Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 7, 2022; 10(1): 79-90
Published online Jan 7, 2022. doi: 10.12998/wjcc.v10.i1.79
Distribution of transient receptor potential vanilloid-1 channels in gastrointestinal tract of patients with morbid obesity
Unal Atas, Nuray Erin, Gokhan Tazegul, Gulsum Ozlem Elpek, Bülent Yıldırım
Unal Atas, Gokhan Tazegul, Department of Internal Medicine, Akdeniz University Medical School, Antalya 07070, Turkey
Nuray Erin, Department of Pharmacology, Akdeniz University Medical School, Antalya 07070, Turkey
Gulsum Ozlem Elpek, Department of Pathology, Akdeniz University Medical School, Antalya 07070, Turkey
Bülent Yıldırım, Department of Gastroenterology, Akdeniz University Medical School, Antalya 07070, Turkey
Author contributions: Atas U, Erin N, and Yildirim B designed the study and collected materials; Elpek GO evaluated the histopathological findings; Tazegul G provided analytical tools; all authors assessed the results; Atas U and Tazegul G wrote the manuscript; Erin N, Yildirim B and Elpek GO critically revised the draft; and all the authors checked the final version of the manuscript.
Institutional review board statement: The study was reviewed and approved by the Scientific Research Projects Coordination Unit of Akdeniz University, No. 2333.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gulsum Ozlem Elpek, MD, Professor, Research Assistant Professor, Department of Pathology, Akdeniz University Medical School, Dumlupınar Bulvarı, Antalya 07070, Turkey. elpek@akdeniz.edu.tr
Received: April 21, 2021
Peer-review started: April 21, 2021
First decision: June 13, 2021
Revised: June 25, 2021
Accepted: November 23, 2021
Article in press: November 23, 2021
Published online: January 7, 2022
Processing time: 252 Days and 21.9 Hours
Abstract
BACKGROUND

Transient receptor potential vanilloid-1 (TRPV1), a nonselective cation channel, is activated by capsaicin, a pungent ingredient of hot pepper. Previous studies have suggested a link between obesity and capsaicin-associated pathways, and activation of TRPV1 may provide an alternative approach for obesity treatment. However, data on the TRPV1 distribution in human gastric mucosa are limited, and the degree of TRPV1 distribution in the gastric and duodenal mucosal cells of obese people in comparison with normal-weight individuals is unknown.

AIM

To clarify gastric and duodenal mucosal expression of TRPV1 in humans and compare TRPV1 expression in obese and healthy individuals.

METHODS

Forty-six patients with a body mass index (BMI) of > 40 kg/m2 and 20 patients with a BMI between 18-25 kg/m2 were included. Simultaneous biopsies from the fundus, antrum, and duodenum tissues were obtained from subjects between the ages of 18 and 65 who underwent esophagogastroduodenoscopy. Age, sex, history of alcohol and cigarette consumption, and past medical history regarding chronic diseases and medications were accessed from patient charts and were analyzed accordingly. Evaluation with anti-TRPV1 antibody was performed separately according to cell types in the fundus, antrum, and duodenum tissues using an immunoreactivity score. Data were analyzed using SPSS 17.0.

RESULTS

TRPV1 expression was higher in the stomach than in the duodenum and was predominantly found in parietal and chief cells of the fundus and mucous and foveolar cells of the antrum. Unlike foveolar cells in the antrum, TRPV1 was relatively low in foveolar cells in the fundus (4.92 ± 0.49 vs 0.48 ± 0.16, P < 0.01, Mann-Whitney U test). Additionally, the mucous cells in the duodenum also had low levels of TRPV1 compared to mucous cells in the antrum (1.33 ± 0.31 vs 2.95 ± 0.46, P < 0.01, Mann-Whitney U test). TRPV1 expression levels of different cell types in the fundus, antrum, and duodenum tissues of the morbidly obese group were similar to those of the control group. Staining with TRPV1 in fundus chief cells and antrum and duodenum mucous cells was higher in patients aged ≥ 45 years than in patients < 45 years (3.03 ± 0.42, 4.37 ± 0.76, 2.28 ± 0.55 vs 1.9 ± 0.46, 1.58 ± 0.44, 0.37 ± 0.18, P = 0.03, P < 0.01, P < 0.01, respectively, Mann-Whitney U test). The mean staining levels of TRPV1 in duodenal mucous cells in patients with diabetes and hypertension were higher than those in patients without diabetes and hypertension (diabetes: 2.11 ± 0.67 vs 1.02 ± 0.34, P = 0.04; hypertension: 2.42 ± 0.75 vs 1.02 ± 0.33, P < 0.01 Mann-Whitney U test).

CONCLUSION

The expression of TRPV1 is unchanged in the gastroduodenal mucosa of morbidly obese patients demonstrating that drugs targeting TRPV1 may be effective in these patients.

Keywords: Capsaicin; Transient receptor potential vanilloid 1; Immunohistochemistry; Morbid obesity; Obesity; Transient receptor potential channels; Transient receptor potential vanilloid cation channels

Core Tip: Capsaicin-associated pathways may provide an alternative approach for obesity treatment. Our results suggest that transient receptor potential vanilloid (TRPV1) activation can provide anti-obesity and gastroprotective activity. TRPV1 distribution in the gastric and duodenal mucosal cells of morbidly obese people is similar to that in patients with normal weight. Hence, drugs targeting TRPV1 may be an effective approach in these patients. Further studies are needed in this area.