vasoactive-intestinal-peptide and Liver-Cirrhosis

This study aims to investigate the relationship between gastrointestinal dysfunction (GD) and cirrhosis severity in cirrhotic patients, to provide evidences for the prevention and treatment of GD in cirrhotic patients.A total of 95 cirrhotic inpatients and outpatients, who were treated in the Department of Gastroenterology of Xinqu Hospital of the First Affiliated Hospital of Henan University of Science and Technology, were enrolled in the present study, and assigned as the experimental group (cirrhosis group). According to Child-Pugh classification, these patients were divided into 3 groups: group A (n = 45), group B (n = 23), and group C (n = 27). Forty healthy adults who received health check-ups during the same period served as the control group. The gastrointestinal (GI) symptoms of cirrhotic patients were scored, and the fasting serum gastrin (GAS), motilin (MTL), and vasoactive intestinal peptide (VIP) levels were measured in all subjects.The potential correlations of GI symptom scores of patients in these cirrhosis groups with GI hormone levels and cirrhosis severity were analyzed. In cirrhotic patients, the GI symptom scores significantly increased. Furthermore, the symptom scores gradually increased along with the aggravation of liver damage. Moreover, serum GAS and VIP levels were significantly higher in the cirrhosis groups than in the control group, whereas MTL levels were significantly lower. These changes were significantly correlated with cirrhosis severity. The linear correlation analysis revealed that the GI symptom score was positively correlated with GAS and VIP levels, and negatively correlated with MTL level. In addition, the linear correlation analysis revealed that GI symptom score and GAS and VIP levels were positively correlated with cirrhosis severity, whereas MTL level was negatively correlated with cirrhosis severity.Cirrhotic patients have more obvious GI symptoms and higher GI hormone levels, which are closely correlated with the progression of liver cirrhosis and the degree of liver function damage.

Topics: Adult; Aged; Biomarkers; Disease Progression; Female; Gastrins; Gastrointestinal Diseases; Humans; Liver Cirrhosis; Male; Middle Aged; Motilin; Severity of Illness Index; Vasoactive Intestinal Peptide; Young Adult

To investigate mechanism and relation of some disorder motive forces of digest system in patients with liver cirrhosis.. Plasma vasoactive intestinal peptide (VIP), gastrin and motilin (MTL), electrogastrogram (EGG) and pH value of gastric juice in 24 hours; gastric elimination time by isotope. All above factors have been determined in patients with liver cirrhosis and analyzed with multiple linear regressions. While a group of normal cases has been observed as control.. Compared to the control group, higher level of VIP and Gastrin and lower MTL down were observed in liver cirrhosis group (Plasma VIP, Gastrin and MTL are 14.8+/-4.8, 58.6+/-29.8 and 360+/-54.2 separately, t=5.181, 0.05, t=3.871, 0.01 and t=5.529, 0.05 separately). The EGG dominant frequency (DF) and dominant power (DP) decreased around diet; normal slow wave number (N%) decreased and gastric excretion time prolonged, lower bradygastrias (B%) and pH value of 24 hours gastric juice denoted the incline of return movement, there are remarked different with 0.05 or 0.01 separately. Throughout analyzing these factors with multiple linear regressions, there are remarkable relationship between liver cirrhosis and pH value of gastric juice; gastrointestinal hormone and EGG with 0.05 or 0.01.. (1) There are remarkable gastro esophageal function abnormal which has been conveyed by disorder gastric electric physiology and gastric elimination time in patients with liver cirrhosis. It is suggested that unusual gastrointestinal hormone played an important role during these abnormal process. (2) There is remarkable changing of pH value of 24 hours gastric juice denoted the opposite movement of gastroduodenal juice in patients with liver cirrhosis.

Topics: Female; Gastric Acidity Determination; Gastric Emptying; Gastrointestinal Motility; Humans; Liver Cirrhosis; Male; Middle Aged; Vasoactive Intestinal Peptide

Platelet cytosolic calcium concentration ([Ca2+]i) has been proposed to reflect changes in vascular smooth muscle cells. This study investigated if the platelet [Ca2+]i is altered in cirrhotic patients and determined its relationship with peripheral hemodynamics and peptide levels.. Fourteen patients with cirrhosis and 11 healthy, age- and sex-matched controls had blood samples taken for determining platelet [Ca2+]i and glucagon, substance P (SP), and vasoactive intestinal peptide (VIP) values. Mean arterial pressure (MAP) and forearm blood flow (FBF) were measured on the same day of blood sampling. Forearm vascular resistance (FVR) was calculated.. Patients with cirrhosis had lower platelet [Ca2+]i (50.1 +/- 2 vs. 73.0 +/- 5 nmol/L; P < 0.001) than normal controls. Glucagon levels were significantly higher in patients with cirrhosis, but there was no difference in SP or VIP levels in both groups. MAP (80.5 +/- 3 vs. 94.7 +/- 3; P < 0.005) and FVR (20.1 +/- 1 vs. 36.3 +/- 2; P < 0.001) were significantly lower in patients with cirrhosis. A significant correlation was observed between platelet [Ca2+]i and MAP in patients with cirrhosis (r = 0.81; P < 0.001), between platelet [Ca2+]i and FVR (r = 0.87; P < 0.001), and between platelet [Ca2+]i and diastolic blood pressure (r = 0.78; P < 0.001). No correlation was found between platelet [Ca2+]i and peptide levels.. Patients with cirrhosis have a significant reduction in the platelet [Ca2+]i. This finding correlates well with peripheral hemodynamics. Platelets may be a useful tool to study the etiologic mechanisms leading to the vasodilation of chronic liver disease.

