Is autonomic dysfunction a necessary condition for chronic peptic ulcer formation?

Nomura, Masahiro; Yukinaka, Michiko; Miyajima, Hitoshi; Nada, Teru; Kondo, Yoshitaka; Okahisa, Toshiya; Shibata, Hideyuki; Okamura, Seisuke; Honda, Hirohito; Shimizu, Ichiro; Saito, Ken; Oki, Takashi; Nakaya, Yutaka; Ito, Susumu

doi:10.1046/j.1365-2036.2000.014s1082.x

Cited by 12 publications

(14 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Testoni et al [68] also showed a significantly greater prevalence of H. pylori infection in patients without evidence of gastric phase Ⅲ of the migrating motor complex. Collectively, these data indicate that the coexistence of ANS dysfunction and H. pylori infection is a necessary condition for H. pylori invasion, as well as for chronic gastritis and peptic ulcer formation [6,14,15,21,22,29,[35][36][37][38][39] (but see Chang et al [69] ).…”

Section: Role Of the Brain-gut Axis In Acute H Pylori Infectionmentioning

confidence: 99%

“…Lugon et al [122] reported blunted sympathetic reactivity and an exacerbated vagal response to feeding in H. pyloripositive subjects. However, Katoh et al [36] have shown that H. pylori eradication in duodenal ulcer patients does not change nocturnal sympatheticotonia or parasympatheticotonia, which may be the cause for persistently increased gastric acid secretion, gastric mucosal vasoconstriction and ulcer recurrence [38,121] , though the time course between eradication and ANS evaluation may have been too short to reveal statistically significant differences. Indeed, Stanghellini et al [123] suggest there is long-term recovery of H. pylori-induced neuroplastic changes in the ANS and highlight the importance of an incomplete resolution of gastritis and the presence of a persistent production of inflammatory mediators even after successful H. pylori eradication.…”

Section: H Pylori and Ans Activitymentioning

confidence: 99%

“…(2) patients with digestive tract disorders have a high prevalence of neuropsychological comorbidities, such as depression, anxiety and alexithymia [13] ; (3) changes in cognitive function occur after diet-induced gut-dysbiosis [18] or with alimentary tract diseases (e.g., hepatic encephalopathy) which may be altered after antibiotics, probiotics or laxative administration [15,30] ; (4) patients with major depression show altered intestinal fermentation profiles [31] ; (5) individuals with autism have abnormal microbiota and experience shorter antibiotic effects [32][33][34] ; (6) some patients with digestive tract disorders demonstrate an ANS imbalance [6,14,15,21,22,29,[35][36][37][38][39] ; and (7) digestive tract stimulation and/or infection can produce abnormalities in brainimaging techniques that show the activation (evoked potentials) or deactivation of specific brain regions, such as functional magnetic resonance imaging, positron emission tomography, magnetoencephalography and electroencephalography [40] .…”

Section: Brain-gut Axis and Helicobacter Pylorimentioning

confidence: 99%

“…Disturbances in ANS balance are observed in patients presenting with H. pylori infection and functional and organic digestive tract disorders [10,14,15,21,22,29,[35][36][37][38][39] . Our study found that among patients diagnosed as a result of atypical chest pain, subjects infected with H. pylori had increased ANS activity, an effect that was confirmed by multifactorial analysis [35] .…”

Section: H Pylori and Ans Activitymentioning

confidence: 99%

“…We therefore concluded that gastric mucosal colonization by H. pylori affects ANS activity and can evoke disturbances in esophageal and gastric function. Vagal nerve predominance, as diagnosed by heart rate variability analyses, was also recognized as a risk factor for duodenal ulcer development [2,[38][39]121] . Lugon et al [122] reported blunted sympathetic reactivity and an exacerbated vagal response to feeding in H. pyloripositive subjects.…”

Section: H Pylori and Ans Activitymentioning

confidence: 99%

See 4 more Smart Citations

Brain-gut axis in the pathogenesis ofHelicobacter pyloriinfection

Budzyński¹

2014

WJG

View full text Add to dashboard Cite

Helicobacter pylori (H. pylori) infection is the main pathogenic factor for upper digestive tract organic diseases. In addition to direct cytotoxic and proinflammatory effects, H. pylori infection may also induce abnormalities indirectly by affecting the brain-gut axis, similar to other microorganisms present in the alimentary tract. The brain-gut axis integrates the central, peripheral, enteric and autonomic nervous systems, as well as the endocrine and immunological systems, with gastrointestinal functions and environmental stimuli, including gastric and intestinal microbiota. The bidirectional relationship between H. pylori infection and the brain-gut axis influences both the contagion process and the host's neuroendocrine-immunological reaction to it, resulting in alterations in cognitive functions, food intake and appetite, immunological response, and modification of symptom sensitivity thresholds. Furthermore, disturbances in the upper and lower digestive tract permeability, motility and secretion can occur, mainly as a form of irritable bowel syndrome. Many of these abnormalities disappear following H. pylori eradication. H. pylori may have direct neurotoxic effects that lead to alteration of the brain-gut axis through the activation of neurogenic inflammatory processes, or by microelement deficiency secondary to functional and morphological changes in the digestive tract. In digestive tissue, H. pylori can alter signaling in the brain-gut axis by mast cells, the main brain-gut axis effector, as H. pylori infection is associated with decreased mast cell infiltration in the digestive tract. Nevertheless, unequivocal data concerning the direct and immediate effect of H. pylori infection on the brain-gut axis are still lacking. Therefore, further studies evaluating the clinical importance of these host-bacteria interactions will improve our understanding of H. pylori infection pathophysiology and suggest new therapeutic approaches.

