Antibodies against Gonadotropin-Releasing Hormone in Patients with Posterior Laryngitis

Pendleton, Hillevi; Alm, Ragnar; Fredrikson, Gunilla Nordin; Ohlsson, Bodil

doi:10.4137/dti.s10837

Cited by 3 publications

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“…depression and anxiety [ 38 ], which also has been noted in patients with PL [ 30 ]. The likelihood of a functional component is further strengthened by the expression of serum antibodies against gonadotropin-releasing hormone in patients both with PL and IBS [ 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

Posterior laryngitis: a disease with different aetiologies affecting health-related quality of life: a prospective case–control study

Pendleton

Ahlner-Elmqvist

Olsson

et al. 2013

BMC Ear Nose Throat Disord

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BackgroundLaryngo-pharyngeal reflux (LPR) is assumed to be the most common cause of posterior laryngitis (PL). Since LPR is found in healthy subjects, and PL patients are not improved by acid-reducing therapy, other aetiologies to PL must be considered. The aims of this study in PL were to investigate the prevalence of acid reflux in the proximal oesophagus and functional gastrointestinal symptoms, to analyse motilin levels in plasma, and to assess health-related quality of life (HRQOL) before and after treatment.MethodsForty-six patients (26 women), with verified PL, median age 55 (IQR 41–68) years, were referred to oesophago-gastro-duodenoscopy and 24-h pH monitoring. Plasma motilin was analysed. The 36-item Short-Form questionnaire was completed at inclusion and at follow-up after 43±14 months, when also the Visual Analogue Scale for Irritable Bowel Syndrome was completed. Values were compared to controls. Treatment and relief of symptoms were noted from medical records.ResultsThirty-four percent had proximal acid reflux and 40% showed signs of distal reflux. Ninety-four percent received acid-reducing treatment, with total relief of symptoms in 17%. Patients with reflux symptoms had lower plasma motilin levels compared to patients without reflux symptoms (p = 0.021). The HRQOL was impaired at inclusion, but improved over time. Patients, especially men, had more functional gastrointestinal symptoms than controls.ConclusionsThis study indicates that a minority of patients with PL has LPR and is cured by acid-reducing therapy. Disturbed plasma motilin levels and presence of functional gastrointestinal symptoms are found in PL. The impaired HRQOL improves over time.

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Section: Discussionmentioning

confidence: 99%

Posterior laryngitis: a disease with different aetiologies affecting health-related quality of life: a prospective case–control study

Pendleton

Ahlner-Elmqvist

Olsson

et al. 2013

BMC Ear Nose Throat Disord

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“…Based on all of the studies in this field [8,9,10,37,38,40,41,42,43,44,46], our hypothesis is that antibodies reflect neuronal damage in a subgroup of patients and are not causal. Several antibodies against neuronal tissue have previously been described to occur subsequent to gut dysmotility [66].…”

Section: Discussionmentioning

confidence: 99%

“…Several antibodies against neuronal tissue have previously been described to occur subsequent to gut dysmotility [66]. IgM antibodies against GnRH1 and progonadoliberin-2 are the most interesting because they are expressed at some point in all patients with GnRH-induced dysmotility [8,9,46] and in a subgroup of patients with diabetes mellitus, dysmotility, and functional bowel diseases [37,38,41,42,43,44]. IgA and IgG antibodies or antibodies against LH or the LH receptor are of no clinical interest in patients with diabetes or in those with gastrointestinal complaints [9,38,39,43,44,46].…”

Section: Discussionmentioning

confidence: 99%

“…Elevated levels of IgM antibodies against GnRH1 have been found in patients with diabetes mellitus, gastrointestinal dysmotility, IBS, posterior laryngitis, and primary Sjögren's syndrome, independent of treatment with GnRH analogs. This is in contrast to patients with celiac disease, inflammatory bowel disease (IBD), microscopic colitis, and scleroderma, who express antibodies to the same extent as control subjects [37,38,39,41,42,43,44]. Furthermore, IgM antibodies against GnRH receptors have been found in patients with dysmotility, IBS, and primary Sjögren's syndrome [43,44], and IgM antibodies against progonadoliberin-2, the precursor of GnRH2 [45], have been found in patients with diabetes mellitus, dysmotility, and IBS [44].…”

Section: Antibody Formation Against Gnrh and Gonadotropinsmentioning

confidence: 99%

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Gonadotropin-Releasing Hormone and Its Physiological and Pathophysiological Roles in Relation to the Structure and Function of the Gastrointestinal Tract

