Diarrhoea-predominant IBS patients show mast cell activation and hyperplasia in the jejunum
Diarrhoea-predominant IBS patients show mast cell activation and hyperplasia in the jejunum
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DOI：
10.1136/gut.2006.100594
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发表时间：
2007-02-01
期刊：
影响因子：
24.5
通讯作者：
Ramon Malagelada, Juan
中科院分区：
文献类型：
--
作者：
Guilarte, Mar;Santos, Javier;Ramon Malagelada, Juan
背景资料：肠易激综合征（IBS）患者肠远端肥大细胞数量增加和肥大细胞活化与症状发作和严重程度相关。虽然上消化道症状是常见的，肥大细胞在近端肠道IBS patients.Methods：空肠活检获得的沃森的胶囊，肠液和一个血液样本的抽吸获得20例大肠杆菌为主的IBS患者（D-IBS）和14名健康志愿者（H）。在基线时评估心理压力（Holmes-Rahe量表）和抑郁（Beck抑郁量表），排除食物和呼吸道过敏。对活检进行H&E染色，并通过计数上皮内淋巴细胞来评估显微镜下炎症。用CD 117（c-kit）免疫组化法计数固有层肥大细胞。结果：D-IBS患者比健康志愿者表现出更高的心理应激（D-IBS：203（SD 114）vH：112（SD 99）; p = 0.019）。空肠粘膜的免疫组织化学染色显示D-IBS患者中上皮内CD 3+细胞轻度增加（D-IBS：15.3（SD 5.5; 95% CI 12.7至17.9）v H：10.3（SD 3.9; 95% CI 8.0至12.5）; p = 0.006）。此外，D-IBS患者的肥大细胞数量显着增加（DIBS：34个（SD 9.3）; H：15.3个（SD 4.4）肥大细胞/hpf; p < 0.001），并且空肠液中类胰蛋白酶浓度较高（D-IBS：0.45（SD 0.38）; H：0.09（SD 0.10）μ g/l; p = 0.005）。上消化道症状与性别，肥大细胞计数，空肠类胰蛋白酶或基础stress.Conclusion：空肠粘膜炎症的配置文件可能有助于确定肠易激综合征，应激相关疾病。
Background: Increased numbers of mast cells and mast cell activation in distal gut segments are associated with symptom onset and severity in irritable bowel syndrome (IBS). Although upper gut symptoms are common, mast cells have not been thoroughly evaluated in proximal gut in IBS patients.Methods: Jejunal biopsies obtained by Watson's capsule, aspiration of intestinal fluid and one blood sample were obtained in 20 diarrhoea-predominant patients with IBS (D-IBS) and 14 healthy volunteers (H). Psychological stress (Holmes-Rahe Scale) and depression (Beck's Depression Inventory) were evaluated at baseline and food and respiratory allergy excluded. Biopsies were processed for H&E staining and microscopic inflammation assessed by counting intraepithelial lymphocytes. Mast cells in lamina propria were counted by immunohistochemistry with CD117 (c-kit). Tryptase concentration was measured in intestinal fluid and serum.Results: D-IBS patients showed higher psychological stress than healthy volunteers (D-IBS: 203 (SD 114) v H: 112 (SD 99); p = 0.019). Immunohistochemical staining of jejunal mucosa revealed mild increase in intraepithelial CD3+ cells in D-IBS patients (D-IBS: 15.3 (SD 5.5; 95% CI 12.7 to 17.9) v H: 10.3 (SD 3.9; 95% CI 8.0 to 12.5); p = 0.006). Moreover, D-IBS patients showed marked increase in mast cells numbers (DIBS: 34 (SD 9.3); H: 15.3 (SD 4.4) mast cells/hpf; p < 0.001) and higher tryptase concentration in jejunal fluid (D-IBS: 0.45 (SD 0.38); H: 0.09 (SD 0.10) mu g/l; p = 0.005). Upper gut symptoms were not associated with gender, mast cell counts, jejunal tryptase or basal stress.Conclusion: This jejunal mucosal inflammatory profile may help identify diarrhoea-predominant IBS, a stress-related disorder.