Basic Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 7, 2016; 22(37): 8349-8360
Published online Oct 7, 2016. doi: 10.3748/wjg.v22.i37.8349
Childhood chronic gastritis and duodenitis: Role of altered sensory neuromediators
Ali Islek, Aygen Yilmaz, Gulsum Ozlem Elpek, Nuray Erin
Ali Islek, Aygen Yilmaz, Department of Pediatric Gastroenterology, Akdeniz University School of Medicine, Antalya 07070, Turkey
Gulsum Ozlem Elpek, Department of Pathology, Akdeniz University School of Medicine, Antalya 07070, Turkey
Nuray Erin, Department of Medical Pharmacology, Akdeniz University School of Medicine, Antalya 07070, Turkey
Author contributions: Islek A, Yilmaz A, Elpek GO and Erin N substantially contributed to the conception and design of the study and the acquisition, analysis and interpretation of the data; all authors drafted the article and made critical revisions related to the intellectual content of the manuscript and approved the final version of the article to be published.
Supported by Akdeniz University Research Unit, Antalya, Turkey, No. 2012.01.0103.012.
Institutional review board statement: The study was reviewed and approved by the Committee of Ethics at the Faculty of Medicine, Akdeniz University, Antalya, Turkey (protocol number: 14.05.2012/110).
Informed consent statement: All patients and/or their families gave written and verbal consent to participate in the study.
Conflict-of-interest statement: The authors declared that no conflict of interest exists.
Data sharing statement: Technical appendix, statistical codes, and the dataset are available from the corresponding author at islekali@hotmail.com. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ali Islek, MD, Assistant Professor, Department of Pediatric Gastroenterology, Akdeniz University School of Medicine, Dumlupinar Bulvari, Antalya 07070, Turkey. islekali@hotmail.com
Telephone: +90-505-7664380 Fax: +90-242-2274320
Received: June 22, 2016
Peer-review started: June 24, 2016
First decision: August 8, 2016
Revised: August 18, 2016
Accepted: September 8, 2016
Article in press: September 8, 2016
Published online: October 7, 2016
Processing time: 99 Days and 20.1 Hours
Abstract
AIM

To investigate the roles of the neuropeptides vasoactive intestinal peptide (VIP), substance P (SP), and calcitonin gene-related peptide (CGRP) in chronic gastritis and duodenitis in children.

METHODS

Biopsy samples from the gastric and duodenal mucosa of 52 patients and 30 control subjects were obtained. Samples were taken for pathological examination, immunohistochemical staining, enzyme activity measurements and quantitative measurements of tissue peptide levels.

RESULTS

We observed differential effects of the disease on peptide levels, which were somewhat different from previously reported changes in chronic gastritis in adults. Specifically, SP was increased and CGRP and VIP were decreased in patients with gastritis. The changes were more prominent at sites where gastritis was severe, but significant changes were also observed in neighboring areas where gastritis was less severe. Furthermore, the degree of changes was correlated with the pathological grade of the disease. The expression of CD10, the enzyme primarily involved in SP hydrolysis, was also decreased in patients with duodenitis.

CONCLUSION

Based on these findings, we propose that decreased levels of VIP and CGRP and increased levels of SP contribute to pathological changes in gastric mucosa. Hence, new treatments targeting these molecules may have therapeutic and preventive effects.

Keywords: Gastritis; Neuropeptides; Childhood; Neutral endopeptidase

Core tip: The etiology and pathogenesis of childhood gastritis are not entirely known. The lamina propria of the gastrointestinal tract includes sensory neuropeptides that regulate gastric blood flow, local inflammatory responses and healing processes. Vasoactive intestinal peptide (VIP), substance P (SP), and calcitonin gene-related peptide (CGRP) are such neuropeptides, and their roles in chronic childhood gastritis are not known. In this study, we investigated the changes in neuropeptides in childhood gastritis and duodenitis. Disturbances in the neuropeptide content in gastric mucosa may cause gastritis. On the basis of our findings, we propose that decreased levels of VIP and CGRP and increased levels of SP may contribute to pathological changes in gastric mucosa. New treatments targeting these molecules may have therapeutic and preventive effects.