Liu Lulu, Yang Wenguang, Lu Ya, Wang Jue, Zheng Yan, Gu Sai
Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, No.1, Youyi Road, Yuzhong District, Chongqing, 40016, China.
Dig Dis Sci. 2023 Feb;68(2):521-528. doi: 10.1007/s10620-022-07717-z. Epub 2022 Nov 16.
Functional dyspepsia (FD) is characterized with multiple symptoms of indigestion and often accompanied with anxiety. However, there is currently an absence of effective treatment. Tandospirone is commonly used to treat generalized anxiety disorders. Whether tandospirone can improve the clinical symptoms of FD remain unknown.
The present study was designed to explore the pharmacological effect of tandospirone on FD patient with anxiety, and the potential mechanisms were also elucidated.
FD patients with anxiety were randomly divided into placebo and tandospirone treatment groups. Healthy volunteers were simultaneously recruited as control group. The gastrointestinal symptom score (GIS) and Hamilton anxiety scale (HAM-A) were performed before and after treatments with placebo or tandospirone. The serum levels of brain-derived neurotrophic factor (BDNF) and multiple inflammatory cytokines including tumor necrosis factor-α (TNF-α), and interleukin (IL)-6, IL-4, IL-1β, and IL-10 were determined. Regression analyses relating BDNF levels and gastrointestinal symptoms were performed.
Tandospirone significantly alleviated the gastrointestinal and anxiety symptoms of FD patient, as evidenced by reductions of GIS index and HAM-A scores. Compared with the healthy volunteers, FD patients had lower BDNF and IL-10 levels, but higher levels of IL-6 and TNF-α. Importantly, tandospirone increased serum BDNF and IL-10 and decreased IL-6 levels in FD patients. Relative analysis revealed that BDNF level was negatively associated with gastrointestinal symptoms in FD patients.
Tandospirone effectively improved both anxiety and gastrointestinal symptoms of patients with FD, and these therapeutic effects may be associated with the modulation of BDNF and inflammatory cytokines.
功能性消化不良（FD）的特征是多种消化不良症状，且常伴有焦虑。然而，目前尚无有效的治疗方法。坦度螺酮常用于治疗广泛性焦虑症。坦度螺酮是否能改善FD的临床症状尚不清楚。
本研究旨在探讨坦度螺酮对伴有焦虑的FD患者的药理作用，并阐明其潜在机制。
将伴有焦虑的FD患者随机分为安慰剂组和坦度螺酮治疗组。同时招募健康志愿者作为对照组。在使用安慰剂或坦度螺酮治疗前后进行胃肠道症状评分（GIS）和汉密尔顿焦虑量表（HAM-A）评估。测定血清脑源性神经营养因子（BDNF）水平以及多种炎性细胞因子，包括肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-6、IL-4、IL-1β和IL-10。进行BDNF水平与胃肠道症状的回归分析。
坦度螺酮显著减轻了FD患者的胃肠道和焦虑症状，GIS指数和HAM-A评分降低证明了这一点。与健康志愿者相比，FD患者的BDNF和IL-10水平较低，但IL-6和TNF-α水平较高。重要的是，坦度螺酮提高了FD患者血清BDNF和IL-10水平，并降低了IL-6水平。相关性分析显示，FD患者的BDNF水平与胃肠道症状呈负相关。
坦度螺酮有效改善了FD患者的焦虑和胃肠道症状，这些治疗效果可能与BDNF和炎性细胞因子的调节有关。
