After sacrifice, enteric neuronal subpopulations were analyzed. Blood samples were analyzed for zonulin and antibodies against GnRH and luteinizing hormone, and their receptors.
Buserelin treatment transiently increased the body weight after 5 and 9 weeks (p < 0.001). Increased estradiol in plasma and thickened uterine muscle layers indicate high estrogen activity. The numbers of both submucous and myenteric neurons were reduced by 27%-61% in ileum and colon. The relative numbers of neurons containing calcitonin gene-related peptide (CGRP), cocaine- and amphetamine-related transcript (CART), galanin, gastrin-releasing peptide (GRP), neuropeptide Y (NPY), nitric oxide synthase (NOS), serotonin, substance P (SP), vasoactive intestinal peptide (VIP) or vesicular acetylcholine transporter (VAchT), and their nerve fiber density, were unchanged after buserelin treatment, but the relative number of submucous neurons containing somatostatin tended to be increased (p = 0.062). The feces weight decreased in buserelin-treated rats (p < 0.01), whereas feces fat content increased (p < 0.05), compared to control rats. Total GI transit time, galactose absorption, zonulin levels in plasma, and antibody titers in serum were unaffected by buserelin treatment.
A marked enteric neuronal loss with modest effects on GI function is found after buserelin treatment. Increased feces fat content is suggested an early sign of dysfunction.
接受促性腺激素释放激素(GnRH)类似物治疗的女性可能会出现肠道神经病变和动力障碍。给大鼠注射GnRH类似物会导致类似的退行性神经病变和神经节神经炎。本研究在大鼠身上的目的是从神经元亚群分布和胃肠(GI)功能方面评估早期GnRH诱导的肠道神经病变。
40只大鼠皮下注射GnRH类似物布舍瑞林(20μg,1mg/ml)或生理盐水,每天一次,共5天,随后恢复3周,代表一个治疗疗程。在第四个治疗疗程后两周,对动物进行胃肠转运时间和半乳糖吸收测试,并分析粪便重量和脂肪含量。处死后,分析肠道神经元亚群。分析血样中的zonulin以及抗GnRH和促黄体生成素及其受体的抗体。
布舍瑞林治疗在5周和9周后使体重短暂增加(p<0.001)。血浆中雌二醇增加和子宫肌层增厚表明雌激素活性高。回肠和结肠中黏膜下和肌间神经元数量减少了27%-61%。布舍瑞林治疗后,含有降钙素基因相关肽(CGRP)、可卡因和苯丙胺调节转录肽(CART)、甘丙肽、胃泌素释放肽(GRP)、神经肽Y(NPY)、一氧化氮合酶(NOS)、5-羟色胺、P物质(SP)、血管活性肠肽(VIP)或囊泡乙酰胆碱转运体(VAchT)的神经元相对数量及其神经纤维密度未改变,但含有生长抑素的黏膜下神经元相对数量有增加趋势(p=0.062)。与对照大鼠相比,布舍瑞林治疗的大鼠粪便重量降低(p<0.01),而粪便脂肪含量增加(p<0.05)。布舍瑞林治疗对总胃肠转运时间、半乳糖吸收、血浆中zonulin水平和血清中抗体滴度无影响。
布舍瑞林治疗后发现明显的肠道神经元丢失,对胃肠功能有适度影响。粪便脂肪含量增加提示功能障碍的早期迹象。