Studies describing mast cell infiltration and activation in FD and IBS and potential correlation with symptoms
| Condition and number of subjects | Site of biopsy | Mast cell numbers | Mast cell detection | Mast cell mediators | Correlation with symptoms | Reference |
|---|---|---|---|---|---|---|
| 141 FD and 39 controls | Duodenum | Increased counts | Toluidine blue staining | NA | NA | 66 |
| 15 FD and 15 controls | Duodenum | Increased | Anti- tryptase | NA | NA | 9 |
| 19 FD and 19 controls (paediatric) | No change | Anti- tryptase | NA | No correlation between permeability and mast cell density | 120 | |
| 65 H. pylori-negative FD (paediatric) | Gastric body and duodenum | Anti- tryptase | NA | Headache was associated with high mast cell counts in the gastric body and duodenum | 65 | |
| 51 FD, 20 IBS-D and 21 IBS-C and 48 controls | Duodenum | Increased counts in IBS-C and IBS-D and trend for increase in FD | Anti-CD-117 | NA | NA | 61 |
| 62 FD (33 H. pylori-positive, 29 H. pylori-negative and 29 H. pylori-positive inflammatory control subjects and 20 controls | Antrum and corpus | Increased in H. pylori-negative and positive FD samples in antrum and corpus | Anti- tryptase | NA | NA | 64 |
| 225 patients with non-ulcer dyspepsia | Antrum | 31 (13%) were found to have 11 or greater mast cells per high-power field | Alcian blue staining | NA | NA | 121 |
| Total of 101 IBS and 23 controls, for IHC: 15 controls; 15 IBS-C; 14 IBS-D | Descending colon | Increased counts | Anti-tryptase | NA | NA | 77 |
| 13 IBS-D, 8 IBS-C and 10 controls (paediatric) | Ileum, right colon and left colon | No change in numbers but mast cells in closer proximity to nerves in IBS (MC-NF/mm2) | Anti-tryptase | NA | Abdominal pain correlated with MC/mm2 in the ileum and MC-NF/mm2 in the right colon | 122 |
| 49 IBS-D and 30 controls | Jejunum | Increased counts in non-atopic IBS | Anti-CD-117 | NA | NA | 35 |
| 100 IBS and 100 controls | Colon, ileum, duodenum and stomach | No change | Anti-CD-117 and anti-CD-25 | NA | NA | 52 |
| 55 IBS-D and 18 controls with lactase deficiency | Sigmoid colon, ascending colon and terminal ileum | Increased counts in the terminal ileum, ascending and sigmoid colon | Anti-tryptase | NA | Anxiety scores were associated with mast cell counts in sigmoid colon, ascending colon and terminal ileum. Visceral sensitivity (ie, decrease in urgency, discomfort/pain threshold) was increased in patients with high mast cell density in the terminal ileum | 123 |
| 22 IBS-D and 21 controls | Rectum | Increased counts in IBS-D | Anti-tryptase | NA | Mast cell counts did not correlate with IBS symptoms including abdominal pain; mast cell counts correlated with substance P and VIP in women but not in men | 124 |
| 83 IBS-D, 49 UC (28 in remission and 21 mildly active UC) and 25 controls | Ascending, transverse, descending, and sigmoid colon | Increased counts in patients with IBS-D, UC in remission and mildly active UC | Anti-tryptase | NA | NA | 125 |
| 51 IBS, 49 quiescent IBD (31 CD and 18 UC) and 27 controls | Caecum | increased in patients with IBS, CD or UC (no difference between patients between patients with or without IBS-like symptoms | Anti-CD-117 | NA | NA | 126 |
| 16 IBS-D and 7 controls | Rectum | No change | Anti-tryptase | Increased tryptase release | Mast cell counts correlated with intestinal permeability | 127 |
| 45 IBS-D and 30 controls | Jejunum | Increased counts | Anti-CD-117 | Increased tryptase mRNA and protein | Tryptase mRNA expression but not mast cell counts correlated with stool frequency and consistency in IBS-D patients; tryptase protein expression correlated CLDN2 protein overexpression and increased OCLN cytoplasmic staining | 8 |
| 16 IBS-D, 21 IBS-C and 11 controls | Descending colon | Increased counts in IBS-C but not IBS-D | Anti-tryptase | NA | Mast cell counts of IBS but not controls correlated with the twitch enhancement evoked by biopsy supernatants | 87 |
| 34 IBS and 15 controls | Rectum | Increased counts | Anti-CD-117 | Increased tryptase release | IBS severity correlated with colonic permeability, mast cell counts and tryptase | 95 |
| 4 IBS-C, 11 IBS-D, 8 IBS-A and 15 controls | Colorectum | No change | Anti-tryptase | NA | NA | 128 |
| 11 IBS-D and 14 controls (paediatric) | Rectum | No change | Anti-tryptase and anti-CD-117 | NA | NA | 129 |
| 15 IBS-D, 15 IBS-C, 36 IBS-A and 20 controls | Descending colon | decreased mast cell counts | Anti-CD-117 | NA | No correlation between the number of mast cells and abdominal pain or sensory thresholds of first sensation, urge or discomfort | 51 |
