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Published on: September 11, 2012
The study on the role of inflammatory cells and mediators in post-infectious functional dyspepsia
Xiaobo Li1, Huimin Chen, Hong Lu
1Department of Gastroenterology, Shanghai Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China.
Objective:
Functional dyspepsia is a common gastrointestinal disorder. The pathogenesis of functional dyspepsia remains unclear. Functional dyspepsia may begin after a bout of gastroenteritis (post-infectious functional dyspepsia) or de novo (nonspecific functional dyspepsia). The aim of this study was to investigate the prevalence and probable mechanisms of post-infectious functional dyspepsia.
Material And Methods:
Functional dyspepsia patients with a history of unsanitary food intake and acute gastroenteritis 6-12 months ago were enrolled. (13)C-UBT confirmed absence of H. pylori infection. Controls consisted of healthy nondyspeptic volunteers and patients with nonspecific functional dyspepsia. Gastric biopsies were used for routine histology, immunohistochemistry, electron microscopy, ELISA, HPLC assays and Western blot examination.
Results:
Eighty-five subjects were entered including 35 with post-infectious functional dyspepsia, 30 with nonspecific functional dyspepsia, and 20 healthy controls. The number of mast cells in post-infectious functional dyspepsia and nonspecific functional dyspepsia were significantly greater than that in healthy controls. The number of enterochromaffin cells (ECs) in post-infectious functional dyspepsia was significantly higher than those in nonspecific functional dyspepsia or in healthy controls. The number of mast cells and ECs increased with the density of chronic inflammatory cells. The release of histamine and 5-hydroxytryptamine from gastric mucosa of post-infectious functional dyspepsia patients was significantly greater than those from nonspecific functional dyspepsia or healthy controls. Tryptase protein expression was higher in post-infectious functional dyspepsia and nonspecific functional dyspepsia than in healthy controls. The histological score of chronic gastric inflammation was greater in post-infectious functional dyspepsia versus patients with nonspecific functional dyspepsia or healthy controls. Electron microscopy showed secreting granules in the cytoplasm of both mast cells and ECs. The number of activated mast cells and Ecs at a distance of < 5 microm of nerve fibers were significantly greater in post-infectious functional dyspepsia versus nonspecific functional dyspepsia or controls.
Conclusions:
Dyspepsia may occur after an acute onset of gastroenteritis in a part of patients. Potent chemicals derived from mast cells and ECs, including histamine, tryptase and 5-hydroxytryptamine may be involved in the pathogenesis of post-infectious functional dyspepsia.
Insights
Post-infectious functional dyspepsia involves increased mast cells and enterochromaffin cells (ECs) in the gastric mucosa. These cells release potent chemicals like histamine and serotonin, contributing to dyspepsia symptoms after gastroenteritis.
Area of Science:
- Gastroenterology
- Immunology
- Cell Biology
Background:
- Functional dyspepsia (FD) is a prevalent gastrointestinal disorder with unclear pathogenesis.
- FD can manifest post-gastroenteritis (post-infectious FD) or de novo (nonspecific FD).
- Understanding the mechanisms of post-infectious FD is crucial for targeted therapies.
Purpose of the Study:
- To investigate the prevalence of post-infectious functional dyspepsia.
- To explore the probable mechanisms underlying post-infectious functional dyspepsia.
- To compare cellular and chemical mediators in post-infectious FD versus nonspecific FD and healthy controls.
Main Methods:
- Enrolled patients with post-infectious FD (history of gastroenteritis) and nonspecific FD, alongside healthy controls.
- Utilized gastric biopsies for histology, immunohistochemistry, electron microscopy, ELISA, HPLC, and Western blot.
- Confirmed absence of H. pylori infection using (13)C-UBT.
Main Results:
- Post-infectious FD and nonspecific FD showed significantly higher mast cell and enterochromaffin cell (EC) counts than controls.
- Post-infectious FD exhibited significantly higher EC numbers than nonspecific FD or controls.
- Elevated histamine and 5-hydroxytryptamine release, increased tryptase expression, and greater chronic inflammation scores were observed in post-infectious FD.
Conclusions:
- Post-infectious functional dyspepsia may develop after acute gastroenteritis in susceptible individuals.
- Mast cells and ECs, through the release of histamine, tryptase, and 5-hydroxytryptamine, likely play a key role in post-infectious FD pathogenesis.
- Activated mast cells and ECs near nerve fibers suggest a neuro-immune interaction in post-infectious FD.
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