Chronic Intestinal Pseudo-Obstruction due to Buserelin-Induced Formation of Anti-GnRH Antibodies

Abstract

Background/Aim. A 30 year-old woman, treated with buserelin, an analogue of gonadotropin

Expression and distribution of GnRH, LH, and FSH and their receptors in gastrointestinal tract of man and rat

“…Our present and previous findings of GnRH and LH-R in human and LH-R in rat gastrointestinal tract [12,15,17,18], may provide an explanation for the small intestinal dysmotility noted after administration of GnRH analogs or LH [9,10,11]. Patients with enteric dysmotility and chronic intestinal pseudo-obstruction exhibit disturbances in small intestinal motility patterns [26,27].…”

“…Previously, we reported expression of GnRH in submucous and myenteric neurons in human small and large intestine [12,18], while GnRH and GnRH-R-IR enteric neurons were absent in rat [15]. In contrast, other groups have found GnRH and GnRH-R immunoreactivity in rat enteric neurons, smooth muscle cells, and on parietal cells in the epithelium [5,6,7,13].…”

“…Patients with enteric dysmotility and chronic intestinal pseudo-obstruction exhibit disturbances in small intestinal motility patterns [26,27]. We have observed that such disorders can manifest themselves after repeated treatment with high doses of GnRH analogs, along with reduced number of GnRH-IR myenteric neurons and appearance of antibodies against GnRH in serum [12,18]. Furthermore, intermittent administration of the GnRH analog buserelin to rats rendered up to 50% reduction of enteric neurons, accompanied with a down-regulation of the neuronal expression of LH-R [15].…”

“…Paraffin sections of ileum from one man (20 years of age) diagnosed with enteric inflammatory neuropathy [12,17] and from one woman (30 years of age) diagnosed with enteric degenerative neuropathy [12,18] were used for immunocytochemistry. In addition, ileum tissue was collected from one woman (84 years of age) undergoing gastrointestinal surgery due to sigmoideum diverticulosis, and colonic tissue from one woman (65 years of age) with non-obliterating adenocarcinoma of rectosigmoideum and one woman (68 years of age) due to sigmoideum diverticulosis.…”

Síndrome de intestino irritable y autoinmunidad

“…Además, mostraron que el tratamiento con análogos de la GnRH desencadenó la producción de anticuerpos contra la misma GnRH, con la consiguiente destrucción de los nervios entéricos que la contenían 68 . Posteriormente estudiaron la presencia de anticuerpos anti-GnRH en pacientes con trastornos gastrointestinales, incluyendo 26 sujetos con SII, tres con gastroparesia, dos con pseudoobstrucción intestinal crónica idiopática, 20 con diabetes mellitus y sínto-mas gastrointestinales, 19 con enfermedad de Crohn, 15 con colitis ulcerativa, 96 con enfermedad celíaca y 456 controles 69 .…”