Van den Houte Karen, Scarpellini Emidio, Verbeure Wout, Mori Hideki, Schol Jolien, Masuy Imke, Carbone Florencia, Tack Jan
Translational Research Center for Gastrointestinal Diseases, University of Leuven, Leuven, Belgium.
Front Psychiatry. 2020 Mar 18;11:172. doi: 10.3389/fpsyt.2020.00172. eCollection 2020.
Functional dyspepsia (FD) and gastroparesis (GP) are common disorders of the upper gastrointestinal tract. The pathophysiology of these conditions is likely to be heterogenous, and factors such as altered motility, sensitivity and response to nutrition have been identified as putative underlying mechanisms. Motility, sensitivity as well as responses to nutrition can be influenced or mediated by peptide hormones and serotonin released from the gastrointestinal mucosa. This review summarizes the role of GI peptides in functional dyspepsia and gastroparesis. In most studies, the levels of somatostatin, ghrelin, and motilin did not differ between healthy volunteers and FD or GP patients, but higher symptom burden was often correlated with higher peptide levels. Ghrelin and motilin receptor agonists showed promising results in improvement of the gastric emptying, but the link with improvement of symptoms is less predictable. Serotonin agonists have a potential to improve symptoms in both FD and idiopathic gastroparesis. Drugs acting on the GLP-1 and on the PYY receptors deserve further investigation. There is a need for systematic large scale studies.
功能性消化不良（FD）和胃轻瘫（GP）是上消化道的常见疾病。这些病症的病理生理学可能具有异质性，并且诸如运动改变、敏感性和对营养的反应等因素已被确定为潜在的潜在机制。胃肠道黏膜释放的肽类激素和5-羟色胺可影响或介导运动、敏感性以及对营养的反应。本综述总结了胃肠肽在功能性消化不良和胃轻瘫中的作用。在大多数研究中，健康志愿者与FD或GP患者之间生长抑素、胃饥饿素和胃动素的水平并无差异，但较高的症状负担通常与较高的肽水平相关。胃饥饿素和胃动素受体激动剂在改善胃排空方面显示出有前景的结果，但与症状改善的关联较难预测。5-羟色胺激动剂有改善FD和特发性胃轻瘫症状的潜力。作用于胰高血糖素样肽-1（GLP-1）和肽YY（PYY）受体的药物值得进一步研究。需要进行系统的大规模研究。
