rss
Gut 2008;57:923-929 doi:10.1136/gut.2007.138982
  • Neurogastroenterology

Increased capsaicin receptor TRPV1-expressing sensory fibres in irritable bowel syndrome and their correlation with abdominal pain

This article has been Unlocked
  1. A Akbar1,
  2. Y Yiangou2,
  3. P Facer2,
  4. J R F Walters1,
  5. P Anand2,
  6. S Ghosh1
  1. 1
    Department of Gastroenterology, Imperial College London, UK
  2. 2
    Department of Clinical Neuroscience, Imperial College London, UK
  1. Professor S Ghosh, Department of Gastroenterology, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK; s.ghosh{at}imperial.ac.uk
  • Revised 21 December 2007
  • Accepted 22 January 2008
  • Published Online First 5 February 2008

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Footnotes

  • Funding: Funding has been provided by GlaxoSmithKline, Harlow, UK and The National Association of Colitis and Crohns disease (NACC).

  • Competing interests: None.

  • Ethics approval: The study was approved by Hammersmith Hospitals Research Ethics Committee.

This article has been Unlocked

This Article

  1. Abstract
  2. Full text
  3. PDF
  4. All versions of this article:
    1. gut.2007.138982v1
    2. 57/7/923 most recent

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.