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The paper by Akbar et al (Gut 2008;57:923–9) characterises the expression of the capsaicin receptor, transient receptor potential vanilloid type-1 (TRPV1), immune cell markers, and their relationship to symptoms in irritable bowel syndrome (IBS). They conclude that the increase in TRPV1-expressing nerve fibres may contribute to visceral hypersensitivity in IBS, and therefore provide a novel therapeutic target. An important parallel finding was that the overall density of innervation (protein gene product 9.5 (PGP9.5)- and substance P-positive) is increased along with TRPV1. Therefore, the upregulation of neuronal markers is not selective for TRPV1, and probably represents axonal sprouting. Most colonic sensory nerves normally express TRPV1,1 indicating that it may be a useful general marker for them and their proximity to other cells.
Akbar et al also show a dramatic increase in the numbers of lymphocytes (CD3+) and mast cells (ckit+) in IBS, which are therefore more likely to release mediators in the vicinity of TRPV1+ sensory fibres. This corroborates …
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