Changes of plasma cAMP and cGMP levels in chronic atrophic gastritis patients with spleen-qi deficiency

Abstract

AIM: To investigate the relationship between plasma cAMP and cGMP levels and spleen-qi deficiency in chronic atrophic gastritis.

METHODS: Plasma cAMP and cGMP levels were detected in chronic atrophic gastritis patients with spleen-qi deficiency (n = 87). Thirty patients underwent self-controlled study prior to and after 1-2 courses of Weiweian therapy, with each course lasting 3 mo. The samples were detected using ¹²⁵I-labelled cAMP and cGMP kits.

RESULTS: Plasma cAMP and cGMP levels in all cases of chronic atrophic gastritis patients with spleen-qi deficiency syndrome were lower than or at the lower margin level. In the 30 patients receiving Weiweian therapy, both plasma cAMP and cGMP levels increased significantly after the therapy as compared with those prior to the therapy (P < 0.01, and < 0.05).

CONCLUSION: Measurements of plasma cAMP and cGMP levels are of great importance in CAG patients with spleen-pi deficiency, and Weiweian therapy can correct the spleen-qi deficiency. Furthermore, plasma cAMP may serve as a prognostic factor in CAG, and it might prevent CAG from progressing into gastric cancer since plasma cAMP is low in gastric cancer.

Key Words: Gastritis, atrophic; Spleen-qi deficiency; cAMP; cGMP

INTRODUCTION

It had been proved that plasma cAMP level was lowered in experimental animals with spleen-deficiency syndrome[1,2]. Both plasma cAMP and cGMP levels were decreased in experimental qi deficiency (i.e., energy deficiency)[2], thus providing valid clues to the insight of this syndrome. This study mainly explored the relationship between plasma cyclic nucleotides and spleen-qi deficiency in chronic atrophic gastritis (CAG).

MATERIALS AND METHODS

Patients

Eighty-seven patients were diagnosed with CAG by fibergastroscopy and pathologic examination. Of these patients, 57 were male and 30 were female with an average age of 47.9 years (range, 21 to 72 years). Thirty of the 87 patients were subjected to self-controlled study prior to and after one or two courses of Weiweian therapy, with each course lasting 3 mo. Among these 30 patients, 17 were male and 13 female with an average age of 50.2 years (range, 36 to 72 years).

Method

The samples were detected using ¹²⁵I-labelled cAMP and cGMP kits provided by the Nuclear Laboratory of Shanghai Traditional Chinese Medicine College. The samples were pretreated with anticoagulant and detected according to the instructions of the kits and counted by Beckman 5800 liquid scintigraphy.

RESULTS

Plasma cAMP and cGMP levels in 87 CAG patients are shown in Table 1.

Table 1 Plasma cAMP and cGMP levels in 87 chronic atrophic gastritis patients.

	Normal value	CAG patients	t
cAMP	23.1 ± 7.7	14.629 ± 4.307b	6.742
cGMP	4.6 ± 0.7	4.668 ± 1.317	0.449

^bP < 0.01. CAG: Chronic atrophic gastritis

The plasma cAMP and cGMP levels in 30 patients with CAG prior to and after therapy are shown in Table 2.

Table 2 Plasma cAMP and cGMP levels in 30 patients with chronic atrophic gastritis prior to and after Weiweian therapy.

	Prior to therapy	After therapy	t
cAMP	13.234 ± 3.968	27.285 ± 7.330b	8.955
cGMP	4.159 ± 1.494	7.366 ± 7.290a	2.217

^aP < 0.05,

^bP < 0.01.

DISCUSSION

The cAMP is universally present in the body cells and body fluids, through which the neurohumoral functions were mediated. The cAMP and cGMP were released by the cells and tissues into blood. The evaluation of cAMP and cGMP is of importance in the study of the physiology and pathophysiology of human diseases. CAG patients usually manifest spleen-qi deficiency syndrome which is caused not only by gastric mucosal glandular atrophy, but also by the abnormal neurohumoral function. Decrease in plasma cAMP reflects hypofunction of sympathetic nervous activity and relative hyperfunction of parasympathetic nervous activity. Spleen-qi deficiency is characterized by epigastric fullness or aching, loose bowel movement, weakness, poor appetite, swollen tongue with teeth printing and thready pulse, which is called spleen-stomach-qi deficiency symptom complex. In all cases, plasma cAMP was lower than normal (Table 1) (P < 0.01), and cGMP was at its lower normal limit. The spleen deficiency syndrome of CAG is closely related to the plasma levels of cAMP and cGMP which can be modulated by the body’s neurohumoral function. The 30 patients were treated with Weiweian powder, and the results were satisfactory. The effective rate of symptom relief was 90% with regression of pathologic lesions in 73.3%. Through this self-controlled study, we observed a remarkable increase of plasma cAMP which was of marked statistical significance (P < 0.01), so was that of cGMP (P < 0.05). Weiweian powder has the effects of strengthening spleen and benefiting qi, so that the spleen-qi deficiency syndrome can be improved remarkably. It was also found that spleen-qi deficiency with low cAMP usually occur in gastric cancer[3].

In conclusion, modulating the plasma cAMP and cGMP levels is of importance in correcting spleen-stomach-qi deficiency. Therefore, the increase of cyclic nucleotides in CAG is of prognostic significance. Meanwhile the increase of the concentration of plasma cAMP is conducive to preventing CAG from progressing into gastric cancer, since plasma cAMP level is usually low in patients with gastric cancer.