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  • Belinostat (PXD101) br Fig The influence of food intake

    2020-08-05


    Fig. 3. The influence of food intake on selected EGG parameters - the differences between each of the investigated groups.
    overactivity. The results are presented in Table 7.
    3.5. Correlations
    Positive correlations between the feeling of fullness in the epigastric region and the percentage of preprandial bradygastria were found in patients from group C and A (r = 0.61; p = 0.035 vs. r = 0.71; p = 0.027, respectively). Moreover, the feeling of food retention in the stomach correlated positively with dysrhythmia in a preprandial state (r = 0.61; p = 0.037) and showed an inverse correlation with DP (r= -0.76; p = 0.038) in subjects from group C.
    4. Discussion
    Motility, sensation, absorption, secretion, digestion and barrier function are the pivotal roles of gastrointestinal tract. A variety of motor patterns can be observed in the small and large intestine, both innervated by the autonomic nervous system. Intrinsic peristaltic movements facilitate the anterograde propulsion of luminal contents [30,31]. Enteric nervous system (ENS) is under the autonomic nervous system control. Neurons of the enteric ganglia communicate via che-mical synapses, forming an independent nervous system, similar to the Belinostat (PXD101) and spinal cord. Moreover, the brain-in-the-gut includes inter-neurons and motor neurons, which due to chemical neurotransmission act as a neural network, similar to that present in the central nervous system [30,31].
    Enteric mast cells are a type of immune/inflammatory cells pro-viding paracrine signaling for the ENS. The brain-to-mast cell connec-tion explains the relationship between stress and irritable bowel syn-drome-like symptoms in the gut [31]. Furthermore, this mechanism may contribute to carcinogenesis and processes taking place in 
    neoplastic tissue.
    In the present study, we analyzed an association between gastric myoelectric activity disturbances, dyspeptic symptoms and autonomic system disturbances in patients with gastrointestinal malignancies. Principal findings of our study can be summarized as follows:
    1) Up to 50% of the study subjects presented with abnormal elec-trogastrographic findings. When examined in a fasted state, colon, rectal and gastric cancer patients showed lower percentages of nor-mogastria time, lower percentages of ACSWC and higher values of DP than the controls.
    2) Contrary to the controls, no improvement in the percentage of normogastria time, DP, DF and ACSWC was observed in patients with GI malignancies during examination in a fed state. Abnormal response to the test meal was observed in 60% (48 subjects) of cancer patients.
    3) Severity of dyspeptic symptoms correlated with EGG parameters. A positive correlation was found between the feeling of fullness in the upper abdomen and increased preprandial bradygastria in the colon and gastric cancer patients. Moreover, the feeling of food retention in the stomach correlated positively with dysrhythmia in a fasted state and showed an inverse correlation with DP in the gastric cancer patients. 4) Patients with colorectal and gastric cancers showed lower values of HRV parameters (LF, HF) at rest than the healthy controls. These findings corresponded to the disruption of parasympathetic-sympa-thetic balance in the GI cancer patients, primarily in the form of sym-pathetic overactivity. The most severe changes were observed in the patients with gastric cancer. So far, GI dysmotility problems have been only sporadically studied in the oncological patients. Several previous experimental and clinical studies analyzed a relationship between the EGG parameters and gastric emptying [9,11,12,32]. Delayed gastric emptying turned out to be linked to EGG changes, namely to a decrease in the percentage of normal gastric slow waves and to a smaller postprandial increase in DP. In previous studies, gastric myoelectric activity was generally evaluated after gastrectomy performed due to gastric cancer [19,20,33,34]. Murakami et al. [33] observed that patients after vagus nerve-preser-ving distal gastrectomy presented with better preserved gastric myo-electric activity than individuals subjected to standard distal gas-trectomy without vagal sparing. Moreover, they found significant inverse correlations between the percentage of slow wave coupling and GSRS scores (reflux, abdominal pain, indigestion scores and total score) in patients who have been operated on without vagus nerve
    Table 5
    Questionnaire to determine the severity of dyspeptic symptoms (the intensification of symptoms) in each investigated patient’s groups. (n = 80).
    Symptom Group A Group B Group C
    Table 6
    Severity of gastrointestinal symptoms determined with the dyspeptic symptoms questionnaire in gastrointestinal cancer’s patients. (Appendix 1 in supplementary material).