Bernstein C N, Robert M E, Eysselein V E
Inflammatory Bowel Disease Center, Harbor-UCLA Medical Center, Torrance.
Am J Gastroenterol. 1993 Jun;88(6):908-13.
Substance P, a neurotransmitter found in colonic mucosa, can alter gut immunologic, vascular, and motor phenomena. Thus, it may have an important role in the pathogenesis of ulcerative colitis (UC) and Crohn's disease (CD). By radioimmunoassay of the extracts of endoscopically obtained rectal mucosal biopsies in affected patients, we evaluated mucosal substance P levels. Non-inflammatory bowel disease patients undergoing lower endoscopies and biopsies served as controls. There were significantly increased concentrations of substance P in patients with UC, compared with controls (p < 0.05) and compared with patients with CD (p < 0.005). The mucosal levels in CD patients were significantly lower than in controls (p < 0.05). Patients with active rectal CD had lower levels than patients with no evidence of active rectal disease. For the CD and UC patients, there was a strongly positive correlation between rectal mucosal substance P concentrations and total histologic inflammation scores (r = 0.7, p = 0.001). A strong correlation existed for rectal mucosal substance P concentrations and mucosal mononuclear cell scores (r = 0.7, p = 0.001) and for rectal mucosal substance P concentrations and the combined scores of mucosal neutrophils and eosinophils (r = 0.7, p = 0.002). In conclusion, the rectal mucosal substance P concentrations in patients with UC and CD are significantly different. Thus, substance P may have a different role in the pathogenesis of each of these entities. It is possible that the elevated concentrations in patients with UC are contributing to the increased inflammation seen in these patients. Alternatively, measured mucosal substance P levels may simply reflect the end result of the different inflammatory processes in UC and CD, rather than the cause. It is possible that the inflammatory cells are contributing to the measured concentrations.
P物质是一种在结肠黏膜中发现的神经递质，可改变肠道免疫、血管及运动现象。因此，它可能在溃疡性结肠炎（UC）和克罗恩病（CD）的发病机制中起重要作用。通过对受影响患者经内镜获取的直肠黏膜活检组织提取物进行放射免疫测定，我们评估了黏膜P物质水平。接受下消化道内镜检查和活检的非炎性肠病患者作为对照。与对照组相比（p < 0.05）以及与CD患者相比（p < 0.005），UC患者的P物质浓度显著升高。CD患者的黏膜水平显著低于对照组（p < 0.05）。有直肠CD活动的患者水平低于无直肠疾病活动证据的患者。对于CD和UC患者，直肠黏膜P物质浓度与组织学总炎症评分之间存在强正相关（r = 0.7，p = 0.001）。直肠黏膜P物质浓度与黏膜单核细胞评分之间（r = 0.7，p = 0.001）以及直肠黏膜P物质浓度与黏膜中性粒细胞和嗜酸性粒细胞综合评分之间（r = 0.7，p = 0.002）存在强相关性。总之，UC和CD患者的直肠黏膜P物质浓度有显著差异。因此，P物质在这些疾病各自的发病机制中可能起不同作用。UC患者中浓度升高可能导致这些患者炎症增加。或者，所测黏膜P物质水平可能仅仅反映了UC和CD中不同炎症过程的最终结果，而非原因。炎症细胞可能对所测浓度有影响。
