Increased Immunoendocrine Cells in Intestinal Mucosa of Postinfectious Irritable Bowel Syndrome Patients 3 Years after Acute Shigella Infection: An Observation in a Small Case Control Study.
- Author:
Hee Sun KIM
1
;
Jung Hyun LIM
;
Hyojin PARK
;
Sang In LEE
Author Information
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords: Post infectious irritable bowel syndrome; enterochromaffin cell; T lymphocyte; mast cell; macrophage
- MeSH: Adult; Antigens, CD/metabolism; Antigens, Differentiation, Myelomonocytic/metabolism; CD8-Positive T-Lymphocytes/cytology; Case-Control Studies; Colon, Descending/pathology; Colon, Sigmoid/pathology; Colonoscopy; Dysentery, Bacillary/*complications; Enterochromaffin Cells/cytology; Female; Humans; Immunohistochemistry; Intestinal Mucosa/*pathology; Irritable Bowel Syndrome/metabolism/*pathology; Macrophages/cytology; Male; Mast Cells/cytology; Peptide YY/metabolism; Rectum/pathology; Serotonin/metabolism
- From:Yonsei Medical Journal 2010;51(1):45-51
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Postinfectiously irritable bowel syndrome (PI-IBS) develops in 3-30% of individuals with bacterial gastroenteritis. Recent studies demonstrated increases in inflammatory components in gut mucosa of PI-IBS patients even after complete resolution of infection. We aimed to investigate histological changes in colon and rectum of PI-IBS subjects after long term period of infection. MATERIALS AND METHODS: We recruited PI-IBS subjects who had been diagnosed IBS after complete resolution of enteritis caused by shigellosis outbreak 3 years earlier. We compared unmatched four groups, PI-IBS (n = 4), non PI-IBS (n = 7), D-IBS (n = 7, diarrhea predominant type) and healthy controls (n = 10). All of them underwent colonoscopic biopsy at three areas, including descending colon (DC), sigmoid colon (SC) and rectum, which were assessed for 5-hydroxytryptamine (5-HT)/peptide YY (PYY)-containing enterochromaffin (EC) cell, intraepithelial (IEL) and lamina propria T lymphocyte (CD3), CD8 lymphocytes, mast cells and CD68/calprotectin+ macrophages. RESULTS: All subjects had no structural or gross abnormalities at colonoscopy. In PI-IBS, 5-HT containing EC cells, PYY containing EC cells, IELs, CD3 lymphocytes, CD8 lymphocytes, mast cells, and CD68 + macrophages were increased compared to control (p < 0.05). In D-IBS, PYY containing EC cells, IELs, and CD3 lymphocytes were increased compared to control (p < 0.05). In PI-IBS, 5-HT containing EC cells tended to increase and PYY containing EC cells, CD8 lymphocytes, mast cells, and CD68+ macrophages were increased compared to non PI-IBS (p < 0.05). Calprotectin + marcrophages were decreased in PI-IBS, non PI-IBS and IBS compared to control. CONCLUSION: The immunoendocrine cells were sporadically increased in PI-IBS, non PI-IBS and D-IBS compared with control. Our findings in a very small number of patients suggest that mucosal inflammation may play a role in long-term PI-IBS, and that other sub-groups of IBS and larger scale studies are needed to confirm this observation.
