NEW YORK (Reuters Health) - In patients with irritable bowel syndrome (IBS), treatment with a corticotropin releasing hormone (CRH) receptor antagonist improved gastrointestinal motility and visceral perception, Japanese investigators report in the July issue of Gut.
In fact, senior investigator Dr. Shin Fukudo told Reuters Health that “after the discovery of CRH as a key mediator of the stress response in the brain-gut axis, many investigators dreamed of modifying its function in the clinical situation.”
“Our study,” he said, “clearly demonstrates that the colonic sensory and motor function in IBS patients is modified by peripheral administration of a CRH antagonist.”
Dr. Fukudo, from Tohoku University Graduate School of Medicine in Sendai and colleagues established, in 10 IBS and 10 control patients, that rectal electrical stimulation induced significantly higher motility indices of the colon in IBS than in control patients.
This exaggerated response was “significantly suppressed” in IBS but not control patients following IV administration of 10 µg/kg alpha-helical CRH, a non-selective CRH receptor antagonist. Pharmacologic CRH receptor antagonism also significantly reduced abdominal pain and anxiety induced by gut stimuli in IBS but not control patients.
Plasma adrenocorticotropic hormone (ACTH) and serum cortisol levels were largely unchanged by alpha-helical CRH administration.
The findings, the authors conclude, provide “strong support for the hypothesis that CRH signaling pathways play a key role in the pathophysiology of IBS.”
Source: Gut 2004;53:958-964. [ Google search on this article ]
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