Topics: Adult; Aged; Blood Platelets; Blood Pressure; Calcium; Cytosol; Glucagon; Hemodynamics; Humans; Liver; Liver Cirrhosis; Male; Middle Aged; Muscle, Smooth, Vascular; Substance P; Vascular Resistance; Vasoactive Intestinal Peptide; Vasodilation

To elucidate pathophysiological characteristics of the peripheral circulation in liver cirrhosis, cutaneous microcirculation was analyzed at the finger, palm, toe, and arch of the foot using laser Doppler spectroscopy in 19 patients with liver cirrhosis, and the results were correlated with cardiovascular hemodynamics (n = 10) and plasma neurohormonal factors (n = 8). Cutaneous blood flow at each area was all significantly reduced (P < 0.001, < 0.05, < 0.01, < 0.001, respectively) in patients with liver cirrhosis compared to those in normals (n = 20). Cutaneous blood mass was also significantly reduced (P < 0.05, < 0.01, < 0.001, respectively) except at the arch of foot in patients with liver cirrhosis. There were significant correlations between finger cutaneous blood flow and systemic vascular resistance (r = -0.73, P < 0.05), plasma norepinephrine level (r = -0.84, P < 0.01), plasma renin activity (r = -0.77, P < 0.01), plasma concentrations of aldosterone (r = -0.76, P < 0.05) and angiotensin II (r = -0.76, P < 0.05), between palm blood flow and plasma vasoactive intestinal polypeptide concentration (r = 0.83, P < 0.05). From these results and our previous data demonstrating increased forearm muscular blood flow in patients with liver cirrhosis, increases in arteriovenous anastomotic flow and the contribution of neurohormonal factors will represent pathophysiological mechanisms for these changes.

Topics: Adult; Aged; Aldosterone; Angiotensin II; Cardiovascular System; Female; Hemodynamics; Hormones; Humans; Liver Cirrhosis; Male; Microcirculation; Middle Aged; Norepinephrine; Renin; Skin; Vasoactive Intestinal Peptide

Determination of plasma levels of vasoactive intestinal polypeptide (VIP) has been used for screening patients with chronic diarrhea to identify potential neuroendocrine tumors. This 6-year blinded study from 1981 to 1986 examines the causes of elevated VIP levels in patients. In healthy volunteers ( n = 144), VIP concentrations ranged from 14 to 76 pg/mL (mean +/- SE, 28 +/- 12), whereas in chronic renal failure, 4 of 34 patients or 12% [serum creatinine 4.5 - 9.0 mg/dL (397-795 mumols/L)] had an elevation to greater than 100 pg/mL. No patient with idiopathic hepatic cirrhosis (n = 12) had elevation of serum concentration of this peptide. Among 588 consecutive unselected patients undergoing evaluation for chronic diarrhea (n = 362; 62%) or possible neuroendocrine tumor (n = 214; 36%), 23 patients (3.9%) had concentrations greater than 76 pg/mL. In this group, 5 patients had functioning (VIP, 160-5975 pg/mL) and 5 had nonfunctioning (VIP, 80-120 pg/mL) pancreatic islet cell carcinomas: all 10 patients had hepatic metastases. Other known cases of elevated levels of VIP, ranging from 80 to 340 pg/mL, included other neurogenic tumors (n = 3), small- bowel resection (n = 2), inflammatory bowel disease (n = 2), chronic renal failure (n = 1), and prolonged fasting (n = 1). Patients with diarrhea in which VIP-secreting tumors were identified had plasma vasoactive intestinal peptide concentrations greater than 140 pg/mL. In patients with chronic diarrhea, determination of plasma vasoactive intestinal peptide levels did identify tumors secreting this peptide, but the results from this referral institution did not show identification of these tumors early in their clinical course.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Autoantibodies; Chromatography, Gel; Chronic Disease; Diarrhea; Female; Humans; Kidney Failure, Chronic; Liver Cirrhosis; Male; Middle Aged; Radioimmunoassay; Vasoactive Intestinal Peptide

Topics: Adult; Female; Histamine; Humans; Hypertension, Portal; Liver Cirrhosis; Male; Middle Aged; Portal Vein; Serotonin; Somatostatin; Vasoactive Intestinal Peptide

Topics: Adult; Aged; Female; Gastrins; Hepatic Encephalopathy; Humans; Liver Cirrhosis; Male; Middle Aged; Neurotensin; Pancreatic Polypeptide; Somatostatin; Vasoactive Intestinal Peptide

