Neuropeptides in the duodenal mucosa of chronic alcoholic heavy drinkers.

Previous studies have shown that patients with chronic alcohol ingestion may show a variety of morphological and functional alterations in the small intestine. In this study, we have focused on the neuroendocrine system in the duodenal muco sa in chronic alcoholics; an area little studied. Twenty-three defined chronic alcoholics admitted to the hospital for detoxification underwe nt clinical examination, followed by upper gastrointestinal endoscopy and blood tests on average 4 days after the most recent alcohol intak e. Biopsy specimens were taken from the distal part of the descending duodenum for both immunohistochemical and routine histologic al examination. The control group consisted of 25 patients referred for upper endoscopy mainly because of dyspepsia (ulcer, reflux type), but who were otherwise healthy. A normal carbohydrate-deficient transferrin and a history of low alcohol consumption (<40 g/wee k) were required for inclusion in the control group. The tissue specimens were studied using antisera for the following neuropepti des: cholecystokinin, galanin, gastric inhibitory peptide (GIP), glucagon, motilin, neuropeptide Y, pituitary adenylyl cyclase activ ating pep- tide, secretin, serotonin, somatostatin, substance P, vasoactive intestinal polypeptide and protein gene product, as a general marker for neurones and cells of the diffuse neuroendocrine system. The density of nerve fibres was evaluated semi-quantitatively and the number of endocrine cells per unit length of mucosa was counted in sections cut perpendicularly to the mucosal surface. All the differ ent peptidergic nerve fibres in the alcohol group showed higher densities than the corresponding controls. However, this was not a statistic- ally significant difference. A slightly significant increase ( P = 0.02) in the numbers of glucagon and GIP cells was seen in the alcohol group. Gastrointestinal symptoms were frequently present (87%) in chronic alcoholics. We suggest that chronic alcohol consumpti on in man may have a general effect on the peptidergic nerve system and some endocrine cell types in the duodenal mucosa.