Intravenous Corticotropin-releasing Hormone Administration Increases Esophageal Electrical Sensitivity in Healthy Individuals

Abstract

Background/AimsWhen a person is experiencing stress, corticotropin-releasing hormone (CRH) can modulate gut physiologies, such as visceral sensation or gastrointestinal motility, and its intravenous administration mimics stress-induced physiological changes. However, the influence of CRH on the esophagus is yet unknown. Accordingly, we investigated whether intravenous CRH administration increases esophageal sensitivity to electrical stimulation in healthy Japanese subjects. MethodsTwenty healthy subjects were recruited. We quantified the initial perception threshold (IPT) every 15 minutes after CRH injection. Venous blood was collected with a cannula, and both plasma adrenocorticotropic hormone (ACTH) and cortisol were measured at pre-stimulation, 0, 30, 60, 90, and 120 minutes. The results from each time point were compared against a baseline IPT obtained before electrical stimulation was initiated. ResultsWhen compared to the baseline IPT value (16.9 ± 4.5), CRH significantly decreased electrical threshold of the esophagus at 30, 45, 60, 75 minutes (14.1 ± 4.2, 13.1 ± 5.0, 12.1 ± 5.7, 14.0 ± 5.8 minutes, P < 0.01, respectively) after CRH injection, suggesting that CRH increased esophageal sensitivity to the electrical stimulus. CRH also significantly increased plasma ACTH levels at 30 minutes (50.3 ± 17.7, P < 0.01), and cortisol levels at 30 minutes (22.0 ± 6.7 minutes, P < 0.01) and 60 minutes (20.3 ± 6.7 minutes, P < 0.01) after CRH injection, when compared to the pre-stimulation ACTH and cortisol values. ConclusionIntravenous CRH administration increased esophageal electrical sensitivity in normal subjects, emphasizing the important role of stress in esophageal sensitivity.

Progress on the Mechanism of Visceral Hypersensitivity in Nonerosive Reflux Disease

“…Moreover, CRH plays a key role in activating the HPA axis for endocrine regulation. Yamasaki et al [ 35 ] demonstrated that esophageal sensitivity increases after the intravenous injection of CRH in a normal population, indirectly emphasizing the importance of psychological stress in esophageal VH. Brain-gut peptides, which can regulate visceral sensation, gastrointestinal motility, and mental psychology, are small molecular substances distributed within the brain and the intestines.…”

Phenotypes of gastroesophageal reflux disease: classification, pathogenesis and diagnostic criteria: A review

“…T. Yamasaki и соавт. [42] продемонстрировали, что чувствительность пищевода в нормальной популяции повышалась после внутривенного введения кортикотропин-рилизинг-гормона, что косвенно подчеркивает влияние психологического стресса на развитие висцеральной гиперчувствительности пищевода.…”