Clinical-alimentary tractActivated mast cells in proximity to colonic nerves correlate with abdominal pain in irritable bowel syndrome☆
Section snippets
Patients
IBS patients were all seen in the Department of Internal Medicine and Gastroenterology of the University of Bologna and met the Rome II criteria.1 Healthy controls were recruited by public advertisement and included in the study after thorough exclusion of gastrointestinal complaints. None of the study participants were taking nonsteroidal anti-inflammatory drugs or other anti-inflammatory drugs (including mast cell stabilizers, immunosuppressants, and steroids); had undergone major abdominal
Patients
Forty-four consecutive patients with IBS (aged 22–75 years; mean, 40.1 years; 31 females, 13 males) as well as 22 healthy controls (aged 20–71 years; mean, 32.5 years; 12 females, 10 males) participated in the study. All patients complained of abdominal pain/discomfort (severity score: 1.78 ± 1.15; frequency score: 2.20 ± 1.49; mean ± SD); 50% had diarrhea and 50% constipation; furthermore, the most frequently associated symptom was bloating (97.8%).
Mast cell counts
Thirty-four (77.3%) of the 44 IBS patients
Discussion
In this study, we demonstrated that severity and frequency of perceived abdominal painful sensations are correlated with the presence of activated mast cells in proximity of nerve endings in the gut wall. Furthermore, we showed increased histamine and tryptase release by the colonic mucosa of IBS patients. Because these mast cell mediators are known to alter enteric nervous system physiology and induce visceral hypersensitivity,19, 34 their increased release in close proximity to colonic
Acknowledgements
The authors thank Dr. P. Chieco for his help with morphometric studies, Dr. S. Guerrini for her contribution to immunohistochemical studies, Dr. S. Pileri for the generous gift of anti-tryptase antibodies used in the study, and Drs. R. and L. Cogliandro for their contribution to patient selection and management.
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Supported by the Italian Ministry of University, Research, Science and Technology (to G.B., V.S., R.D.G., and R.C.), by National Institutes of Health grants DK43207 and 57840 (to N.W.B.), by the Canadian Institutes for Health Research (to S.M.C.), and by an educational grant from Janssen (to V.S.).