Diminished neurokinin-1 receptor availability in patients with two forms of chronic visceral pain

作者：Jarcho Johanna M; Feier Natasha A; Bert Alberto; Labus Jennifer A; Lee Maunoo; Stains Jean; Ebrat Bahar; Groman Stephanie M; Tillisch Kirsten; Brody Arthur L; London Edythe D; Mandelkern Mark A; Mayer Emeran A^*

来源：Pain, 2013, 154(7): 987-996.

DOI：10.1016/j.pain.2013.02.026

• PET
• NK-1 receptor
• Irritable bowel syndrome
• Inflammatory bowel disease
• Somatic pain
• Quality of life

Central sensitization and dysregulation of peripheral substance P and neurokinin-1 receptor (NK-1R) signaling are associated with chronic abdominal pain in inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). Although positron emission tomography (PET) has demonstrated that patients with injury-related chronic pain have diminished NK-1R availability in the brain, it is unknown whether these deficits are present in IBD and IBS patients, who have etiologically distinct forms of non-injury-related chronic pain. This study's aim was to determine if patients with IBD or IBS exhibit deficits in brain expression of NK-1Rs relative to healthy controls (HCs), the extent to which expression patterns differ across patient populations, and if these patterns differentially relate to clinical parameters. PET with [F-18] SPA-RQ was used to measure NK-1R availability by quantifying binding potential (BP) in the 3 groups. Exploratory correlation analyses were performed to detect associations between NK-1R BP and physical symptoms. Compared to HCs, IBD patients had NK-1R BP deficits across a widespread network of cortical and subcortical regions. IBS patients had similar, but less pronounced deficits. BP in a subset of these regions was robustly related to discrete clinical parameters in each patient population. Widespread deficits in NK-1R BP occur in IBD and, to a lesser extent, IBS; however, discrete clinical parameters relate to NK-1R BP in each patient population. This suggests that potential pharmacological interventions that target NK-1R signaling may be most effective for treating distinct symptoms in IBD and IBS.

• 出版日期2013-7