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Die Rolle gastrointestinaler Peptidhormone für REM-Schlaf-Verhaltensstörung und Morbus Parkinson

The role of gastrointestinal peptide hormones for REM sleep behavior disorder and Parkinson’s disease

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Zusammenfassung

Hintergrund

Ghrelin und andere Peptidhormone des Gastrointestinaltrakts beeinflussen Stoffwechselprozesse und die Motilität des Verdauungstraktes. Viele dieser Peptidhormone wirken zusätzlich über eine Bindung an spezifische Rezeptoren im zentralen Nervensystem (ZNS) auf Prozesse wie Gedächtnisfunktion, Stimmung, Belohnungsverhalten und Schlaf. Die Ausschüttung der Peptidhormone des Gastrointestinaltrakts wird über unterschiedliche Mechanismen gesteuert. Der N. vagus spielt hierbei eine wichtige Rolle.

Fragestellung

Ziel dieses Artikels ist es, den Zusammenhang zwischen gastrointestinalen Peptidhormonen (insbesondere dem im Magen gebildeten Peptidhormon Ghrelin) und den Erkrankungen REM-Schlaf-Verhaltensstörung und M. Parkinson darzustellen.

Ergebnisse

Klinische und neuropathologische Untersuchungen legen eine vagale Dysfunktion bei den beiden Erkrankungen M. Parkinson und REM-Schlaf-Verhaltensstörung (einem möglichen frühen Stadium der Parkinson Erkrankung) nahe. Peptidhormone des Gastrointestinaltrakts spielen auch aufgrund der Modulation von Prozessen im ZNS eine Rolle für neurologische Erkrankungen wie REM-Schlaf-Verhaltensstörung und M. Parkinson. In eigenen Arbeiten konnten wir zeigen, dass sich das postprandiale Ausschüttungsmuster von Ghrelin und pankreatischem Polypeptid von Patienten mit REM-Schlaf-Verhaltensstörung und M. Parkinson ähnelt und beide Patientengruppen sich von gesunden Kontrollpersonen unterscheiden. Diese Befunde unterstützen die Annahme, dass der REM-Schlaf-Verhaltensstörung und dem M. Parkinson eine gemeinsame Pathologie im neuroendokrinen System zugrunde liegt.

Schlussfolgerungen

Experimentelle Daten zeigen, dass einige der im Gastrointestinaltrakt gebildeten Peptidhormone eine neuroprotektive Wirkung haben. Da beispielsweise Ghrelin-Agonisten in anderen Indikationen bereits klinisch getestet werden, könnten Peptidhormone mittelfristig auch Bedeutung für neuroprotektive Therapiestrategien bei den beiden oben angegebenen Erkrankungen erlangen.

Abstract

Background

Ghrelin and other peptide hormones of the gastrointestinal tract influence metabolism and motility. Many of these peptides also modulate cognitive function, mood, reward-associated behavior, and sleep by binding to specific receptors in the central nervous system (CNS). The secretion of peptide hormones of the gastrointestinal tract is regulated by various mechanisms including the vagal nerve.

Objectives

The objective of this article is to summarize data about the association between gastrointestinal peptides (with focus on the gastric peptide ghrelin) and the two neurological disorders Parkinson’s disease and REM sleep behavior disorder.

Results

Clinical and neuropathological studies indicate vagal dysfunction in Parkinson’s disease and REM sleep behavior disorder (a putative premotor state of Parkinson’s disease). Due to the fact that peptide hormones of the gastrointestinal tract act on various CNS functions, these peptides might be of importance for the two neurological disorders Parkinson’s disease and REM sleep behavior disorder. In diagnostic studies investigating the postprandial secretion of ghrelin and pancreatic polypeptide, we observed a similar postprandial secretion pattern of these peptides in patients with REM sleep behavior disorder and in patients with Parkinson’s disease. The pattern seen in both patient groups was distinct from the pattern seen in healthy controls. Hence, studies investigating the neuroendocrine system support the assumption that Parkinson’s disease and REM sleep behavior disorder have a common underlying pathology.

Conclusions

Experimental data indicate that some peptide hormones of the gastrointestinal tract have neuroprotective potential. Considering the fact that ghrelin receptor agonists, for example, are available and have already been tested in clinical studies for other indications, these peptides might be of interest for neuroprotective or disease-modifying strategies in the future.

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Einhaltung ethischer Richtlinien

M.M. Unger, V. Ries, D. Thomi, D. Vadasz, M. Krenzer, M. Zoche und W.H. Oertel geben an, dass keine Interessenkonflikte bestehen.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Hinweis zur Wiederverwendung eigener früherer Arbeiten: Dieser Beitrag basiert neben den im Literaturverzeichnis aufgeführten Arbeiten inhaltlich auch auf folgenden Buchkapiteln der Autoren:

Unger MM, Oertel WH (2013) Ghrelin: a gastric peptide linking sleep and energy balance. Handbook of nutrition, diet and sleep. Preedy (Hrsg.) Wageningen Academic Publishers, ISBN: 978-9086862085.

Unger MM, Oertel WH (2014) Ghrelin and Parkinson’s Disease. Central Functions of the Ghrelin Receptor. Portelli, Smolders (Hrsg.), Springer, ISBN: 978-1493908226.

Acknowledgment

Prof. Dr. med. Dr. h.c. Wolfgang H. Oertel ist Hertie-Senior-Forschungsprofessor der gemeinnützigen Hertie-Stiftung Frankfurt/Main, Deutschland.

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Authors and Affiliations

  1. Klinik für Neurologie, Universität des Saarlandes, Kirrberger Straße, 66421, Homburg/Saar, Deutschland

    M.M. Unger

  2. Klinik für Neurologie, Philipps-Universität Marburg, Marburg, Deutschland

    V. Ries, D. Thomi, D. Vadasz, M. Krenzer, M. Zoche & W.H. Oertel

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  1. M.M. Unger
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  2. V. Ries
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  3. D. Thomi
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  4. D. Vadasz
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  5. M. Krenzer
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  6. M. Zoche
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  7. W.H. Oertel
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Correspondence to M.M. Unger.

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Unger, M., Ries, V., Thomi, D. et al. Die Rolle gastrointestinaler Peptidhormone für REM-Schlaf-Verhaltensstörung und Morbus Parkinson. Somnologie 18, 166–171 (2014). https://doi.org/10.1007/s11818-014-0675-8

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