title: Duodenal mastocytosis, eosinophilia and intraepithelial lymphocytosis as possible disease markers in the irritable bowel syndrome and functional dyspepsia.
abstract: BACKGROUND
  Irritable bowel syndrome (IBS) and functional dyspepsia (FD) are common functional disorders without defined pathology. Mast cells and eosinophils interact with T lymphocytes and may alter enteric nerve and smooth muscle function.
  
  
  OBJECTIVE
  To examine mast cell, eosinophil and intraepithelial lymphocyte populations in duodenal biopsies of subjects with IBS and FD.
  
  
  METHODS
  A random sample of an adult Swedish population (n = 1001; mean age 54 years; 51% female) underwent upper endoscopy and biopsy; 51 cases with FD and 41 cases with IBS were compared with 48 randomly selected controls. Eosinophils were identified by light microscopy; mast cells by immunocytochemistry (CD117). Intraepithelial lymphocytes were counted per 100 enterocytes. Cell counts were quantified by counting the number per high power field (HPF) in 5HPFs in the bulb (D1) and second part of duodenum (D2), summed over 5HPFs at each site.
  
  
  RESULTS
  Cases and controls showed similar demographics. Compared to controls, IELs in IBS-constipation were significantly increased (P = 0.005). Mast cells were significantly increased in IBS in D2 (P < 0.001), while eosinophils were significantly increased in FD in D1 and D2 (P < 0.001).
  
  
  CONCLUSIONS
  Duodenal mast cell hyperplasia is linked to IBS and eosinophilia to FD, and duodenal biopsy may identify subsets of these disorders.
authors.affiliation: Department of Histopathology, Faculty of Medicine, St Mary's Campus, Imperial College, London, UK. mm.walker@imperial.ac.uk
authors.forename: M M
authors.initials: MM
authors.lastname: Walker
authors.forename: N J
authors.initials: NJ
authors.lastname: Talley
authors.forename: M
authors.initials: M
authors.lastname: Prabhakar
authors.forename: C J
authors.initials: CJ
authors.lastname: Pennaneac'h
authors.forename: P
authors.initials: P
authors.lastname: Aro
authors.forename: J
authors.initials: J
authors.lastname: Ronkainen
authors.forename: T
authors.initials: T
authors.lastname: Storskrubb
authors.forename: W S
authors.initials: WS
authors.lastname: Harmsen
authors.forename: A R
authors.initials: AR
authors.lastname: Zinsmeister
authors.forename: L
authors.initials: L
authors.lastname: Agreus
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D004378:Duodenal Diseases / Q000473:pathology*; D004415:Dyspepsia / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology; D004802:Eosinophilia / Q000276:immunology* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D043183:Irritable Bowel Syndrome / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology; D008218:Lymphocytosis / Q000276:immunology* / Q000473:pathology; D008297:Male; D008415:Mastocytosis / Q000276:immunology* / Q000473:pathology; D008875:Middle Aged
chemical_list: D015415:Biomarkers