Molecular Crosstalk of the Motilin–Somatostatin– Vascular Endothelial Growth Factor Axis in Duodenal Dysfunction Underlying IBS-C and Functional Dyspepsia
Keywords:
motilin; somatostatin; vascular endothelial growth factor; irritable bowel syndrome with constipation; functional dyspepsiaAbstract
Background The duodenal mucosa plays a pivotal role in gastrointestinal physiology through its endocrine cells (ECs), which secrete key regulatory factors including motilin (MLN), somatostatin (SS), and vascular endothelial growth factor (VEGF). Alterations in the expression of these mediators have been implicated in the pathogenesis of irritable bowel syndrome with constipation (IBS-C) and its overlap with functional dyspepsia (FD). Objective To determine the role of duodenal mucosal endocrine cells (ECs) secreting MLN, SS, and VEGF in the development of IBS-C and its overlap with FD. Methods The study included 35 patients with IBS-C and FD, 35 patients with IBS-C without FD, and 30 healthy controls. Participants underwent clinical, laboratory, instrumental, and immunomorphological investigations. To exclude organic intestinal pathology, all subjects underwent EGDS, colonoscopy and a fecal calprotectin content analysis. H. pylori verification was based on histiobacillioscopy data with the study of imprints` smears of the antral part of the stomach mucous membrane, stained according to Romanovsky-Giemsa. Statistical analysis was performed in SPSS 22.0 (SPSS Inc., USA) for Windows (Microsoft Corporation, USA), and p<0.05 was considered statistically significant. Results The results demonstrated a significant reduction in MLN-secreting ECs, accompanied by increased SS- and VEGF-positive ECs in IBS-C with FD patients compared to other groups. The fecal calprotectin test showed that in IBS-C patients and in the patients with FD there is activation of the minimal statistically insignificant inflammatory process in the mucosal intestine (in IBS-C with FD – 52.7; in IBS-C - 43.8 and in healthy controls - 39.9 μg/g). The EC expression area in duodenum retrobulbar part (DRBP) secreting VEGF, MLN and SS in IBS-C with FD patients was characterised by a significant decrease in the area of expression of EC secreting MLN and high expression of EC producing SS and VEGF. Conclusion The findings highlight the contribution of duodenal EC dysfunction to impaired motility, visceral hypersensitivity, and low-grade inflammation, supporting the concept of the duodenum as a critical neuroendocrine hub within the gut–brain axis. This study underscores the relevance of MLN, SS, and VEGF as potential biomarkers and therapeutic targets in IBS-C and FD comorbidity.
Bangladesh Journal of Medical Science Vol. 25 No. 04 October’26 Page: 1315-1323
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Copyright (c) 2026 Mikhail A Osadchuk, Inna N Vasileva, Yulia S Krylova, Maxim M Osadchuk, Ekaterina D Mironova, Lidianys Maria Lewis Luján, Annette Pulcherie Iloki, Juan Carlos Galvez, Simon Bernard Iloki-Assanga, Maxim V Trushin
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