Novel findings regarding the role of the endocannabinoid system in pediatric functional gastrointestinal disorders

Abstract. Introduction:. Pain constitutes the chief complaint of some functional gastrointestinal disorders (FGIDs). The endocannabinoid (EC) and peroxisome proliferator–activated receptors (PPARs) agonist systems have not been explored as possible contributors. Objective:. To determine if EC and PP...

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Main Authors: Gisela Chelimsky, Lisa Conant, Pippa Simpson, Liyun Zhang, Serge Marchand, Cecilia Hillard, Thomas Chelimsky
Format: Article
Language:English
Published: Wolters Kluwer 2025-08-01
Series:PAIN Reports
Online Access:http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001273
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author Gisela Chelimsky
Lisa Conant
Pippa Simpson
Liyun Zhang
Serge Marchand
Cecilia Hillard
Thomas Chelimsky
author_facet Gisela Chelimsky
Lisa Conant
Pippa Simpson
Liyun Zhang
Serge Marchand
Cecilia Hillard
Thomas Chelimsky
author_sort Gisela Chelimsky
collection DOAJ
description Abstract. Introduction:. Pain constitutes the chief complaint of some functional gastrointestinal disorders (FGIDs). The endocannabinoid (EC) and peroxisome proliferator–activated receptors (PPARs) agonist systems have not been explored as possible contributors. Objective:. To determine if EC and PPAR agonist abnormalities occur in adolescents with FGID. Methods:. Institutional Review Board approved study compared 33 children (12-18 years) with a FGID to 18 healthy controls (HC). Clinical measures: functional disability inventory and pediatric pain questionnaire (PPQ). Endocannabinoid and PPAR agonist concentrations were determined in serum from blood. Data were analyzed using Mann–Whitney and Fisher exact tests (2-sided P < 0.05 considered significant). Results:. When compared to HC, FGID subjects used different terms to describe their pain, which also occurred in more body areas. Functional gastrointestinal disorder subjects exhibited higher palmitoylethanolamide (PEA) and N-oleoylethanolamide, while EC did not differ. Interestingly, PEA correlated significantly with PPQ “worst pain the week before” in the HC group with Spearman ρ = 0.519, P = 0.003, but not in the FGID group (ρ = 0.079, P = 0.66). Conclusion:. Children with FGID exhibit significant pain in nongastrointestinal regions. The higher concentrations of PEA found in the FGID subjects, also occurring in other chronic pain conditions, could reflect a compensatory response due to feedback loops from a downregulated or nonresponsive PPAR system, while the absence of the expected relationship between pain intensity and PEA levels in the FGID group suggests that the PPAR system may not be functioning normally.
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spelling doaj-art-a21dc45e7c1c49baaddcc42c5a2e84642025-08-20T03:23:07ZengWolters KluwerPAIN Reports2471-25312025-08-01104e127310.1097/PR9.0000000000001273PR90000000000001273Novel findings regarding the role of the endocannabinoid system in pediatric functional gastrointestinal disordersGisela Chelimsky0Lisa Conant1Pippa Simpson2Liyun Zhang3Serge Marchand4Cecilia Hillard5Thomas Chelimsky6a Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Virginia Commonwealth University, Richmond, VA, USAb Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USAc Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USAc Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USAd Department of Surgery, Department of Anesthesia Medical Faculty, Clinical Pain Research Laboratories, CHUS Research Center, Sherbrooke University, Sherbrooke, Canadae Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, WI, USAf Department of Neurology, Virginia Commonwealth University, Richmond, VA, USAAbstract. Introduction:. Pain constitutes the chief complaint of some functional gastrointestinal disorders (FGIDs). The endocannabinoid (EC) and peroxisome proliferator–activated receptors (PPARs) agonist systems have not been explored as possible contributors. Objective:. To determine if EC and PPAR agonist abnormalities occur in adolescents with FGID. Methods:. Institutional Review Board approved study compared 33 children (12-18 years) with a FGID to 18 healthy controls (HC). Clinical measures: functional disability inventory and pediatric pain questionnaire (PPQ). Endocannabinoid and PPAR agonist concentrations were determined in serum from blood. Data were analyzed using Mann–Whitney and Fisher exact tests (2-sided P < 0.05 considered significant). Results:. When compared to HC, FGID subjects used different terms to describe their pain, which also occurred in more body areas. Functional gastrointestinal disorder subjects exhibited higher palmitoylethanolamide (PEA) and N-oleoylethanolamide, while EC did not differ. Interestingly, PEA correlated significantly with PPQ “worst pain the week before” in the HC group with Spearman ρ = 0.519, P = 0.003, but not in the FGID group (ρ = 0.079, P = 0.66). Conclusion:. Children with FGID exhibit significant pain in nongastrointestinal regions. The higher concentrations of PEA found in the FGID subjects, also occurring in other chronic pain conditions, could reflect a compensatory response due to feedback loops from a downregulated or nonresponsive PPAR system, while the absence of the expected relationship between pain intensity and PEA levels in the FGID group suggests that the PPAR system may not be functioning normally.http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001273
spellingShingle Gisela Chelimsky
Lisa Conant
Pippa Simpson
Liyun Zhang
Serge Marchand
Cecilia Hillard
Thomas Chelimsky
Novel findings regarding the role of the endocannabinoid system in pediatric functional gastrointestinal disorders
PAIN Reports
title Novel findings regarding the role of the endocannabinoid system in pediatric functional gastrointestinal disorders
title_full Novel findings regarding the role of the endocannabinoid system in pediatric functional gastrointestinal disorders
title_fullStr Novel findings regarding the role of the endocannabinoid system in pediatric functional gastrointestinal disorders
title_full_unstemmed Novel findings regarding the role of the endocannabinoid system in pediatric functional gastrointestinal disorders
title_short Novel findings regarding the role of the endocannabinoid system in pediatric functional gastrointestinal disorders
title_sort novel findings regarding the role of the endocannabinoid system in pediatric functional gastrointestinal disorders
url http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001273
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