Increased capsaicin receptor TRPV1-expressing sensory fibres in irritable bowel syndrome and their correlation with abdominal pain.
Increased capsaicin receptor TRPV1-expressing sensory fibres in irritable bowel syndrome and their correlation with abdominal pain.
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作者：
Akbar A;Yiangou Y;Facer P;Walters JR;Anand P;Ghosh S
辣椒素受体TRPV 1（瞬时受体电位香草酸1型）可能在内脏痛和超敏状态中发挥重要作用。在肠易激综合征（IBS）中，腹痛是一种常见且令人痛苦的症状，其病理生理机制尚未明确定义。TRPV 1免疫反应神经纤维在肠易激综合征患者的结肠活检中进行了研究，这与腹痛有关。从23例符合罗马II标准的IBS患者和22例对照组中收集直肠乙状结肠活检。使用经验证的问卷记录腹痛评分。TRPV 1-，P物质-和神经元标记蛋白基因产物（PGP）9.5-表达神经纤维，肥大细胞（c-kit）和淋巴细胞（CD 3和CD 4）进行定量，免疫组化后与特定的抗体。活检结果与腹痛评分相关。与对照组相比，IBS患者的活检组织中TRPV 1免疫反应纤维的中位数显着增加了3.5倍（p<0.0001）。IBS组中P物质免疫反应纤维（p = 0.01）、总神经纤维（PGP9.5）（p = 0.002）、肥大细胞（c-kit）（p = 0.02）和淋巴细胞（CD 3）（p =0.03）也显著增加。 在多变量回归分析中，只有TRPV 1免疫反应纤维（p = 0.005）和肥大细胞（p = 0.008）与腹痛评分显著相关。 在IBS中观察到TRPV 1神经纤维增加，以及低度炎症反应。TRPV 1神经纤维的增加可能与IBS的内脏高敏感性和疼痛有关，并提供了一个新的治疗靶点。
The capsaicin receptor TRPV1 (transient receptor potential vanilloid type-1) may play an important role in visceral pain and hypersensitivity states. In irritable bowel syndrome (IBS), abdominal pain is a common and distressing symptom where the pathophysiology is still not clearly defined. TRPV1-immunoreactive nerve fibres were investigated in colonic biopsies from patients with IBS, and this was related to abdominal pain. Rectosigmoid biopsies were collected from 23 IBS patients fulfilling Rome II criteria, and from 22 controls. Abdominal pain scores were recorded using a validated questionnaire. TRPV1-, substance P- and neuronal marker protein gene product (PGP) 9.5-expressing nerve fibres, mast cells (c-kit) and lymphocytes (CD3 and CD4) were quantified, following immunohistochemistry with specific antibodies. The biopsy findings were related to the abdominal pain scores. A significant 3.5-fold increase in median numbers of TRPV1-immunoreactive fibres was found in biopsies from IBS patients compared with controls (p<0.0001). Substance P-immunoreactive fibres (p = 0.01), total nerve fibres (PGP9.5) (p = 0.002), mast cells (c-kit) (p = 0.02) and lymphocytes (CD3) (p = 0.03) were also significantly increased in the IBS group. In multivariate regression analysis, only TRPV1-immuno-reactive fibres (p = 0.005) and mast cells (p = 0.008) were significantly related to the abdominal pain score. Increased TRPV1 nerve fibres are observed in IBS, together with a low-grade inflammatory response. The increased TRPV1 nerve fibres may contribute to visceral hypersensitivity and pain in IBS, and provide a novel therapeutic target.
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