[Excretion and metabolism of dopamine in patients with functional dyspepsia]. / Wydzielanie i metabolizm dopaminy u osób z dyspepsja czynnosciowa.

UNLABELLED: Dopamine is one of major neurotransmitter in the central and peripheral nervous system. A significant amount of dopamine is also produced in the visceral nervous system and in gastrointestinal tract, where exhibits inhibitory activity on motility. AIM: The aim of the study was to assess the parameters of dopamine secretion and metabolism in patients with functional dyspepsia. MATERIAL AND METHODS: The study was conducted in a group of 30 healthy subjects and 60 patients with functional dyspepsia (FD), that met the Rome Criteria III, for epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS). The severity of dyspeptic symptoms was determined using a 10-point Visual-Analogue Scale (VAS). Fasting plasma concentration of dopamine (DA) and the contents of homovanillic acid (HVA) in the urine collection were determined by ELISA. RESULTS: DA concentration in plasma was similar in both clinical forms FD (EPS - 55.6 pg/ml, in patients with PDS - 63.5 pg/ml, p>0.05). Urine excretion of HVA in patients with PDS - 6.63 mg/24 h (p<0.05) was higher than in heathy subjects - 5.65 mg/24 h (p<0.05) and those with EPS - 5.07 mg/24 h (p<0.001). In the group with PDS severity of dyspeptic symptoms showed a positive correlation with the DA concentration in plasma and HVA excretion in the urine. CONCLUSIONS: Increased secretion of DA may play a significant role in the pathogenesis of PDS.

Melatonin and female hormone secretion in postmenopausal overweight women.

Estrogen deficiency is considered to be the main cause of increased appetite and increased weight in postmenopausal women. In this period, reduced secretion of melatonin (MEL) was also observed. The aim of the study was to evaluate the secretion of melatonin, 17-ß estradiol and follicle-stimulating hormone (FSH) in relation to body mass index (BMI) in pre- and postmenopausal women. The study included 90 women divided into three equal groups: group I (control)-women without menstrual disorders, group II-postmenopausal women without change in appetite and body weight, group III-postmenopausal women experiencing increased appetite and weight gain. In each patient, serum melatonin, 17-ß-estradiol, FSH and urine a 6-sulfatoxymelatonin (aMT6s) were determined. Compared to the control group, the level of melatonin and estradiol was statistically lower. The FSH level was higher than in the groups of postmenopausal women. No significant correlation was found in all groups between the level of melatonin and the levels of estradiol and FSH. A negative correlation was found between aMT6s excretion and BMI, and a positive correlation between the level of FSH and BMI, mainly in overweight women. The obtained results indicate a significant effect of melatonin deficiency on the process of weight gain in postmenopausal women and justify its use in treatment of these disorders.

[Efficacy of sulpiride and itopride in the treatment of functional dyspepsia in women with emotional and eating disorders]. / Ocena skutecznosci sulpirydu i itoprydu w leczeniu dyspepsji czynnosciowej u kobiet z zaburzeniami emocji i laknienia.

UNLABELLED: Functional dyspepsia is often accompanied by emotional disturbances, especially in postmenopausal women. Impaired homeostasis of the dopaminergic system maybe one of the common pathogenetic factors. The aim of the study was to assess the effect of drugs which block dopamine D2 receptors on psychosomatic condition in postmenopausal women. MATERIAL AND METHODS: The study was conducted in a group of 60 women, aged 53-61 years, with postprandial distress syndrome (PDS) that met the Rome Criteria III. The severity of dyspeptic symptoms was determined statistically using a 10-point Visual Analogue Scale (VAS). The emotional state was estimated with the Hamilton Anxiety Rating Scale (HARS) and the Beck Depression Inventory (BDI), whereas the body mass index (BMI) was the indicator of the nutritional status. Sulpiride (2 x 50 mg) was administered to 30 women for 16 weeks and itopride (2 x 50 mg) to 30 others. RESULTS: After sulpiride and itopride treatment equal decrease of dyspeptic symptoms was observed, respectively from 9.08 to 4.76 pts and from 9.02 to 4.64 pts. Significant reduction in the level of anxiety (p < 0.001) and depression (p < 0.01) was obtained in both groups, slightly higher after sulpiride. However, no significant change in BMI was found. CONCLUSIONS: Sulpiride and itopride are effective in the treatment of dyspepsia in the form of postprandial distress syndrome. These drugs in the several-month treatment have no significant effect on body weight.

Melatonin secretion and metabolism in patients with hepatic encephalopathy.

