J Neurogastroenterol Motil  
Neuroendocrine Dysregulation in Irritable Bowel Syndrome Patients: A Pilot Study
Cristina Stasi,1* Massimo Bellini,2 Dario Gambaccini,2 Emiliano Duranti,3 Nicola de Bortoli,2 Bernardo Fani,2 Eleonora Albano,2 Salvatore Russo,2 Isabella Sudano,4 Giacomo Laffi,1 Stefano Taddei,3 Santino Marchi,2 and Rosa Maria Bruno3
1Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Gastrointestinal Unit, Departments of 2Gastroenterology, 3Clinical and Experimental Medicine, University of Pisa, Italy; and 4Cardiovascular Center, University Hospital, Zürich, Switzerland
Correspondence to: Cristina Stasi, MD, PhD
Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 3, 50134 Florence, Italy
Tel: +39-0557947154, Fax: +39-0557947154, E-mail: cristina.stasi@gmail.com
Received: September 19, 2016; Revised: February 7, 2017; Accepted: February 16, 2017; Published online: April 26, 2017.
© The Korean Society of Neurogastroenterology and Motility. All rights reserved.

cc This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims
Irritable bowel syndrome (IBS) is a multifactorial disorder, involving dysregulation of brain-gut axis. Our aim was to evaluate the neuroendocrine activity in IBS.
Methods
Thirty IBS and 30 healthy subjects were enrolled. Psychological symptoms were evaluated by questionnaires. Urinary 5-hydroxyindoleacetic acid (5-HIAA), plasma serotonin, endothelin, neuropeptide Y (NPY), plasma, and urinary cortisol levels were evaluated. Fourteen IBS subjects underwent microneurography to obtain multiunit recordings of efferent postganglionic muscle sympathetic nerve activity (MSNA).
Results
Prevalent psychological symptoms in IBS were maladjustment (60%), trait (40%) and state (17%) anxiety, obsessive compulsive-disorders (23%), and depressive symptoms (23%). IBS showed increased NPY (31.9 [43.7] vs 14.8 [18.1] pmol/L, P = 0.006), serotonin (214.9 [182.6] vs 141.0 [45.5] pg/mL, P = 0.010), and endothelin [1.1 [1.4] vs 2.1 [8.1], P = 0.054], compared to healthy subjects. Moreover, plasma NPY, endothelin, cortisol and serotonin, and urinary 5-HIAA were associated with some psychological disorders (P < 0.05). Despite a similar resting MSNA, after cold pressor test, IBS showed a blunted increase in MSNA burst frequency (+4.1 vs +7.8 bursts/minute, P = 0.048; +30.1% vs +78.1%, P = 0.023). Baseline MSNA tended to be associated with urinary cortisol (ρ = 0.557, P = 0.059), and moreover, changes in heart rate and MSNA after mental stress were associated with urinary (ρ = 0.682, P = 0.021) and plasma cortisol (ρ = 0.671, P = 0.024), respectively.
Conclusion
Higher concentrations of endothelin, NPY, and serotonin were found to be associated with some psychological disorders in IBS patients together with an altered cardiovascular autonomic reactivity to acute stressors compared to healthy subjects.
Keywords: Autonomic nervous system; Endothelin-1; Irritable bowel syndrome; Neuropeptide Y; Serotonin


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