Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Esophagus. 2023 Jan;20(1):158-169. doi: 10.1007/s10388-022-00955-0. Epub 2022 Oct 16.
To explore the relationships between anxiety/depression and NERD, we focused on dynorphin (Dyn), an important member of visceral hypersensitivity, and its related pathways.
Pearson's correlation analysis on patients with NERD and in vivo experiment on NERD rat model. Part 1: Pearson's correlation analysis among serum levels of Dyn, clinical symptoms and HADS scores of NERD patients were carried on. Part 2: Wistar rats were randomly divided into 2 groups: control group and model group. The data of pH value, immobility time, serum Dyn concentration, NMDAR1 and SP expression were, respectively, derived from automatic pH recorder, tail suspension test, enzyme-linked immunosorbent assay, immunohistochemistry and immunofluorescence.
Part 1: Pearson's correlation analysis showed that there was a linear correlation between Clinical Symptom (CS) score and HADS score (HAD-A, HAD-D), and the correlation coefficients were 0.385 and 0.273 respectively; the correlation coefficient between lg (Dyn) and lg (CS score) was r = 0.441, P = 0.002; the correlation coefficient between lg(Dyn) and lg (HAD-D score) was r = 0.447, P = 0.002. Part 2: The pH value of the lower esophagus in the model group was lower than that in the control group (P < 0.01). The tail suspension immobility time of model group was significantly longer than that of control group (P < 0.01). The serum Dyn concentration and the expression level of NMDAR1 in spinal cord and SP in lower esophageal mucosa of model group were significantly higher than those of control group (P < 0.05).
Increased serum dynorphin level may be a sign of correlation between depression and NERD.
为了探讨焦虑/抑郁与非糜烂性反流病（NERD）的关系，我们专注于强啡肽（Dyn），一种内脏高敏性的重要成员，及其相关途径。
对 NERD 患者进行 Pearson 相关性分析及 NERD 大鼠模型的体内实验。第 1 部分：对 NERD 患者的血清 Dyn 水平、临床症状和 HADS 评分进行 Pearson 相关性分析。第 2 部分：Wistar 大鼠随机分为 2 组：对照组和模型组。自动 pH 记录仪、尾部悬挂试验、酶联免疫吸附试验、免疫组化和免疫荧光分别得出 pH 值、不动时间、血清 Dyn 浓度、NMDAR1 和 SP 表达的数据。
第 1 部分：Pearson 相关性分析显示，临床症状（CS）评分与 HADS 评分（HAD-A、HAD-D）之间存在线性相关，相关系数分别为 0.385 和 0.273；lg（Dyn）与 lg（CS 评分）的相关系数为 r=0.441，P=0.002；lg（Dyn）与 lg（HAD-D 评分）的相关系数为 r=0.447，P=0.002。第 2 部分：模型组食管下段 pH 值低于对照组（P<0.01）。模型组的尾部悬挂不动时间明显长于对照组（P<0.01）。模型组血清 Dyn 浓度及脊髓 NMDAR1 表达水平和食管下段黏膜 SP 表达水平均明显高于对照组（P<0.05）。
血清 Dyn 水平升高可能是抑郁与 NERD 相关的标志。
