Mathieu Meleine1, Chloé Melchior1,2, Philip Prinz3, Alfred Penfornis4, Benoît Coffin5, Andreas Stengel3, Philippe Ducrotté1,6, Guillaume Gourcerol1,2,7. 1. Inserm UMR 1073, Institute for Innovation and Biomedical Research, Rouen University, Rouen, France. 2. Physiology Department, Rouen University Hospital, Rouen, France. 3. Charité Center for Internal Medicine and Dermatology, Clinic for Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany. 4. Endocrinology, Diabetology and Metabolic Diseases Department, Sud-Francilien Hospital of Corbeil-Essonnes, Paris-Sud University, Corbeil-Essonnes, France. 5. Gastroenterology Department, Louis Mourier Hospital, Colombes, France. 6. Gastroenterology Department, Rouen University Hospital, Rouen, France. 7. Clinical Investigation Center - Biological Research Center (CIC-CRB), Rouen University Hospital, Rouen, France.
Abstract
OBJECTIVES: Gastric electrical stimulation (GES) is an alternative therapy to treat patients with intractable vomiting. A preclinical study has demonstrated the modulation of the gastrointestinal (GI) peptide ghrelin by GES but such mechanism has never been investigated in patients. The aim of this work was to assess the effect of GES on GI peptide levels in patients with intractable vomiting. MATERIALS AND METHODS: Twenty-one patients were randomized to receive either ON or OFF GES, 14 completed the study (10 ON, 4 OFF stimulation). Vomiting episodes, gastric emptying, and gastrointestinal quality of life index (GIQLI) were assessed. Gastric and blood samples were collected before and four months after the ON period of gastric stimulation. mRNA and/or peptide levels were assessed in gastric biopsies for ghrelin, leptin, and NUCB2/nesfatin-1 and in duodenal biopsies for glucagon-like peptide 1 (GLP-1) and peptide YY (PYY) using RT-qPCR and multiplex technology. Ghrelin, leptin, GLP-1, PYY, gastric inhibitory peptide (GIP), and NUCB2/nesfatin-1 levels also were quantified in blood samples. RESULTS: Among clinical parameters, vomiting episodes were slightly reduced by GES (p = 0.09). In tissue, mRNA or protein levels were not modified following chronic GES. In blood, a significant reduction of postprandial PYY levels (p < 0.05) was observed at M4 and a reduction of NUCB2/nesfatin-1 levels in fasted patients (p < 0.05). Increased plasma leptin levels after GES were correlated with reduction of vomiting and improvement of GIQLI. CONCLUSIONS: GES reduces NUCB2/nesfatin-1 levels under fasting conditions and postprandial PYY levels in patients suffering from nausea and/or vomiting refractory to pharmacological therapies.
OBJECTIVES: Gastric electrical stimulation (GES) is an alternative therapy to treat patients with intractable vomiting. A preclinical study has demonstrated the modulation of the gastrointestinal (GI) peptide ghrelin by GES but such mechanism has never been investigated in patients. The aim of this work was to assess the effect of GES on GI peptide levels in patients with intractable vomiting. MATERIALS AND METHODS: Twenty-one patients were randomized to receive either ON or OFF GES, 14 completed the study (10 ON, 4 OFF stimulation). Vomiting episodes, gastric emptying, and gastrointestinal quality of life index (GIQLI) were assessed. Gastric and blood samples were collected before and four months after the ON period of gastric stimulation. mRNA and/or peptide levels were assessed in gastric biopsies for ghrelin, leptin, and NUCB2/nesfatin-1 and in duodenal biopsies for glucagon-like peptide 1 (GLP-1) and peptide YY (PYY) using RT-qPCR and multiplex technology. Ghrelin, leptin, GLP-1, PYY, gastric inhibitory peptide (GIP), and NUCB2/nesfatin-1 levels also were quantified in blood samples. RESULTS: Among clinical parameters, vomiting episodes were slightly reduced by GES (p = 0.09). In tissue, mRNA or protein levels were not modified following chronic GES. In blood, a significant reduction of postprandial PYY levels (p < 0.05) was observed at M4 and a reduction of NUCB2/nesfatin-1 levels in fasted patients (p < 0.05). Increased plasma leptin levels after GES were correlated with reduction of vomiting and improvement of GIQLI. CONCLUSIONS: GES reduces NUCB2/nesfatin-1 levels under fasting conditions and postprandial PYY levels in patients suffering from nausea and/or vomiting refractory to pharmacological therapies.
Authors: Zengbing Lu; Dexuan Cui; Julia Yuen Hang Liu; Bin Jiang; Man Piu Ngan; Ichiro Sakata; Shota Takemi; Takafumi Sakai; Ge Lin; Sze Wa Chan; John A Rudd Journal: Front Pharmacol Date: 2022-04-06 Impact factor: 5.988
Authors: Thomas L Abell; Goro Yamada; Richard W McCallum; Mark L Van Natta; James Tonascia; Henry P Parkman; Kenneth L Koch; Irene Sarosiek; Gianrico Farrugia; Madhusudan Grover; William Hasler; Linda Nguyen; William Snape; Braden Kuo; Robert Shulman; Frank A Hamilton; Pankaj J Pasricha Journal: Neurogastroenterol Motil Date: 2019-10-04 Impact factor: 3.598