PMID- 22488080
OWN - NLM
STAT- MEDLINE
DCOM- 20120619
LR  - 20131121
IS  - 1572-0241 (Electronic)
IS  - 0002-9270 (Linking)
VI  - 107
IP  - 5
DP  - 2012 May
TI  - Mucosal immune cell numbers and visceral sensitivity in patients with irritable 
      bowel syndrome: is there any relationship?
PG  - 715-26
LID - 10.1038/ajg.2012.54 [doi]
AB  - OBJECTIVES: Repeated exposure to stress leads to mast cell degranulation, 
      microscopic inflammation, and subsequent visceral hypersensitivity in animal 
      models. To what extent this pathophysiological pathway has a role in patients 
      with the irritable bowel syndrome (IBS) has not been properly investigated. The 
      objective of this study was to assess the relationship between visceral 
      hypersensitivity, microscopic inflammation, and the stress response in IBS. 
      METHODS: Microscopic inflammation of the colonic mucosa was evaluated by 
      immunohistochemistry in 66 IBS patients and 20 healthy volunteers (HV). Rectal 
      sensitivity was assessed by a barostat study using an intermittent 
      pressure-controlled distension protocol. Salivary cortisol to a psychological 
      stress was measured to assess the stress response. RESULTS: Compared with HV, 
      mast cells, T cells, and macrophages were decreased in IBS patients. Similarly, 
      lambda-free light chain (FLC)-positive mast cells were decreased but not 
      immunoglobulin E (IgE)- and IgG-positive mast cells. There were no differences 
      between hypersensitive and normosensitive IBS patients. No relation was found 
      between any of the immune cells studied and the thresholds of discomfort, urge, 
      first sensation, or IBS symptoms (e.g., abdominal pain, stool-related complaints, 
      bloating). Finally, stress-related symptoms and the 
      hypothalamic-pituitary-adrenal-axis response to stress were not correlated with 
      the number of mast cells or the presence of visceral hypersensitivity. 
      CONCLUSIONS: Although the number of mast cells, macrophages, T cells, and 
      lambdaFLC-positive mast cells is decreased in IBS compared with HV, this is not 
      associated with the presence of visceral hypersensitivity or abnormal stress 
      response. Our data question the role of microscopic inflammation as an underlying 
      mechanism of visceral hypersensitivity, but rather suggest dysregulation of the 
      mucosal immune system in IBS.
FAU - Braak, Breg
AU  - Braak B
AD  - Department of Gastroenterology and Hepatology, AMC, Amsterdam, The Netherlands.
FAU - Klooker, Tamira K
AU  - Klooker TK
FAU - Wouters, Mira M
AU  - Wouters MM
FAU - Welting, Olaf
AU  - Welting O
FAU - van der Loos, Chris M
AU  - van der Loos CM
FAU - Stanisor, Oana I
AU  - Stanisor OI
FAU - van Diest, Sophie
AU  - van Diest S
FAU - van den Wijngaard, Rene M
AU  - van den Wijngaard RM
FAU - Boeckxstaens, Guy E
AU  - Boeckxstaens GE
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120410
PL  - United States
TA  - Am J Gastroenterol
JT  - The American journal of gastroenterology
JID - 0421030
RN  - WI4X0X7BPJ (Hydrocortisone)
SB  - IM
CIN - Nat Rev Gastroenterol Hepatol. 2012 Jun;9(6):304. PMID: 22547308
CIN - Am J Gastroenterol. 2012 May;107(5):727-9. PMID: 22552242
MH  - Adult
MH  - Biopsy, Needle
MH  - Cell Count
MH  - Colon/immunology/pathology/physiopathology
MH  - Colonoscopy
MH  - Female
MH  - Humans
MH  - Hydrocortisone/blood
MH  - Immunohistochemistry
MH  - Intestinal Mucosa/*immunology/pathology
MH  - Irritable Bowel Syndrome/*immunology/pathology/*physiopathology/psychology
MH  - Macrophages/immunology/pathology
MH  - Male
MH  - Mast Cells/immunology/pathology
MH  - Middle Aged
MH  - Pressure
MH  - Rectum/*physiopathology
MH  - Sensory Thresholds
MH  - Stress, Psychological/physiopathology
MH  - T-Lymphocytes/immunology/pathology
MH  - Young Adult
EDAT- 2012/04/11 06:00
MHDA- 2012/06/20 06:00
CRDT- 2012/04/11 06:00
PHST- 2012/04/11 06:00 [entrez]
PHST- 2012/04/11 06:00 [pubmed]
PHST- 2012/06/20 06:00 [medline]
AID - ajg201254 [pii]
AID - 10.1038/ajg.2012.54 [doi]
PST - ppublish
SO  - Am J Gastroenterol. 2012 May;107(5):715-26. doi: 10.1038/ajg.2012.54. Epub 2012 
      Apr 10.