Cover Image

Quantitation of Colonic Cells as Severity Markers in Patients with Irritable Bowel Syndrome

Mohammad Bagher Miri, Amir Sadeghi, Afshin Moradi, Mohammad Rostami-Nejad, Mohammad-Javad Ehsani-Ardekani, Hamid Asadzadeh-Aghdaei, Mohammad-Taghi Safari, Mohammad Reza Zali

Background: Irritable bowel syndrome (IBS) is the most common gastrointestinal syndrome. Routine histopathology and immunohistochemistry (IHC) evaluations have shown an increase in the number of different inflammatory cells in the colon of IBS patients. In this study, we have compared the number of intraepithelial lymphocytes (IELs), eosinophils, mast cells and CD3+ T cells, in IBS patients and normal subjects. Materials and Methods: In 2016, seventy-nine patients with IBS and seventy-nine healthy subjects who underwent colonoscopy for other non-specific causes and with no pathologic findings, were enrolled in this cross-sectional study. Biopsy specimens obtained from the colon were stained, using IHC methods to determine the number of IELs, eosinophils, mast cells and CD3+ T cells. Quantitative and qualitative variables were compared between the two groups, using a Chi-square test and Student’s t-test. Results: Seventy-nine patients with IBS, 79.7% females with a mean age of 42.5±14.6 years, were recruited, as the case group, and seventy-nine individuals, 51.9% females with a mean age of 39.7±18.9 years, were enrolled as controls. The average number of IELs per high power fields (hpf) was found to be higher in the IBS group, and this difference was statistically significant (32.8±11.8 vs. 28.6±12.9; P=0.034). Also, the mean count/hpf of CD3+ T lymphocytes (23.1±7.9 vs. 20.2±8.1; P=0.024) and mast cells (7.6±3.1 vs. 6.6±3.0; P=0.041) were significantly higher in the IBS group, compared to the control group. The number of eosinophils was higher in the IBS group, but the differences were not statistically significant (P=0.066). Conclusion: According to the results, we suggest that analysis of immune cells and IELs in intestinal biopsies might be an appropriate method for diagnosis of IBS. [GMJ.2018;7:e1063]

Irritable Bowel Syndrome, Biopsy, Intra-epithelial Lymphocytes

Defrees DN, Bailey J. Irritable Bowel Syndrome: Epidemiology, Pathophysiology, Diagnosis, and Treatment. Prim Care. 2017;44(4):655-71.

Khoshkrood-Mansoori B, Pourhoseingholi MA, Safaee A, Moghimi-Dehkordi B, Sedigh-Tonekaboni B, Pourhoseingholi A, et al. Irritable bowel syndrome: a population based study. J Gastrointestin Liver Dis. 2009;18(4):413-8.

Ishihara S, Tada Y, Fukuba N, Oka A, Kusunoki R, Mishima Y, et al. Pathogenesis of irritable bowel syndrome-review regarding associated infection and immune activation. Digestion. 2013;87(3):204-11.

Vahedi M, Pourhoseingholi MA, Ashtari S, Moghimi-Dehkordi B, Safaee A, Zali MR. Irritable bowel syndrome, gastro-oesophageal reflux disease and dyspepsia: overlap analysis using loglinear models. Arab J Gastroenterol. 2012;13(1):20-3.

Zhao J-h, Dong L, Shi H-t, Wang Z-y, Shi H-y, Ding H. The expression of protease-activated receptor 2 and 4 in the colon of irritable bowel syndrome patients. D Dig Dis Sci. 2012;57(1):58-64.

Philpott H, Gibson P, Thien F. Irritable bowel syndrome-An inflammatory disease involving mast cells. Asia Pac Allergy. 2011;1(1):36-42.

Barbara G, Cremon C, Carini G, Bellacosa L, Zecchi L, De Giorgio R, et al. The immune system in irritable bowel syndrome. J Neurogastroenterol Motil. 2011 Oct;17(4):349-59.

Öhman L, Simrén M. Pathogenesis of IBS: role of inflammation, immunity and neuroimmune interactions. Nat Rev Gastroenterol Hepatol. 2010;7(3):163-73.

Bai T, Xia J, Jiang Y, Cao H, Zhao Y, Zhang L, et al. Comparison of the Rome IV and Rome III criteria for IBS diagnosis: A cross-sectional survey. J Gastroenterol Hepatol. 2017;32(5):1018-25.

Ortiz Lucas M, Saz Peiró P, Sebastián Domingo J. Irritable bowel syndrome immune hypothesis. Part one: the role of lymphocytes and mast cells. Rev Esp Enferm Dig. 2010;102(11):637-47.

Martínez C, González-Castro A, Vicario M, Santos J. Cellular and molecular basis of intestinal barrier dysfunction in the irritable bowel syndrome. Gut Liver. 2012;6[3]:305.

Chang L, Adeyemo M, Karagiannides I, Videlock EJ, Bowe C, Shih W, et al. Serum and colonic mucosal immune markers in irritable bowel syndrome. Am J Gastroenterol. 2012;107(2):262-72.

Matricon J, Meleine M, Gelot A, Piche T, Dapoigny M, Muller E, et al. Associations between immune activation, intestinal permeability and the irritable bowel syndrome. Aliment Pharmacol Ther. 2012;36(11-12):1009-31.

Gwee K, Leong Y, Graham C, McKendrick M, Collins S, Walters S, et al. The role of psychological and biological factors in postinfective gut dysfunction. Gut. 1999;44(3):400-6.

Lee KJ, Kim YB, Kim JH, Kwon HC, Kim DK, Cho SW. The alteration of enterochromaffin cell, mast cell, and lamina propria T lymphocyte numbers in irritable bowel syndrome and its relationship with psychological factors. J Gastroenterol Hepatol. 2008;23(11):1689-94.

Dunlop SP, Jenkins D, Spiller RC. Distinctive clinical, psychological, and histological features of postinfective irritable bowel syndrome. Am J Gastroenterol. 2003;98(7):1578-83.

Lee H, Park JH, Park DI, Kim HJ, Cho YK, Sohn CI, et al. Mucosal mast cell count is associated with intestinal permeability in patients with diarrhea predominant irritable bowel syndrome. J Neurogastroenterol Motil. 2013;19(2):244-50.

Goral V, Kucukoner M, Buyukbayram H. Mast cells count and serum cytokine levels in patients with irritable bowel syndrome. Hepatogastroenterology. 2010;57(101):751-4.

Hahn HP, Hornick JL. Immunoreactivity for CD25 in gastrointestinal mucosal mast cells is specific for systemic mastocytosis. Am J Surg Pathol. 2007;31(11):1669-76.

Barbara G, Cremon C, De Giorgio R, Dothel G, Zecchi L, Bellacosa L, et al. Mechanisms underlying visceral hypersensitivity in irritable bowel syndrome. Curr Gastroenterol Rep. 2011;13(4):308-15.

Keszthelyi D, Troost FJ, Masclee A. Irritable bowel syndrome: methods, mechanisms, and pathophysiology. Methods to assess visceral hypersensitivity in irritable bowel syndrome. Am J Physiol Gastrointest Liver Physiol. 2012;303(2):G141-54.

Faure C, Patey N, Gauthier C, Brooks EM, Mawe GM. Serotonin signaling is altered in irritable bowel syndrome with diarrhea but not in functional dyspepsia in pediatric age patients. Gastroenterology. 2010;139(1):249-58.

Refbacks

  • There are currently no refbacks.