Ohlsson

2016

Eur Surg Res

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Background: Gonadotropin-releasing hormone (GnRH), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) are involved in the reproductive cycle and regulate the secretion of sex steroids from the gonads. In mammals, GnRH1 is secreted as a hormone from the hypothalamus, whereas both GnRH1 and GnRH2 are present as neuropeptides in a variety of tissues. This review describes the role of GnRH in the gastrointestinal tract. Summary: GnRH1, GnRH2, and LH receptors in humans and rats, and GnRH receptors in rats, have been described in the gastrointestinal tract, where they affect motility, gastric and hormone secretion, and cell proliferation. GnRH analogs are clinically used in the treatment of sex hormone-dependent diseases, i.e., endometriosis and malignancies, and as pretreatments for in vitro fertilization. Severe gastrointestinal dysmotility has been shown to develop in some women after such treatment, along with a reduction in the number of enteric neurons and autoantibodies against GnRH. Consequently, a rat model of enteric neurodegeneration has been developed based on the administration of the GnRH analog buserelin. Serum IgM antibodies against GnRH1, the GnRH2 precursor progonadoliberin-2, and the GnRH receptor have also been described in patients with irritable bowel syndrome and dysmotility, as well as in patients with gastrointestinal disorders associated with diabetes mellitus, posterior laryngitis, and primary Sjögren's syndrome, although no treatments using GnRH analogs have been administered. Conclusion: GnRH and receptors for GnRH and LH are present in the human and rat gastrointestinal tract. Treatment with GnRH analogs may induce severe dysmotility, and a rat model of enteric neurodegeneration has been developed based on stimulation by the GnRH analog buserelin. Autoantibodies against GnRH and its receptor are found in a subgroup of patients with functional bowel disorders and dysmotility, independent of treatment with GnRH analogs.

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Gonadotropin-Releasing Hormone and Its Role in the Enteric Nervous System

Ohlsson

2017

Front. Endocrinol.

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Gonadotropin-releasing hormone (GnRH), follicle-stimulating hormone, and luteinizing hormone orchestrate the reproduction cycle and regulate the sex steroid secretion from the gonads. In mammals, GnRH1 is secreted as a hormone from the hypothalamus, whereas both GnRH1 and GnRH2 are present as neurotransmitters/peptides in various tissues, where the peptides exert many different effects. mRNA coding for GnRH1 and GnRH2 have been described in the human gastrointestinal tract, and GnRH has been found in both submucosal and myenteric neurons. mRNA coding for GnRH and the fully expressed peptide have been found in rat enteric neurons by some researchers but not by others. mRNA coding for GnRH receptors, but not the fully expressed receptor, has been found in one rat study. GnRH influences gastrointestinal motility and secretion. GnRH analogs are clinically used in the treatment of sex hormone-dependent diseases, i.e., endometriosis and malignancies, and as pretreatment for in vitro fertilization. Reduced numbers of enteric neurons and IgM antibodies against GnRH and progonadoliberin-2 (precursor of GnRH2) have been observed after such treatment, with the clinical picture of gastrointestinal dysmotility. Similarly, a rat model of enteric neurodegeneration has been developed after administration of the GnRH analog buserelin. Serum IgM antibodies against GnRH1, progonadoliberin-2, and GnRH receptors have been described in patients with signs and symptoms of gastrointestinal dysmotility and/or autonomic dysfunction, such as irritable bowel syndrome, enteric dysmotility, diabetes mellitus, and primary Sjögren’s syndrome. Thus, apart from regulation of reproduction and sex hormone secretion, GnRH also constitutes a part of enteric nervous system (ENS) and its functions during physiological and pathological conditions. This review aimed to describe the role of GnRH in the ENS.

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Antibodies against Gonadotropin-Releasing Hormone in Patients with Posterior Laryngitis

Cited by 3 publications

References 29 publications

Posterior laryngitis: a disease with different aetiologies affecting health-related quality of life: a prospective case–control study

Posterior laryngitis: a disease with different aetiologies affecting health-related quality of life: a prospective case–control study

Gonadotropin-Releasing Hormone and Its Physiological and Pathophysiological Roles in Relation to the Structure and Function of the Gastrointestinal Tract

Gonadotropin-Releasing Hormone and Its Role in the Enteric Nervous System

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