The concentration of vasoactive intestinal polypeptide (VIP) in peripheral venous plasma was median 6.0 pmol l-1 (range 0-20) in 112 normal subjects. In fifty-three patients with decreased kidney function plasma VIP was significantly increased (median 15.0 pmol l-1, range 0.5-70, P less than 0.0001) and positively correlated to serum creatinine concentration (r = 0.51, P less than 0.001). In 133 patients with liver cirrhosis peripheral venous VIP was slightly elevated (median 7.0 pmol l-1 range 0-86, P less than 0.01). Samples obtained during a central venous catheterization showed significant renal extraction of circulating VIP in control subjects (median extraction fraction 23%, P less than 0.05, n = 6) and in patients with cirrhosis (median 60%, P less than 0.02, n = 8), but not in uraemic patients (median 0%, NS n = 5). In control subjects and patients with cirrhosis the concentration of VIP in the hepatic vein was significantly below that of systemic plasma (-42%, P less than 0.05, n = 6 and -45%, P less than 0.01, n = 10, respectively). On the contrary, in uraemic patients hepatic venous VIP was almost similar to systemic VIP (-4%, NS, n = 7). The results indicate that in normal subjects and patients with cirrhosis both the liver and kidneys are involved in the biodegradation of VIP. The elevated level of circulating VIP in uraemic patients may in part be due to decreased renal and hepatic biodegradation but increased neuronal release of VIP, especially in the splanchnic system, may also contribute to the increased plasma VIP in this condition.

Topics: Adult; Aged; Creatinine; Female; Humans; Kidney; Liver; Liver Circulation; Liver Cirrhosis; Male; Metabolic Clearance Rate; Middle Aged; Renal Circulation; Uremia; Vasoactive Intestinal Peptide

The concentration of vasoactive intestinal polypeptide (VIP) was determined in peripheral venous plasma from 136 patients with liver cirrhosis without gastrointestinal bleeding or coma and from 112 controls. In eight patients (cirrhosis, six; fibrosis, one; steatosis, one) arteriovenous extraction or release of VIP was measured during catheterization at four locations: brain, lower limb, intestine-liver, and kidney. The mean concentration of VIP in peripheral venous plasma from patients with cirrhosis was 9.4 pmol/l (median, 7.0; range, 0-86), which was significantly higher than that of the controls, who had a mean of 6.2 pmol/l (median, 6.0; range, 0-20, P less than 0.01). No significant extraction or release of VIP could be detected across the vascular bed in brain or lower limb. A significant arterio-hepatovenous VIP extraction ratio (mean, 0.43; range, 0.05-0.87) confirmed at net splanchnic elimination of VIP from extra-splanchnic areas and from porto-systemic shunting of VIP in cirrhosis. The net splanchnic elimination rate of VIP was estimated to be about 3 pmol/min. The concentration of VIP in ascitic fluid was on the average three times that of arterial plasma. In conclusion, VIP is significantly elevated in peripheral plasma from patients with cirrhosis, probably due to porto-systemic shunting and/or compromised hepatic elimination. Hepatic elimination is still likely to account for the inactivation of most of the VIP escaping from the neurosynapses throughout the body in patients with cirrhosis without coma.

Topics: Adult; Aged; Blood; Catheterization; Female; Gastrointestinal Hormones; Humans; Liver Cirrhosis; Male; Middle Aged; Vasoactive Intestinal Peptide; Veins

Topics: Animals; Ascites; Hemodynamics; Homeostasis; Humans; Hyperaldosteronism; Kallikreins; Kidney; Kinins; Liver Cirrhosis; Lymph; Natriuresis; Plasma Volume; Potassium; Prostaglandins; Sodium; Sympathetic Nervous System; Vasoactive Intestinal Peptide

In animals, the effects of vasoactive intestinal polypeptide (VIP) include peripheral vasodilation, hyperdynamic circulation, hyperglycemia, and hyperventilation. Because these phenomena are noted in patients with cirrhosis, it has been postulated that VIP might be escaping hepatic inactivation and entering the systemic circulatory system and contributing to these abnormalities. The major purpose of this study is to establish whether or not VIP levels are elevated in patients with cirrhosis. Additional goals are to determine if VIP levels are elevated in acute liver disease and in chronic illnesses with secondary liver involvement. The data demonstrate that patients with cirrhosis and those with acute liver disease or chronic illnesses with secondary hepatic involvement have a wide range of VIP levels with mean values significantly above that of normal individuals and patients with chronic illness and no liver involvement.

Topics: Acute Disease; Chronic Disease; Gastrointestinal Hormones; Humans; Liver Cirrhosis; Liver Diseases; Liver Neoplasms; Neoplasm Metastasis; Vasoactive Intestinal Peptide

Topics: Blood Pressure; Gastrointestinal Hormones; Humans; Inactivation, Metabolic; Intestinal Secretions; Liver Cirrhosis; Respiration; Vasoactive Intestinal Peptide