Yamasaki Takahisa, Tomita Toshihiko, Takimoto Mayu, Kondo Takashi, Tozawa Katsuyuki, Ohda Yoshio, Oshima Tadayuki, Fukui Hirokazu, Watari Jiro, Miwa Hiroto
Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
J Neurogastroenterol Motil. 2017 Oct 30;23(4):526-532. doi: 10.5056/jnm17067.
BACKGROUND/AIMS: When a person is experiencing stress, corticotropin-releasing hormone (CRH) can modulate gut physiologies, such as visceral sensation or gastrointestinal motility, and its intravenous administration mimics stress-induced physiological changes. However, the influence of CRH on the esophagus is yet unknown. Accordingly, we investigated whether intravenous CRH administration increases esophageal sensitivity to electrical stimulation in healthy Japanese subjects.
Twenty healthy subjects were recruited. We quantified the initial perception threshold (IPT) every 15 minutes after CRH injection. Venous blood was collected with a cannula, and both plasma adrenocorticotropic hormone (ACTH) and cortisol were measured at pre-stimulation, 0, 30, 60, 90, and 120 minutes. The results from each time point were compared against a baseline IPT obtained before electrical stimulation was initiated.
When compared to the baseline IPT value (16.9 ± 4.5), CRH significantly decreased electrical threshold of the esophagus at 30, 45, 60, 75 minutes (14.1 ± 4.2, 13.1 ± 5.0, 12.1 ± 5.7, 14.0 ± 5.8 minutes, 〈 0.01, respectively) after CRH injection, suggesting that CRH increased esophageal sensitivity to the electrical stimulus. CRH also significantly increased plasma ACTH levels at 30 minutes (50.3 ± 17.7, 〈 0.01), and cortisol levels at 30 minutes (22.0 ± 6.7 minutes, 〈 0.01) and 60 minutes (20.3 ± 6.7 minutes, 〈 0.01) after CRH injection, when compared to the pre-stimulation ACTH and cortisol values.
Intravenous CRH administration increased esophageal electrical sensitivity in normal subjects, emphasizing the important role of stress in esophageal sensitivity.
背景/目的：当一个人处于应激状态时，促肾上腺皮质激素释放激素（CRH）可调节肠道生理功能，如内脏感觉或胃肠蠕动，静脉注射CRH可模拟应激诱导的生理变化。然而，CRH对食管的影响尚不清楚。因此，我们研究了静脉注射CRH是否会增加健康日本受试者食管对电刺激的敏感性。
招募了20名健康受试者。在注射CRH后，每15分钟对初始感知阈值（IPT）进行量化。用套管采集静脉血，并在刺激前、0、30、60、90和120分钟测量血浆促肾上腺皮质激素（ACTH）和皮质醇。将每个时间点的结果与电刺激开始前获得的基线IPT进行比较。
与基线IPT值（16.9±4.5）相比，CRH在注射后30、45、60、75分钟显著降低食管电阈值（分别为14.1±4.2、13.1±5.0、12.1±5.7、14.0±5.8分钟，P均〈0.01），表明CRH增加了食管对电刺激的敏感性。与刺激前ACTH和皮质醇值相比，CRH还在注射后30分钟显著增加血浆ACTH水平（50.3±17.7，P〈0.01），以及在30分钟（22.0±6.7分钟，P〈0.01）和60分钟（20.3±6.7分钟，P〈0.01）显著增加皮质醇水平。
静脉注射CRH可增加正常受试者食管的电敏感性，强调了应激在食管敏感性中的重要作用。
