Analyzing Determinant Factors for Pathophysiology of Functional Dyspepsia Based on Plasma Cortisol Levels, IL-6 and IL-8 Expressions and H. pylori Activity

Arina Widya Murni, Eryati Darwin, Nasrul Zubir, Adnil Edwin Nurdin

Abstract


Background: there are many determinant factors that may play roles in pathophysiology of functional dyspepsia. One of them is psychological stress that can increase plasma cortisol levels, alter inflammation process and affect Helicobacter pylori activity. No study has been conducted to find out the dominant factor among them. This study aimed to find the dominant factor among plasma cortisol levels, IL-6 and IL-8 expressions and H.Pylori activity, as the determinant factors in the pathophysiology of functional dyspepsia. Methods: a cross-sectional study was conducted in 80 patients with dyspepsia syndrome at M. Djamil General Hospital, Padang, West Sumatera, Indonesia. The patients were categorized into two groups, i.e. the stress and non-stress group, which were identified using DASS 42 questionairre criteria. The inflammatory expressions (IL-6 and IL-8 expressions) as well as H. pylori activity were determined using immunohistochemistry of gastric biopsy specimens; while plasma cortisol levels was measured from peripheral blood samples. Data were analyzed using binary multivariate logistic regression. Results: there were 80 patients with functional dyspepsia with mean age of 38.9 years old. The morning cortisol levels was found significantly higher in the stress group. Higher IL-6 and IL-8 expressions were found in patients of non-stress group compared to those in the other group (IL-6: 73.28 (SD 16.60) vs. 72.95 (SD 19.49; and IL–8: 18.45 (SD 17.32) vs. 14.80 (SD 12.71)); although stastically not significant. There was greater Helicobacter pylori activity in the group with psychological stress compared to those in the non-stress group since there was antigen-antibody reaction invading the submucosa. The dominant determinant factor was the afternoon plasma cortisol levels. Conclusion: many factors can become the determinant factors for gastric mucosal damage; however, our study has demonstrated that the dominant factor is afternoon plasma cortisol levels.

Keywords


functional dyspepsia; stress; plasma cortisol; IL-6; IL-8; H. pylori activity

References


Talley NJ, Vakil NB, Moayyedi P. American Gastroenterological Association

Technical Review on Evaluation of Dyspepsia. Gasteroenterology 2005; 129: 1756-80

Yarandi SS and Christie J, 2013. Functional Dyspepsia in Review: Pathophysiology and Challenges in the Diagnosis and Management due to Coexisting Gastroesophageal Reflux Disease and Irritable Bowel Syndrome. Hindawi Publishing Corporation – Gastroenterology Research and Practice. ; 1-8.

Muhammad EP, Murni AW, Sulastri D. Hubungan Derajat Keasaman Cairan Lambung dengan derajat Dispepsia pada Pasien Dispepsia Fungsional. http://jurnal.fk.unand.ac.id: 2014; 3(1)

Mahadeva S, Goh KL, 2006. Epidemiology of functional dyspepsia, a global

perspective. World Journal of Gastroenterology; 17:2661-6

Konturek PC, Brzozowski T, Konturek SJ, 2011. Stress and gut: Pathophysiology,

clinical consequences, Diagnostic Approach and treatment options; Journal of

Physiology and Pharmacology ;62(6):591-9

Murni AW, 2010. Hubungan depresi dengan infeksi Helicobacter pylori serta

perbedaan gambaran histopatologi mukosa lambung pada penderita dyspepsia fungsional. Tesis Sp2 Divisi Psikosomatik Jakarta Fakultas Kedokteran Universitas Indonesia.

Elhage R, Clamens S, Besnard S, 2001. Involvement of interleukin-6 in atheroslerosis

but not in the prevention of fatty streak fomation by 17 beta-estradiol in apoliprotein

E- deficient mice. Atherosclerosis.; 156: 315-20.

Monack DM, Mueller A, Falkow S. , 2004. Persistent bacterial infections the interface of the pathogen and the host immune system. Nature review Microbiology.

Drossman A Douglass, 2006: The Functional Gastrointestinal Disorder and the Rome III. Gasteroenterology; 30; 1377-90.

Zubir N, 2002. Diagnosis dan Penatalaksanaan Dispepsia Fungsional. Editor: Asman Manaf, Elfizon Amir, Fauzar: naskah Lengkap PIB IPD III, Bag Penyakit Dalam FKUA, Padang: 115-22

Murni AW, 2006. Kadar Kortisol Plasma Pada penderita Dispepsia Fungsional dengan Depresi. Tesis Sp1 Penyakit Dalam, Padang. Fakultas Kedokteran Universitas Andalas..

Harris TB, Ferruci L, Tracy RP, 1999. Association of Elevated interleukin-6 and C-reactive protein levels with mortality in the elderly. Am J Med.; 106: 506-12

Huber SA, Sakkinen P, Conze D, 1999. Interleukin-6 exacerbates early atherosclrerosis in mice. Arterioscler Thromb Vasc Biol.; 19: 2364-7

Dinan TG, Cryan JF. Regulation of the Stress Response by The gut Microbiota: Impilications for Psychoneurology. Psychoneuroendocrinology 2012, 37; 1369-1378

Campbell AW. Review Article : Autoimmunity and The Gut. Hindawi Publishing Corporation, Autoimmune Disease vol 2014; 1-12

Odenbreit S, Linder S, Gebert-Vogel B, Rieder G, Moran AP, Haas R. Interleukin-6 induction by Helicobacter pylori in human macrophages is dependent on phagocytosis. Helicobacter. 2006; 11(3):196–207.

Guiney DG, Hasegawa P, Cole SP. Helicobacter pylori preferentially induces interleukin 12 (IL-12) rather than IL-6 or IL-10 in human dendritic cells. Infect Immun. 2003;71(7):4163–6.


Full Text: PDF

Refbacks

  • There are currently no refbacks.


Copyright (c) 2018 Acta Medica Indonesiana