Patel Mauli, Valaiyaduppu Subas Sharathshiva, Ghani Mohammad R, Busa Vishal, Dardeir Ahmed, Marudhai Suganya, Cancarevic Ivan
Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2020 Oct 18;12(10):e11027. doi: 10.7759/cureus.11027.
Inflammatory bowel disease (IBD) is a multi-factorial, chronic inflammation of the gastrointestinal tract, containing ulcerative colitis (UC) and Crohn's disease (CD). In UC, inflammation and sores are confined morphologically and microscopically to the mucosa, the innermost surface of the colon and the rectum. Although, in CD, the infection is granulomatous and transmural, affecting the entire gastrointestinal tract from the mouth to the anus, with the skip area in-between. A Neuropeptide, substance P (SP), which acts as a neurotransmitter and as a neuromodulator, plays a vital role in the brain-gut axis under stress. Owing to the pro-inflammatory effects of SP, neuropeptide dysregulation induces inflammation in the intestine. There are variations in the distribution of substance P immunoreactive fibres in the various intestinal layers. The highest concentration of SP is in the mucosa and the lowest concentration in the lamina propria of the intestinal muscular membrane. Reduced vasoactive intestinal peptide (VIP) levels and elevated SP levels observed in the colonic mucosa of IBD by using immunohistochemistry and immunoassay. This literature review aims to find out the correlations between the level of substance P (SP) and disease activity. We conducted a literature review on IBD, SP, and we searched PubMed and Google Scholar for relevant articles in English. The result of the study supports a positive relationship between the level of substance P (SP) and disease activity, with increased concentration of substance p in the colon and rectum of CD and UC patients. It is concluded that patients with active CD, along with inflammatory changes, had elevated plasma SP levels and immunoreactivity of SP in the colon than those seen in control and inactive cases. These alterations are more prevalent in ulcerative colitis than Crohn's disease and are more prevalent in the moderately infected area than the least affected area of the intestine.
炎症性肠病（IBD）是一种多因素导致的胃肠道慢性炎症，包括溃疡性结肠炎（UC）和克罗恩病（CD）。在UC中，炎症和溃疡在形态学和显微镜下局限于黏膜，即结肠和直肠的最内表面。而在CD中，感染是肉芽肿性且透壁性的，影响从口腔到肛门的整个胃肠道，中间存在跳跃区域。一种神经肽，即P物质（SP），它作为神经递质和神经调节剂，在应激状态下的脑-肠轴中起着至关重要的作用。由于SP的促炎作用，神经肽失调会诱发肠道炎症。P物质免疫反应性纤维在肠道各层的分布存在差异。SP浓度最高的部位是黏膜，而在肠肌膜固有层中浓度最低。通过免疫组织化学和免疫测定法观察到，IBD结肠黏膜中血管活性肠肽（VIP）水平降低而SP水平升高。这篇文献综述旨在找出P物质（SP）水平与疾病活动之间的相关性。我们对IBD、SP进行了文献综述，并在PubMed和谷歌学术上搜索了英文相关文章。研究结果支持P物质（SP）水平与疾病活动之间存在正相关关系，CD和UC患者的结肠和直肠中P物质浓度升高。研究得出结论，与对照组和非活动期病例相比，活动期CD患者除了有炎症变化外，血浆SP水平升高，结肠中SP的免疫反应性也升高。这些改变在溃疡性结肠炎中比在克罗恩病中更普遍，在肠道中度感染区域比受影响最小的区域更普遍。
