Mast cells and cellularity of the colonic mucosa correlated with fatigue and depression in irritable bowel syndrome.
BACKGROUND
A subset of patients with irritable bowel syndrome (IBS) have an increased number of mast cells (MCs) in the colonic mucosa. Psychological factors are believed to contribute to the course of IBS.


OBJECTIVE
To examine associations between fatigue, depression and MCs of the colonic mucosa in IBS.


METHODS
Colonic biopsies were taken from 50 Rome II IBS patients, 21 healthy controls and 11 depressed/fatigued patients without IBS. The cellularity of the lamina propria was determined as the number of inflammatory cells per high power field (hpf) through a 400x microscope. The Fatigue Impact Scale (FIS) and the short form Beck Depression Inventory (BDI) evaluated the severity of fatigue and depression.


RESULTS
IBS patients had a significant increase in the cellularity of the lamina propria compared with controls or with depressed patients (mean (SD) 94.5 (48-110) vs 68 (58-82) and 78 (87-90) cells per hpf, p = 0.005 and p = 0.05, respectively), in particular of MCs (9.3 (5.6-11.7) vs 4.0 (2.7-6.8) and 4.3 (2.8-7.8) cells per hpf, p = 0.001 and p = 0.005, respectively). Both the FIS and BDI scores were significantly higher in IBS or in depressed patients than in controls (p<0.001). In IBS, the FIS score correlated significantly with the cellularity of the lamina propria (r = 0.51, p<0.0001) and MCs (r = 0.64, p<0.0001). In IBS, the BDI score correlated significantly with MCs (r = 0.29, p = 0.03).


CONCLUSIONS
Elevated MCs counts are a key feature of the low-grade inflammatory infiltrate in the caecal mucosa of IBS. Fatigue and depression are associated with mucosal cell counts, in particular MCs, suggesting that psychological factors are associated with the low-grade inflammatory infiltrate in IBS.
Piche
T
T
Fédération d'Hépato-Gastroentérologie et de Nutrition Clinique, Hôpital de l'Archet, Pôle digestif, CHU de Nice, Nice, France. tpiche@fc.horus-medical.fr
Saint-Paul
M C
MC
Dainese
R
R
Marine-Barjoan
E
E
Iannelli
A
A
Montoya
M L
ML
Peyron
J F
JF
Czerucka
D
D
Cherikh
F
F
Filippi
J
J
Tran
A
A
Hébuterne
X
X
D000328:Adult; D000368:Aged; D001706:Biopsy; D003106:Colon / Q000473:pathology*; D003863:Depression / Q000209:etiology / Q000473:pathology*; D005221:Fatigue / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000473:pathology* / Q000523:psychology; D008016:Life Change Events; D008297:Male; D008407:Mast Cells / Q000473:pathology*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales