十二指肠黏膜屏障功能改变在功能性消化不良发病机制中起作用。
The Altered Mucosal Barrier Function in the Duodenum Plays a Role in the Pathogenesis of Functional Dyspepsia.
机构信息
Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maedashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maedashi, Higashi-ku, Fukuoka, 812-8582, Japan.
出版信息
Dig Dis Sci. 2019 Nov;64(11):3228-3239. doi: 10.1007/s10620-019-5470-8. Epub 2019 Jan 23.
BACKGROUND
An altered gastrointestinal barrier function is reportedly associated with the pathogenesis of functional dyspepsia (FD); however, the pathogenesis of FD has not yet been fully elucidated.
AIMS
The objective of the present study was to determine whether the mucosal barrier function is impaired in patients with FD and to investigate the mechanisms underlying FD.
METHODS
The present study included patients with FD (FD group, n = 24), non-FD patients with abdominal symptoms (symptomatic control group, n = 14), and patients with no abdominal symptoms (asymptomatic control group, n = 20). The groups were compared regarding the mucosal electrical impedance (MI) values of the stomach and duodenum, which were measured using a tissue conductance meter during esophagogastroduodenoscopy.
RESULTS
There were no significant differences between the three groups in the MI of the stomach. In contrast, the duodenal MI of the FD group (17.8 ± 4.3 Ω) was significantly lower than those of the symptomatic control group (27.2 ± 6.4 Ω, p < 0.0001) and asymptomatic control group (23.0 ± 7.4 Ω, p = 0.016). The expression of zonula occludens-1 (ZO-1) was significantly lower in the FD group than in the symptomatic control group (p = 0.011), where ZO-1 was positively correlated with the duodenal MI (β = 0.513, p = 0.017). The interleukin (IL)-1β expression was significantly higher in the FD group than in the symptomatic control group (p = 0.041), where IL-1β was inversely correlated with the duodenal MI (β = - 0.600, p = 0.004).
CONCLUSIONS
The mucosal barrier function of the duodenum was altered in patients with FD. Both a decreased ZO-1 and increased IL-1β may play a role in the pathogenesis of FD.
背景
据报道，胃肠道屏障功能改变与功能性消化不良（FD）的发病机制有关；然而，FD 的发病机制尚未完全阐明。
目的
本研究旨在确定 FD 患者的黏膜屏障功能是否受损，并探讨 FD 的发病机制。
方法
本研究纳入了 FD 患者（FD 组，n=24）、有腹部症状但非 FD 患者（症状对照组，n=14）和无腹部症状患者（无症状对照组，n=20）。通过食管胃十二指肠镜检查，使用组织电导率仪测量胃和十二指肠的黏膜电导率（MI）值，比较三组之间的差异。
结果
三组患者胃 MI 无显著差异。相比之下，FD 组十二指肠 MI（17.8±4.3 Ω）显著低于症状对照组（27.2±6.4 Ω，p<0.0001）和无症状对照组（23.0±7.4 Ω，p=0.016）。FD 组的闭合蛋白-1（ZO-1）表达明显低于症状对照组（p=0.011），且 ZO-1 与十二指肠 MI 呈正相关（β=0.513，p=0.017）。FD 组白细胞介素（IL）-1β表达明显高于症状对照组（p=0.041），且 IL-1β 与十二指肠 MI 呈负相关（β=-0.600，p=0.004）。
结论
FD 患者的十二指肠黏膜屏障功能发生改变。ZO-1 减少和 IL-1β 增加可能在 FD 的发病机制中起作用。
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