Diarrhoea-predominant IBS patients show mast cell activation and hyperplasia in the jejunum
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BACKGROUND: Increased numbers of mast cells and mast cell activation in distal gut segments are associated with symptom onset and severity in irritable bowel syndrome (IBS). Although upper gut symptoms are common, mast cells have not been thoroughly evaluated in proximal gut in IBS patients. METHODS: Jejunal biopsies obtained by Watson's capsule, aspiration of intestinal fluid and one blood sample were obtained in 20 diarrhoea-predominant patients with IBS (D-IBS) and 14 healthy volunteers (H). Psychological stress (Holmes-Rahe Scale) and depression (Beck's Depression Inventory) were evaluated at baseline and food and respiratory allergy excluded. Biopsies were processed for H&E staining and microscopic inflammation assessed by counting intraepithelial lymphocytes. Mast cells in lamina propria were counted by immunohistochemistry with CD117 (c-kit). Tryptase concentration was measured in intestinal fluid and serum. RESULTS: D-IBS patients showed higher psychological stress than healthy volunteers (D-IBS: 203 (SD 114) v H: 112 (SD 99); p = 0.019). Immunohistochemical staining of jejunal mucosa revealed mild increase in intraepithelial CD3+ cells in D-IBS patients (D-IBS: 15.3 (SD 5.5; 95% CI 12.7 to 17.9) v H: 10.3 (SD 3.9; 95% CI 8.0 to 12.5); p = 0.006). Moreover, D-IBS patients showed marked increase in mast cells numbers (D-IBS: 34 (SD 9.3); H: 15.3 (SD 4.4) mast cells/hpf; p<0.001) and higher tryptase concentration in jejunal fluid (D-IBS: 0.45 (SD 0.38); H: 0.09 (SD 0.10) microg/l; p = 0.005). Upper gut symptoms were not associated with gender, mast cell counts, jejunal tryptase or basal stress. CONCLUSION: This jejunal mucosal inflammatory profile may help identify diarrhoea-predominant IBS, a stress-related disorder.
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Inflammation is present in IBS, as indicated by studies on mast cells and cytokines.
“Studies on mast cells and cytokines point out that inflammation is present in IBS. 2, 13-20”
From Clinical trial: multispecies probiotic supplementation alleviates the symptoms of irritable bowel syndrome and stabilizes intestinal microbiota (2008) · cites this paper as [14]
Patients with IBS have increased concentrations of inflammatory/immune cells in intestinal tissue compared with controls.
“Evidence supporting this hypothesis includes increased concentrations of inflammatory/immune cells in intestinal tissue from IBS patients, altered levels of pro- and anti-inflammatory cytokines in the GI tract and peripheral blood of patients with IBS (Table 1) (11, 13, 24, 36, 46, 50, 51, 62, 73, 75, 89, 90, 94, 98, 102, 118, 121–124, 168, 174, 185, 187), and IBS-associated polymorphisms in genes”
From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [73]
Concentrations of intestinal epithelial lymphocytes may be increased in the small intestine, colon, and rectum of patients with IBS or PI-IBS.
“The concentrations of intestinal epithelial lymphocytes (IELs) may be increased in the small intestine (73, 174, 185), colon, and rectum (36, 89) of patients with IBS or PI-IBS.”
From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [73]
Other studies have reported elevated levels of histamine and tryptase release in patients with IBS compared with controls.
“Other studies have reported elevated levels of histamine and tryptase release in patients with IBS compared with controls (11, 13, 35, 73).”
From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [73]
Patients with IBS have altered levels of pro- and anti-inflammatory cytokines in the GI tract and peripheral blood compared with controls.
“Evidence supporting this hypothesis includes increased concentrations of inflammatory/immune cells in intestinal tissue from IBS patients, altered levels of pro- and anti-inflammatory cytokines in the GI tract and peripheral blood of patients with IBS (Table 1) (11, 13, 24, 36, 46, 50, 51, 62, 73, 75, 89, 90, 94, 98, 102, 118, 121–124, 168, 174, 185, 187), and IBS-associated polymorphisms in genes”
From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [73]
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- Authors
- Guilarte, M., Santos, J., de Torres, I., Alonso, C., Vicario, M., Ramos, L., Martinez, C., Casellas, F., Saperas, E., & Malagelada, J. R.
- Affiliations
- Universitat Autònoma de Barcelona (ES)
- Corresponding author
- Santos, J.
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2007-02-01
- Volume
- 56
- Issue
- 2
- Pages
- 203-209
- ISSN
- 0017-5749 (ISSN-L)
- PMC
- PMC1856785
- OpenAlex
- W2125423663
- Cited by
- 385
- References
- 63
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 9 · 2023: 13 · 2022: 12 · 2021: 16 · 2020: 13 · 2019: 15 · 2018: 22 · 2017: 25 · 2016: 20 · 2015: 21 · 2014: 31 · 2013: 22 · 2012: 42
- FWCI
- 16.94
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Immunology and Microbiology › Immunology › Mast cells and histamine
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Keywords
- diarrhea-predominant irritable bowel syndrome, mast cells, mast cell activation, jejunal mucosa, mast cell hyperplasia, tryptase, psychological stress, depression, intraepithelial lymphocytes, CD117, stress-related disorders
- MeSH terms
- Adult, Cell Count, Depression, Diarrhea, Female, Humans, Hyperplasia, Immunohistochemistry, Intestinal Mucosa, Jejunum, Male, Mast Cells, Middle Aged, Prospective Studies, Stress, Psychological, Receptors, IgE, Irritable Bowel Syndrome, Tryptases
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