Aggestrup S, Uddman R, Jensen S L, Sundler F, Schaffalitzky de Muckadell O, Holst J J, Håkanson R, Ekman R, Sørensen H R
Regul Pept. 1985 Mar;10(2-3):167-78. doi: 10.1016/0167-0115(85)90011-4.
Smooth muscle specimens were taken from the lower esophageal sphincter of patients suffering from achalasia or hiatus hernia with gastro-esophageal reflux. The specimens were analysed for neurohormonal peptides using immunochemistry and immunocytochemistry. Control specimens were obtained from patients subjected to esophageal resection because of esophageal cancer. The concentration of vasoactive intestinal polypeptide (VIP) was higher and the VIP nerve supply greater in patients with hiatus hernia than in control patients. The VIP nerve supply and the content of this peptide was lower in patients with achalasia than in controls. The same tendency was observed for substance P and enkephalin although the changes in their concentrations were not statistically significant. Enkephalin fibers were few, both in specimens from control patients and from patients with hiatus hernia; they could not be detected in specimens from patients with achalasia. Never fibers containing somatostatin or gastrin/cholecystokinin could not be detected in any of the groups and somatostatin and gastrin/cholecystokinin could not be measured in extracts of the lower esophageal sphincter. We propose that changes in the concentration of neuropeptides may at least contribute to manifestations of achalasia and of decreased lower esophageal sphincter pressure and gastro-esophageal reflux.
取自患有贲门失弛缓症或伴有胃食管反流的食管裂孔疝患者的食管下括约肌的平滑肌标本。使用免疫化学和免疫细胞化学分析这些标本中的神经激素肽。对照标本取自因食管癌接受食管切除术的患者。食管裂孔疝患者的血管活性肠多肽（VIP）浓度较高，VIP神经支配也比对照患者更多。贲门失弛缓症患者的VIP神经支配和该肽的含量比对照组低。P物质和脑啡肽也观察到相同的趋势，尽管它们浓度的变化没有统计学意义。在对照患者和食管裂孔疝患者的标本中，脑啡肽纤维都很少；在贲门失弛缓症患者的标本中未检测到。在任何一组中都未检测到含有生长抑素或胃泌素/胆囊收缩素的神经纤维，并且在下食管括约肌提取物中无法测量生长抑素和胃泌素/胆囊收缩素。我们认为神经肽浓度的变化可能至少促成了贲门失弛缓症以及食管下括约肌压力降低和胃食管反流的表现。