BACKGROUND AND AIM: The rhythm of melatonin secretion and its blood level changes in cirrhotic patients, but the causes of these alterations have not been sufficiently appreciated. The aim of study was to estimate the dependence between melatonin secretion and metabolism and the severity of hepatic encephalopathy. METHODS: The study included 75 alcoholic cirrhotic patients (A, B, C) with hepatic insufficiency and 25 healthy subjects (group K). Three groups of patients were identified, 25 patients each, with grade 1, 2, and 3 hepatic encephalopathy according to West-Haven Scale. Immunoenzymatic method was used to measure serum melatonin (at 02:00 h and 09:00 h) level and 6-sulfatoxymelatonin (6-HMS) excretion in the urine (during night and day). RESULTS: Nocturnal serum melatonin levels (pg/mL) in groups were: K-57.1 ± 11.4, A-38.5 ± 11.2, B-53.4 ± 17.9, C-79.5 ± 27.9 (P < 0.01); whereas diurnal levels were: K-10.9 ± 3.5, A-33.5 ± 12.0, B-53.8 ± 23.1, C-98.5 ± 34.6 (P < 0.01). Similar differences were found in the evaluation of 6-HMS excretion (µg/9 h) in urine at night: group K-23.4 ± 14.4, A-16.6 ± 5.4, B-14.3 ± 6.2 (P < 0.01), C-3.3 ± 1.5 (P < 0.001). Diurnal 6-HMS excretion (µg/15 h) was lower only in group C and it was respectively: K-6.9 ± 3.4, A-7.1 ± 1.7, B-7.6 ± 1.7, C-4.3 ± 2.2 (P < 0.001). Serum ammonia concentrations (µg/dL) were: group K-30.4 ± 8.9, A-51.8 ± 25.4 (P < 0.05), B-73.0 ± 29.8 (P < 0.001), C-107.5 ± 34.8 (P < 0.001). No correlation between melatonin and ammonia levels in all groups was found. CONCLUSIONS: The elevated melatonin blood levels both at night and day may account for some of the clinical manifestations of hepatic encephalopathy (daytime sleepiness, fatigue).

Serotonin and melatonin secretion and metabolism in patients with liver cirrhosis.

INTRODUCTION: Hepatic encephalopathy is one of the symptoms of liver failure. The exact causes of encephalopathy are complex and still unclear. Apart from elevated blood ammonia levels, the role of numerous other factors is being considered. OBJECTIVES: The aim of the study was to determine the serum level of serotonin and melatonin and the urinary excretion of their metabolites (5-hydroxyindoleacetic acid [5-HIAA] and 6-sulfatoxymelatonin [6-HMS]) in patients with various stages of liver cirrhosis. PATIENTS AND METHODS: The study comprised 75 patients with alcohol-induced liver cirrhosis and 25 healthy subjects (control group). Based on the Child-Pugh classification, 3 groups of 25 patients each were distinguished - group A, B, and C with grade A, B, and C of liver failure, respectively. Blood samples were drawn at fasting at 9 a.m., and 24-hour urine collection was performed. Immunoenzymatic assays were used to determine serum melatonin and serotonin levels as well as urine 5-HIAA and 6-HMS concentrations. RESULTS: Serum serotonin levels were 159.8 ± 23.1 ng/ml in controls, 179.3 ± 21.1 ng/ml in group A (P >0.05), 143.2 ± 22.8 ng/ml in group B (P >0.05), and 114.5 ± 37.6 ng/ml in group C (P <0.01). Serum melatonin levels were 10.6 ± 1.7 in controls, 31.2 ± 9.8 pg/ml in group A (P <0.01), 49.8 ± 12.2 pg/ml in group B (P <0.001), and 94.8 ± 22.6 pg/ml in group C (P <0.001). Urinary 5-HIAA excretion was 5.9 ± 2.1 mg/24 h in controls, 5.9 ± 1.9 mg/24 h in group A (P >0.05), 4.8 ± 1.2 mg/24 h in group B (P >0.05), and 4.6 ± 1.4 mg/24 h in group C (P <0.05). Urinary 6-HMS excretion was 26.6 ± 15.1 µg/24 h in controls, 23.2 ± 7.9 µg/24 h in group A (P >0.05), 18.3 ± 10.6 µg/24 h in group B (P >0.05), and 6.5 ± 3.6 µg/24 h in group C (P <0.001). CONCLUSIONS: Disturbances in serotonin and melatonin homeostasis observed in patients with liver cirrhosis may be associated with advanced encopaholopathy.

[Evaluation of the influence of tianeptine on the psychosomatic status of patients with ulcerative colitis in remission]. / Ocena wplywu tianeptyny na stan psychosomatyczny.

UNLABELLED: In order to maintain ulcerative colitis (UC) in remission, chronic use of aminosalicylates is recommended. All patients have a fear of the recurrence of symptoms, which makes their mental state and quality of life worse. Because of this a number of patients are recommended to use different sorts of anxiolytic drugs and antidepressants. AIM OF THE STUDY: Evaluation of the influence of tianeptine (selective serotonin reuptake enhancer) on the mental and somatic status in the group of patients. MATERIAL AND METHOD: The research was conducted in two groups of thirty patients, with benign form of ulcerative colitis in remission, aged 24-46 years. Patients, during a period of 12 months, were given aminosalicylates in a daily doses 2 x 1.0 g and tianeptine in a doses 3 x 12.5 mg (group I) or placebo (group II). During the treatment every three months anxiety (Hamilton Anxiety Rating Scale-HARS), depression (Back Depression Inventory-BDI), The Mayo Clinic Disease Activity Index (MCDAI), hemoglobin and C-reactive protein (CRP) level were evaluated. RESULTS: After 12 months in a group of patients who took tianeptine decrease in anxiety (from 20.35 +/- 4.03 to 12.65 +/- 3.78 points) and depression (from 19.95 +/- 4.49 points to 9.60 +/- 2.76 points) was obtained; difference compared with placebo was statistically significant (p < 0.01). At the same time significant decrease compared with placebo (p < 0.05) of disease activity index (respectively 3.05 +/- 1.36 and 4.65 +/- 1.69), insignificantly lower level of CRP (7.00 5.65 and 9.41 +/- 10.12) and higher level of hemoglobin (11.93 +/- 0.83 and 11.0 +/- 0.70) was observed. CONCLUSIONS: Tianeptine has a positive influence on mental and somatic status of patients with UC. Results give the support for tianeptine apllication in UC as adjuvant drug.