Cited by 1,475Gastrointestinal motility and disordersMast cells and histamineCongenital gastrointestinal and neural anomalies

Activated mast cells in proximity to colonic nerves correlate with abdominal pain in irritable bowel syndrome

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Barbara, Giovanni, Stanghellini, Vincenzo, De Giorgio, Roberto, Cremon, Cesare, Cottrell, Graeme S., Santini, Donatella, Pasquinelli, Gianandrea, Morselli-Labate, Antonio M. +4 more·2004·Gastroenterology

Abstract

Background & aims The mechanisms underlying abdominal pain perception in irritable bowel syndrome (IBS) are poorly understood. Intestinal mast cell infiltration may perturb nerve function leading to symptom perception. We assessed colonic mast cell infiltration, mediator release, and spatial interactions with mucosal innervation and their correlation with abdominal pain in IBS patients.Methods IBS patients were diagnosed according to Rome II criteria and abdominal pain quantified according to a validated questionnaire. Colonic mucosal mast cells were identified immunohistochemically and quantified with a computer-assisted counting method. Mast cell tryptase and histamine release were analyzed immunoenzymatically. Intestinal nerve to mast cell distance was assessed with electron microscopy.Results Thirty-four out of 44 IBS patients (77%) showed an increased area of mucosa occupied by mast cells as compared with controls (9.2% +/- 2.5% vs. 3.3 +/- 0.8%, respectively; P < 0.001). There was a 150% increase in the number of degranulating mast cells (4.76 +/- 3.18/field vs. 2.42 +/- 2.26/field, respectively; P = 0.026). Mucosal content of tryptase was increased in IBS and mast cells spontaneously released more tryptase (3.22 +/- 3.48 pmol/min/mg vs. 0.87 +/- 0.65 pmol/min/mg, respectively; P = 0.015) and histamine (339.7 +/- 59.0 ng/g vs. 169.3 +/- 130.6 ng/g, respectively; P = 0.015). Mast cells located within 5 microm of nerve fibers were 7.14 +/- 3.87/field vs. 2.27 +/- 1.63/field in IBS vs. controls (P < 0.001). Only mast cells in close proximity to nerves were significantly correlated with severity and frequency of abdominal pain/discomfort (P < 0.001 and P = 0.003, respectively).Conclusions Colonic mast cell infiltration and mediator release in proximity to mucosal innervation may contribute to abdominal pain perception in IBS patients.

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Crossref · 10.1053/j.gastro.2003.11.055

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  • Approximately 70%-84% of patients with irritable bowel syndrome exhibit local mast cell infiltration in their intestinal tissues.

    “Notably, approximately 70%–84% of patients with IBS exhibit local mast cell infiltration of mast cells in their intestinal tissues.”

    From Nociplastic pain: the prominent role of non-neuronal cells in central and peripheral sensitization (2026) · cites this paper as [72]

    The Mast Cell Counts section reports increased mast-cell-occupied colonic mucosal area in 34 of 44 IBS patients (77.3%), which falls within the claimed range. The paper does not report a 70%–84% range, and its finding concerns colonic mucosa rather than intestinal tissues generally. (LLM, conf=0.85)

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  • Mast cell infiltration surrounding intestinal nerves occurs approximately three times more frequently in irritable bowel syndrome patients than in controls, and the number of degranulated mast cells is increased by approximately 1.5-fold.

    “Moreover, the phenomenon of mast cell infiltration surrounding intestinal nerves occurs approximately three times more frequently in IBS patients than in controls, and the number of degranulated mast cells is increased by approximately 1.5-fold (72).”

    From Nociplastic pain: the prominent role of non-neuronal cells in central and peripheral sensitization (2026) · cites this paper as [72]

    The Mast Cell-Nerve Interactions section reports 7.14 mast cells near nerves per 10 fields in IBS patients versus 2.27 in controls—approximately three times as many. The Mast Cell Degranulation section also reports more degranulating mast cells, but its figures (4.76 versus 2.42) are approximately twofold, not 1.5-fold; the section describes this as a 150% increase. Page numbers were not supplied. (LLM, conf=0.88)

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  • Mucosal mast cell degranulation within the gut can affect host intestinal integrity and has been related to visceral pain.

    “Mucosal mast cell degranulation within the gut can affect host intestinal integrity (Santos et al., 2001) and has been related to visceral pain (Barbara et al., 2004).”

    From The Microbiota-Gut-Brain Axis (2019) · cites this paper as Barbara et al., 2004

  • The severity and frequency of abdominal pain correlates with the presence of activated mast cells in close proximity to nerve endings in the gut mucosa in some studies, but in others mast cell proliferation associates with a reduction, or no change, in visceral sensitivity.

    “The severity and frequency of abdominal pain correlates with the presence of activated mast cells in close proximity to nerve endings in the gut mucosa in some studies, 56 but in others mast cell proliferation associates with a reduction, 57 or no change, 58 in visceral sensitivity.”
  • An increase in mucosal immune cells including mast cells, macrophages or monocytes, T-cells, and eosinophils has been reported in both pediatric and adult FGID populations.

    “An increase in mucosal immune cells including mast cells, macrophages or monocytes, T-cells, and eosinophils has been reported in both pediatric and adult FGID populations79, 113, 114.”

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2 of the 60 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. Metcalfe DD, Baram D, Mekori YA. Mast cells. Physiol Rev 1997; 77:1033-1079.
  2. Macfarlane SR, Seatter MJ, Kanke T, Hunter GD, Plevin R. Pro- teinase-activated receptors. Pharmacol Rev 2001;53:245-282.

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Authors
Barbara, G., Stanghellini, V., De Giorgio, R., Cremon, C., Cottrell, G. S., Santini, D., Pasquinelli, G., Morselli-Labate, A. M., Grady, E. F., Bunnett, N. W., Collins, S. M., & Corinaldesi, R.
Affiliations
  • University of Bologna (IT)
  • University of California, San Francisco (US)
  • McMaster University (CA)
Corresponding author
Barbara, Giovanni
Venue
Gastroenterology
Publisher
Elsevier BV
Published
2004-03
Volume
126
Issue
3
Pages
693-702
ISSN
0016-5085 (ISSN-L)
OpenAlex
W1976068711
Cited by
1,475
References
60
Citations by year
2026: 49 · 2025: 39 · 2024: 49 · 2023: 70 · 2022: 64 · 2021: 74 · 2020: 55 · 2019: 44 · 2018: 74 · 2017: 73 · 2016: 77 · 2015: 71 · 2014: 79 · 2013: 66 · 2012: 84
FWCI
56.33
Type
journal article
Language
en
Open access
Locations
  • Gastroenterology (publishedVersion)
  • PubMed (publishedVersion)
  • Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
  • Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (DK 57840, DK 43207, R01DK057840)
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Life Sciences › Immunology and Microbiology › Immunology › Mast cells and histamine
  • Health Sciences › Medicine › Surgery › Congenital gastrointestinal and neural anomalies
Keywords
irritable bowel syndrome, mast cells, abdominal pain, colonic mucosa, enteric nerves, mast cell degranulation, tryptase, histamine release, visceral pain perception, mast cell infiltration
MeSH terms
Adult, Aged, Cell Count, Colon, Female, Histamine Release, Humans, Immunohistochemistry, Intestinal Mucosa, Male, Mast Cells, Microscopy, Electron, Middle Aged, Nervous System, Serine Endopeptidases, Blotting, Western, Cell Degranulation, Abdominal Pain, Irritable Bowel Syndrome, Tryptases

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