show abstract

Section: Role Of the Brain-gut Axis In Acute H Pylori Infectionmentioning

confidence: 99%

Section: H Pylori and Ans Activitymentioning

confidence: 99%

Section: Brain-gut Axis and Helicobacter Pylorimentioning

confidence: 99%

Section: H Pylori and Ans Activitymentioning

confidence: 99%

Section: H Pylori and Ans Activitymentioning

confidence: 99%

See 3 more Smart Citations

Brain-gut axis in the pathogenesis ofHelicobacter pyloriinfection

Budzyński¹

2014

WJG

View full text Add to dashboard Cite

show abstract

Autonomic nervous activity before and after eradication of Helicobacter pylori in patients with chronic duodenal ulcer

Katoh

Nomura

Nakaya

et al. 2002

Aliment Pharmacol Ther

Self Cite

View full text Add to dashboard Cite

Background: Helicobacter pylori infection is involved in the formation of chronic peptic ulcer. However, a previously reported hypothesis concerning the involvement of central autonomic nervous disorder in this condition cannot be ruled out. Aim: To use spectrum analysis of heart rate viability to examine autonomic nervous activity before and after H. pylori eradication. Methods: Twenty patients with chronic duodenal ulcer (duodenal ulcer group) and 20 age‐matched normal adults (N group). In both groups, 24‐h Holter electrocardiograms (ECGs) were recorded and spectrum analysis of heartrate variability was performed. In the duodenal ulcer group, Holter ECG was recorded before and after H. pylori eradication. Results: In the N group, analysis of heart rate variability showed that high frequency (HF) power, an index of parasympathetic activity, was high at night, while the low frequency (LF)/HF ratio, an index of sympathetic function, was high during the daytime. In the duodenal ulcer group, HF power was higher at night than during the daytime, showing a similar pattern to the N group, but the power value was higher than in the N group (P < 0.05). In the duodenal ulcer group, LF/HF at night was significantly higher than that of the N group. In addition, in the duodenal ulcer group, autonomic activity after H. pylori eradication did not differ significantly from that before H. pylori eradication. Conclusions: In patients with chronic peptic ulcer, both sympatheticotonia and parasympatheticotonia may occur at night, and this abnormality in autonomic nervous activity may cause increased gastric acid secretion and gastric mucosal vasoconstriction. Abnormalities in autonomic activity persist even after H. pylori eradication, suggesting that they may be an independent risk factor in the formation of chronic peptic ulcer in addition to H. pylori infection.

show abstract

Environmental, medical, behavioural and disability factors associated with Helicobacter pylori infection in adults with intellectual disability

Wallace

Webb

Schluter

2002

J intellect Disabil Res

View full text Add to dashboard Cite

In institutionalized adults with intellectual disability (ID), Helicobacter pylori infection occurs at approximately twice the rate it appears in the general population, and it may be responsible for the twofold higher rates of peptic ulcer disease and gastric cancer in this population. Medical, behavioural and additional environmental factors, as well as level of ID, may be related to the risk of infection with H. pylori. One hundred and sixty-eight adults with ID who were currently, had previously been or had never been institutionalized underwent a biopsychosocial evaluation. This included assessment of: level of ID using the Adaptive Behaviour Scale (ABS) Part I; levels of maladaptive behaviour using the ABS Part II; demographic, medical and environmental factors; as well as H. pylori tests using serology and faecal antigen. The overall rates of past or current infection with H. pylori in institutionalized and previously institutionalized participants were about twice that of the overall group of never-institutionalized participants, i.e. 87% and 79% compared to 44%, respectively (P < 0.001). The rates of H. pylori infection appeared to increase with age in the never-institutionalized group, but were consistently high across all ages in the other groups. The rate of infection was higher in those institutionalized for more than 5 years (95% versus 76%, P=0.02), in those with flatmates with excessive oral secretions (65% versus 21%, P < 0.001) or faecal incontinence (67% versus 27%, P < 0.001), and in those with more chronic illness and medications. All mean domain scores of the ABS Part I (Intellectual Disability) were significantly lower (indicating more severe ID) in the group currently infected with H. pylori compared to their non-infected counterparts. The majority of mean domain scores of the ABS Part II (Behaviour) were also worse, with half of these score differences reaching statistical significance in the currently infected group. The presence of alarm symptoms (e.g. vomiting, weight loss, haematemesis and melena), iron deficiency and body mass index were not significantly different in currently infected subjects. Adults with ID appear to be particularly at risk of infection with H. pylori. Environmental associations with infection include past or current institutionalization, a longer period of institutionalization, living with flatmates with excessive oral secretions and faecal incontinence. Medical associations include chronic disease and more medications, but not alarm symptoms or body mass index. Demographic associations may include increasing age in never-institutionalized adults, but no age effect in currently or previously institutionalized individuals. Psychosocial associations include more severe ID and maladaptive behaviour with current infection.

show abstract

Is autonomic dysfunction a necessary condition for chronic peptic ulcer formation?

Cited by 12 publications

References 18 publications

Brain-gut axis in the pathogenesis ofHelicobacter pyloriinfection

Brain-gut axis in the pathogenesis ofHelicobacter pyloriinfection

Autonomic nervous activity before and after eradication of Helicobacter pylori in patients with chronic duodenal ulcer

Environmental, medical, behavioural and disability factors associated with Helicobacter pylori infection in adults with intellectual disability

Contact Info

Product

Resources

About