| 25 IBS-D and 23 controls | Jejunum | Increased counts | Anti-CD-117 | Increased tryptase mRNA | Tryptase and SCF correlated with tight junction ZO protein expression. Bowel frequency and stool consistency correlated with both the number of mast cells and tryptase mRNA expression, and with the expression of ZO proteins | 91 |
| 12 IBS-C, 13 IBS-D and 12 controls | Descending colon | Increased counts | Anti-tryptase | Increased serotonin, histamine and tryptase release irrespective of bowel habit | 5-HT release correlated with mast cell counts and the severity of abdominal pain | 130 |
| 60 IBS and 22 controls | Rectum and descending colon | decreased mast cell counts in rectal biopsies | Anti-tryptase and anti-CD117 | Lower release of tryptase, slight increase in histamine release | The severity of abdominal pain was not correlated with mast cell counts; no correlation between abdominal pain and spontaneous histamine or tryptase release | 103 |
| 13 IBS-D, 8 IBS-C, 4 IBS-A, 10 active CD and 18 controls | Descending colon | Increased counts in IBS-D but not in IBS-C | Anti-CD-117 | Increased trypsin-like protein | NA | 131 |
| 27 IBS-D, 21 IBS-C, 12 MC 20 UC and 24 controls | Descending colon | Increased counts | Anti-tryptase | NA | Mast cell counts in patients with IBS was associated with abdominal bloating frequency and with symptoms of dysmotility-like dyspepsia, but not ulcer-like dyspepsia | 74 |
| 7 IBS-D, 4 IBS-C and 4 controls | Descending colon | Increased counts | Anti-tryptase | Increased tryptase and histamine release but not serotonin | Association between the number of mast cells and the corresponding supernatant-evoked spike frequency. Tryptase, histamine and serotonin concentrations all correlated with the supernatant-evoked action potential discharges | 80 |
| 8 IBS-D, 8 IBS-C, 7 IBS-A and 22 controls | Rectosigmoid | Increased counts | Anti-CD-117 | NA | c-kit+ cells correlated with maximal VAS pain score | 28 |
| 50 IBS, 21 controls, 11 depressed/fatigued patients without IBS | Caecum | Increased in IBS, unchanged in depressed/fatigued patients w/o IBS | Anti-CD-117 | NA | In IBS, but not in controls or depressed patients, mast cell counts correlated with the severity of fatigue and depression | 60 |
| 29 IBS and 15 controls | Descending colon | Increased counts | Anti-tryptase | Increased tryptase, histamine and PGE2 release | NA | 78 |
| 18 IBS and 12 controls and 4 UC and 1 CD | Rectum and ascending colon | No change | Alcian blue staining and anti-tryptase | Increased trypsin and tryptase protein | NA | 79 |
| 20 IBS-D and 14 controls | Jejunum | Increased counts | CD-117 | Increased tryptase release | No correlation between mast cell counts and gender or stress levels | 62 |
| 20 IBS-D, 18 IBS-C and 20 controls | Descending part of the duodenum, proximal end of jejunum and terminal ileum | Increased counts in IBS-C and IBS-D in ileum but not duodenum or jejunum | Anti-tryptase | Decreased 5-HT contents at the jejunum in patients with IBS-C | NA | 132 |
| 18 IBS-D and 15 controls | Terminal ileum, ascending colon and rectum | Increased in the terminal ileum, ascending colon and rectum | Anti-tryptase electron microscopy | NA | Activated mast cells were significantly closer to the nerves in IBS No correlation between mast cell counts and abdominal pain, urgency, depression scores and STAI-S/T; The increase in mucosal mast cell count in the terminal ileum was significantly associated with that in the ascending colon and rectum | 57 |
| 44 IBS and 22 controls | Descending colon | Increased counts | Anti-tryptase | Increased tryptase and histamine release | Vicinity of mast cells to nerves correlated with both severity and frequency of abdominal pain/discomfort | 7 |
| 28 PI-IBS, 28 patient controls and 34 healthy volunteers | Rectum | No change | Anti-tryptase | NA | NA | 63 |
| 42 IBS-D, 11 IBS-C, 20 IBS-A, 4 unknown IBS subtype and 28 controls | Ascending colon, transverse colon, descending colon and rectum | No change | Anti-tryptase | NA | NA | 48 |
| 10 IBS and 15 controls | Jejunum (full thickness) | No change | Giemsa staining | NA | NA | 133 |
| 21 PI-IBS and 12 controls | Rectum | No change | Anti-tryptase | NA | NA | 134 |
| 14 IBS, 7 normal controls and 7 inflammatory controls | Caecum, ascending colon, descending colon and rectum | Increased numbers in caecum but not at other sites | Anti-tryptase | NA | NA | 50 |
CD, Crohn's disease; FD, functional dyspepsia; IBS-A, alternating subtype of IBS; IBS-C, constipation-predominant IBS; IBS-D, diarrhoea-predominant IBS; MC, microscopic colitis; NA, not assessed; OCLN, occludin; PI, post-infectious; SCF, stem cell factor; VAS, visual analogue scale; VIP, vasoactive intestinal peptide; ZO, zonula occludens.