Subtypes of Gastroparesis

胃轻瘫的亚型

• 批准号: 9357567
• 负责人: KENNETH L KOCH
• 金额: $ 38.75万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-15 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9357567
• 关键词: 25-hydroxyvitamin D; Address; Appearance; Autonomic nervous system; Blood Pressure; Botulinum Toxins; Characteristics; Chronic; Clinical; Clinical Research; Data; Databases; Distress; Dyspepsia; Enrollment; Equilibrium; Fludrocortisone; Functional disorder; Gastric Emptying; Gastroparesis; Goals; Head; Individual; Injection of therapeutic agent; Interstitial Cell of Cajal; Lead; Measures; Mediating; Nausea and Vomiting; Patients; Physiological; Placebos; Postural Orthostatic Tachycardia Syndrome; Pylorus; Registries; Satiation; Solid; Stomach; Subgroup; Symptoms; Syndrome; Test Result; Testing; Vitamin D; Vitamin D supplementation; Water; alpha Toxin; associated symptom; base; design; diabetic; diabetic gastroparesis; effective therapy; heart rate variability; improved; indexing; motility disorder; neuromuscular; pressure; response; symptomatic improvement

Project Summary Understanding subtypes of gastroparesis and the pathophysiology of symptoms associated with gastroparesis are required before improved treatments can be designed. Our aims are to 1) define major subtypes of gastroparesis using physiological testing for gastric myoelectrical activity (GMA), accommodation, and autonomic nervous system function and 2) explore pathophysiological mechanisms of meal-induced symptoms in patients with gastroparesis and gastroparesis-like syndromes. Variable depletion of interstitial cells of Cajal (ICCs) creates a continuum of dysfunction of electrical and contractile activities of the stomach. Physiological tests to measure gastric emptying, gastric myoelectrical activity (GMA), and gastric accommodation reflect this continuum of ICC depletion from gastric dysrhythmias and normal gastric emptying to delays in gastric emptying. Our recent observations revealed two important subtypes of gastroparesis: 1) obstructive gastroparesis and 2) gastroparesis with postural orthostatic tachycardia syndrome (POTS). Preliminary studies show positive responses to pyloric therapies and to fludrocortisone and vitamin D in these subtypes, respectively. The important physiological differences in these subgroups of gastroparesis provide the rationale for more precise, individual treatments. Physiological testing during provocative test meals in symptomatic patients with normal gastric emptying (e.g. chronic unexplained nausea and vomiting, dysmotility-like dyspepsia, or postprandial distress syndrome) unmasks subtypes with: 1) gastric dysrhythmias or normal 3 cpm GMA and 2) normal or abnormal gastric accommodation. Our studies will utilize the database of Registry 2 of the Gastroparesis Clinical Research Consortium which contains extensive physiologic data in patients with idiopathic and diabetic gastroparesis and in patients with normal gastric emptying and new data from patients enrolled in the continuation of the Registry. This project will characterize clinically important subgroups of symptomatic patients with or without gastroparesis, increase our understanding of the underlying pathophysiology of gastroparesis-associated symptoms, and lead to more rational therapies based on physiological test results.

项目摘要 了解胃轻瘫的亚型和与之相关的症状的病理生理学 在设计改进治疗之前，需要进行胃肉食。我们的目标是1） 使用生理测试来定义胃肉食的主要亚型 活动（GMA），住宿和自主神经系统功能以及2）探索 胃轻瘫患者和 胃轻瘫样综合征。 Cajal（ICC）的间质细胞的可变耗竭会产生一个 胃电和收缩活性功能障碍的连续性。生理 测量胃排空，胃肌电活动（GMA）和胃的测试 住宿反映了胃异常和正常的ICC耗竭的连续性 胃排空以延迟胃排空。我们最近的观察发现了两个重要的 胃轻瘫的亚型：1）阻塞性胃轻瘫和2）胃肉食 体位性心动过速综合征（POTS）。初步研究表明对 幽门疗法分别在这些亚型中分别针对这些亚型中的氟皮质蛋白和维生素D。这 这些胃轻瘫这些亚组的重要生理差异为 更精确的个人治疗。挑衅性测试餐期间的生理测试 有症状的胃排空患者（例如，慢性无法解释的恶心和 呕吐，运动障碍性疗程障碍或餐后遇险综合症）以： 1）胃异常或正常3 cpm GMA和2）正常或异常胃 住宿。我们的研究将利用胃轻瘫临床注册表2的数据库 研究财团包含特发性和 糖尿病性胃轻瘫和患有正常胃排空的患者和患者的新数据 注册注册表的延续。该项目将表征临床上重要的 有或没有胃轻瘫的有症状患者的亚组，增加了我们对 胃轻瘫相关症状的潜在病理生理学，并导致更多 基于生理测试结果的理性疗法。