Vasoactive intestinal polypeptide level in gastroesophageal reflux disease before and after surgical treatment




gastroesophageal reflux disease, vasoactive intestinal peptide, gastroesophageal reflux disease, vasoactive intestinal peptide


From year to year, wide spread of gastroesophageal reflux disease (GERD) is attracting greater attention of specialists in the field of this pathology diagnosis and treatment. In-depth studies on etiological and pathogenetic factors in the GERD development are being conducted. Of particular interest is the role of humoral factors, one of which is vasoactive intestinal peptide (VIP). There are currently no data on the dynamics of this hormone during surgical treatment of GERD.

The aim of the study was to examine the dynamics of plasma VIP during surgical treatment of GERD and its influence on the lower esophageal sphincter (LES) function.

Materials and methods. Surgical treatment in the Nissen modification was performed for 35 patients with GERD. There were 26 women (74.3 %), men – 9 (25.7 %). mean age – 55.3 ± 11.3 years. Comparison group – 20 apparently healthy individuals: women – 14 (70.0 %); men – 6 (30.0 %), mean age – 56.7 ± 10.6 years. VIP was measured in venous blood plasma by an enzyme immunoassay (Vasoactive intestinal peptide ELISA, S-1201, BCM Diagnostics) using an immunoenzyme complex ImmunoChem-2100 (USA). The sampling of the studied samples in the main group was carried out before the operation and 2–3 months post-surgery.

Results. In the main group before the surgery, the level of VIP was 3.1 ± 1.1 ng/ml, after the surgery – 2.2 ± 1.0 ng/ml. In the comparison group, VIP was determined at the level of 2.1 ± 1.1 ng/ml. In GERD before the surgery, the VIP level was statistically different from the indicators in the comparison group and from postoperative values. After surgical treatment, VIP values were decreased to the level of apparently healthy individuals. There was a positive correlation between the VIP level and acid exposure time (AET), the total number of refluxes, the number of reflux events longer than 5 minutes, the maximum duration of refluxes and the degree of esophageal inflammation.

Conclusions. In the surgical treatment of GERD, the statistically significant decrease in the VIP level to that of apparently healthy individuals is determined. The moderate positive correlation between the levels of VIP, AET, the average number of refluxes, the number of reflux events longer than 5 minutes, and the maximum duration of refluxes confirms the inhibitory effect of VIP on LES tone. The relationship between the degree of esophageal inflammation and the VIP level confirms the indirect, through the action of VIP, inhibitory effect of the esophagitis severity on the LES tone.

Author Biographies

Ye. I. Haidarzhi, Zaporizhzhia State Medical and Pharmaceutical University, Ukraine

MD, PhD, Associate Professor of the Department of Hospital Surgery

M. H. Holovko, Zaporizhzhia State Medical and Pharmaceutical University, Ukraine

MD, PhD, Associate Professor of the Department of Hospital Surgery

H. O. Okhrimenko, Zaporizhzhia State Medical and Pharmaceutical University, Ukraine

MD, PhD, Assistant of the Department of Hospital Surgery


Sandhu, D. S., & Fass, R. (2018). Current Trends in the Management of Gastroesophageal Reflux Disease. Gut and liver, 12(1), 7-16.

Katzka, D. A., & Kahrilas, P. J. (2020). Advances in the diagnosis and management of gastroesophageal reflux disease. BMJ (Clinical research ed.), 371, m3786.

Slater, B. J., Dirks, R. C., McKinley, S. K., Ansari, M. T., Kohn, G. P., Thosani, N., Qumseya, B., Billmeier, S., Daly, S., Crawford, C., P Ehlers, A., Hollands, C., Palazzo, F., Rodriguez, N., Train, A., Wassenaar, E., Walsh, D., Pryor, A. D., & Stefanidis, D. (2021). SAGES guidelines for the surgical treatment of gastroesophageal reflux (GERD). Surgical endoscopy, 35(9), 4903-4917.

Richter, J. E., & Rubenstein, J. H. (2018). Presentation and Epidemiology of Gastroesophageal Reflux Disease. Gastroenterology, 154(2), 267-276.

Horgan, S., & Fuchs, K.-H. (2020). Management of Gastroesophageal Reflux Disease. Surgical and Therapeutic Innovations. Springer Nature Switzerland AG.

Yadlapati, R., Gyawali, C. P., Pandolfino, J. E., & CGIT GERD Consensus Conference Participants (2022). AGA Clinical Practice Update on the Personalized Approach to the Evaluation and Management of GERD: Expert Review. Clinical gastroenterology and hepatology, 20(5), 984-994.e1.

Chen, S., Du, F., Zhong, C., Liu, C., Wang, X., Chen, Y., Wang, G., Gao, X., Zhang, L., Li, L., & Wu, W. (2021). Gastroesophageal reflux disease: recent innovations in endoscopic assessment and treatment. Gastroenterology report, 9(5), 383-391.

