Increased rectal mucosal enteroendocrine cells, T lymphocytes, and increased gut permeability following acute Campylobacter enteritis and in post-dysenteric irritable bowel syndrome
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BACKGROUND AND AIMS: Post-dysenteric irritable bowel syndrome (PD-IBS) develops in up to 25% of patients following Campylobacter enteritis. Our aim was to define the pathological basis of this subgroup of IBS. METHODS: Twenty one patients (group 1) underwent serial rectal biopsy and gut permeability testing following acute Campylobacter enteritis as did 10 PD-IBS patients (group 2) and 12 asymptomatic controls. RESULTS: In group 1, enteroendocrine cell (EC) numbers were markedly increased initially and at six and 12 weeks (p<0.001) compared with controls. Gut permeability, as assessed by the lactulose/mannitol ratio, was significantly elevated, initially and at 12 weeks (p<0.005). CD3, CD4, and CD8 lymphocyte counts in the lamina propria and intraepithelial lymphocytes (IEL) were significantly increased initially compared with controls. At visit 1, EC numbers were positively correlated with CD3 counts ( r =0.6, p=0.01). At one year, seven subjects (five with persistent loose stools) had rectal biopsies which showed significantly elevated EC, CD3, and IEL counts. In group 2, EC and IEL counts were significantly increased compared with controls (p<0.001), as was gut permeability (p<0.01). CONCLUSION: Increased EC, T lymphocytes, and gut permeability are acute changes following Campylobacter enteritis which can persist for more than a year and may contribute to PD-IBS.
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Increased concentrations of CD3+ T cells in the colon and rectum and in the myenteric plexus of the small intestine were increased in patients with IBS or PI-IBS compared with normal controls.
“Additionally, increased concentrations of CD3+ T cells in the colon and rectum and in the myenteric plexus of the small intestine were increased in these patients compared with normal controls (36, 46, 57, 58, 89, 94, 133, 168, 174).”
From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [168]
Some studies failed to demonstrate increased activated mast cells in IBS patients.
“However, some studies failed to demonstrate increased activated mast cells in IBS patients (35, 36, 57, 58, 168) and there are no consistent differences in the tissue concentrations of activated mast cells in patients with different IBS subtypes (36, 189).”
From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [168]
In patients with PI-IBS, activation of the GI immune system follows acute GI infection.
“The importance of the interaction between the intestinal microbiota and immune system in IBS patients is demonstrated by a few studies in patients with PI-IBS, indicating activation of the GI immune system following the acute GI infection (57, 58, 75, 89, 94, 124, 168, 170, 187)”
From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [168]
Mesalamine 3.2 g/day for 12 wk and prednisolone 30 mg/day for 3 wk were not effective in improving GI symptoms in patients with PI-IBS.
“Similarly, mesalamine 3.2 g/day for 12 wk (168) and prednisolone 30 mg/day for 3 wk (52) were not effective in improving the GI symptoms in patients with PI-IBS.”
From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [168]
There is increasing evidence of activation of the intestinal immune system in IBS leading to micro-inflammation, with increased mucosal intraepithelial lymphocytes, mast cells and 5-hydroxytryptamine-secreting enterochromaffin cells.
“First, there is increasing evidence of an activation of the intestinal immune system in IBS leading in a micro-inflammation, with studies demonstrating increased concentrations of mucosal intraepithelial lymphocytes [65,66] , mast cells [6669] and 5hydroxytryptaminesecreting enterochromaffin cells [65] .”
From Gut microbiota role in irritable bowel syndrome: New therapeutic strategies (2016) · cites this paper as [65]
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- Authors
- Spiller, R. C., Jenkins, D., Thornley, J. P., Hebden, J. M., Wright, T., Skinner, M., & Neal, K. R.
- Affiliations
- aDivision of Gastroenterology, University Hospital Nottingham, Nottingham, UK, bDepartment of Pathology, University Hospital Nottingham, Nottingham, UK, cDepartment of Public Health Medicine, University Hospital Nottingham, Nottingham, UK
- Nottingham University Hospitals NHS Trust (GB)
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2000-12-01
- Volume
- 47
- Issue
- 6
- Pages
- 804-811
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1728147
- OpenAlex
- W1970178265
- Cited by
- 1,155
- References
- 51
- Citations by year
- 2026: 17 · 2025: 13 · 2024: 17 · 2023: 24 · 2022: 23 · 2021: 46 · 2020: 24 · 2019: 29 · 2018: 46 · 2017: 38 · 2016: 51 · 2015: 42 · 2014: 69 · 2013: 57 · 2012: 76
- FWCI
- 30.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Epidemiology › Microscopic Colitis
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Keywords
- campylobacteriosis, enteroendocrine cells, T cells, intestinal permeability, intraepithelial lymphocytes, lamina propria lymphocytes, rectal mucosa, lactulose/mannitol ratio
- MeSH terms
- Acute Disease, Adult, Aged, Biopsy, Campylobacter Infections, Cell Count, Colonic Diseases, Functional, Enteritis, Female, Humans, Intestinal Mucosa, Life Change Events, Lymphocytosis, Male, Mast Cells, Middle Aged, Permeability, T-Lymphocytes, Antigens, CD, Enteroendocrine Cells
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