Gallbladder wall inflammatory cells in pediatric patients with biliary dyskinesia and cholelithiasis: a pilot study.
OBJECTIVE
Inflammation has been implicated in functional gastrointestinal disorders, including functional dyspepsia and irritable bowel syndrome. This study was undertaken to evaluate gallbladder wall inflammatory cells in children with abdominal pain related to gallstones and biliary dyskinesia to determine the candidate cell types that may be contributing to the pathophysiology of these entities.


METHODS
Gallbladder specimens from 20 patients with cholelithiasis, 20 biliary patients with dyskinesia, and 12 autopsy controls were evaluated in a blinded fashion. Eosinophil, tryptase-positive, and CD3+ cell densities were determined for the lamina propria and muscularis mucosa layers and compared between groups.


RESULTS
Patients with biliary dyskinesia and cholelithiasis had a 9- to 12-fold increase in mean and peak mast cell densities, respectively, in both layers as compared with controls. Peak (13.7 vs 8.4) and mean (9.2 vs 5.2) CD3+ cell densities were increased in the muscularis mucosae of cholelithiasis specimens as compared with biliary dyskinesia specimens.


CONCLUSIONS
Gallbladder wall inflammatory cell densities, particularly mast cells, differ between children with cholelithiasis, children with biliary dyskinesia, and controls. Future studies are warranted to define the roles for specific inflammatory cell types.
Rau
Brian
B
University of Missouri-Kansas City, Kansas City, MO, USA.
Friesen
Craig A
CA
Daniel
James F
JF
Qadeer
Adnan
A
You-Li
Ding
D
Roberts
Charles C
CC
Holcomb
George W
GW
D000293:Adolescent; D001657:Biliary Dyskinesia / Q000276:immunology* / Q000473:pathology / Q000601:surgery; D017252:CD3 Complex; D002648:Child; D002675:Child, Preschool; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000276:immunology* / Q000473:pathology / Q000601:surgery; D004804:Eosinophils; D005260:Female; D005704:Gallbladder / Q000276:immunology* / Q000473:pathology; D006801:Humans; D008297:Male; D008407:Mast Cells; D010865:Pilot Projects; D012697:Serine Endopeptidases; D053802:Tryptases
D017252:CD3 Complex; D012697:Serine Endopeptidases; D053802:Tryptases