Schoppmann, S. F., & Riegler, M. (Eds.). (2021). Multidisciplinary Management of Gastroesophageal Reflux Disease. Springer, Cham.

Fuchs, K. H., & Meining, A. (2021). Current Insights in the Pathophysiology of Gastroesophageal Reflux Disease. Chirurgia (Bucharest, Romania : 1990), 116(5), 515-523.

Fuchs, K. H., Lee, A. M., Breithaupt, W., Varga, G., Babic, B., & Horgan, S. (2021). Pathophysiology of gastroesophageal reflux disease-which factors are important?. Translational gastroenterology and hepatology, 6, 53.

Chen, J., & Brady, P. (2019). Gastroesophageal Reflux Disease: Pathophysiology, Diagnosis, and Treatment. Gastroenterology nursing, 42(1), 20-28.

Singhartinger, F. X., Wahl, L., Weitzendorfer, M., Gantschnigg, A., Koch, O. O., & Emmanuel, K. (2022). The role of hormones in symptoms and pathophysiology of reflux and esophageal motility disorders. Die Rolle von Hormonen bei Symptomen und Pathophysiologie von Reflux und Ösophagusmotilitätsstörungen. Zeitschrift fur Gastroenterologie, 10.1055/a-1833-9494. Advance online publication.

Sadatomi, D., Kono, T., Mogami, S., & Fujitsuka, N. (2020). Weak acids induce PGE2 production in human oesophageal cells: novel mechanisms underlying GERD symptoms. Scientific reports, 10(1), 20775.

Giuli, R., Siewert, J. R., Couturier, D., & Scarpignato. C. (Eds.). (2003). Barrett’s esophageus (vol. 1). John Libbey Eurotext.

Pouderoux, P., Verdier, E., & Kahrilas, P. J. (2003). Patterns of esophageal inhibition during swallowing, pharyngeal stimulation, and transient LES relaxation. Lower esophageal sphincter. American journal of physiology. Gastrointestinal and liver physiology, 284(2), G242-G247.

Fuchs, K. H., Babic, B., & Fuchs, H. F. (2019). Esophageal Sphincters in Health and Disease. In C. J. Yeo, S. R. DeMeester, & D. W. McFadden (Eds.), Shackelford's Surgery of the Alimentary (8th ed., Vol. 2, pp. 2-10). Elsevier.

Bai, X., Ihara, E., Otsuka, Y., Tsuruta, S., Hirano, K., Tanaka, Y., Ogino, H., Hirano, M., Chinen, T., Akiho, H., Nakamura, K., Oda, Y., & Ogawa, Y. (2019). Involvement of different receptor subtypes in prostaglandin E2-induced contraction and relaxation in the lower esophageal sphincter and esophageal body. European journal of pharmacology, 857, 172405.

Umetsu, Y., Tenno, T., Goda, N., Shirakawa, M., Ikegami, T., & Hiroaki, H. (2011). Structural difference of vasoactive intestinal peptide in two distinct membrane-mimicking environments. Biochimica et biophysica acta, 1814(5), 724-730.

Tobias, A., & Sadiq, N. M. (2022). Physiology, Gastrointestinal Nervous Control. In StatPearls. StatPearls Publishing.

Iwasaki, M., Akiba, Y., & Kaunitz, J. D. (2019). Recent advances in vasoactive intestinal peptide physiology and pathophysiology: focus on the gastrointestinal system. F1000Research, 8, F1000 Faculty Rev-1629.

Allan, V. J. (2000) Basic immunofluorescence. Protein localization by fluorescence microscopy: a practical approach (pp. 1-26). Oxford University Press.

Tsukada, T., Horovitch, S. J., Montminy, M. R., Mandel, G., & Goodman, R. H. (1985). Structure of the human vasoactive intestinal polypeptide gene. DNA (Mary Ann Liebert, Inc.), 4(4), 293-300.

Said, S. I., & Rosenberg, R. N. (1976). Vasoactive intestinal polypeptide: abundant immunoreactivity in neural cell lines and normal nervous tissue. Science (New York, N.Y.), 192(4242), 907-908.

Delgado, M., Pozo, D., & Ganea, D. (2004). The significance of vasoactive intestinal peptide in immunomodulation. Pharmacological reviews, 56(2), 249-290.

Haidarzhi, Ye. I. (2023). Dynamics of prostaglandin E2 in the surgical treatment of gastroesophageal reflux disease. Pathologia, 20(1), 58-62.

Martinez, C., Delgado, M., Abad, C., Gomariz, R. P., Ganea, D., & Leceta, J. (1999). Regulation of VIP production and secretion by murine lymphocytes. Journal of neuroimmunology, 93(1-2), 126-138.




How to Cite

Haidarzhi YI, Holovko MH, Okhrimenko HO. Vasoactive intestinal polypeptide level in gastroesophageal reflux disease before and after surgical treatment. Zaporozhye Medical Journal [Internet]. 2023Jul.20 [cited 2024Jul.20];25(4):346-51. Available from: