title: Clinical-histological associations in gastroparesis: results from the Gastroparesis Clinical Research Consortium.
abstract: BACKGROUND
  Cellular changes associated with diabetic (DG) and idiopathic gastroparesis (IG) have recently been described from patients enrolled in the Gastroparesis Clinical Research Consortium. The association of these cellular changes with gastroparesis symptoms and gastric emptying is unknown. The aim of this study was to relate cellular changes to symptoms and gastric emptying in patients with gastroparesis.
  
  
  METHODS
  Earlier, using full thickness gastric body biopsies from 20 DG, 20 IG, and 20 matched controls, we found decreased interstitial cells of Cajal (ICC) and enteric nerves and an increase in immune cells in both DG and IG. Here, demographic, symptoms [gastroparesis cardinal symptom index score (GCSI)], and gastric emptying were related to cellular alterations using Pearson's correlation coefficients.
  
  
  RESULTS
  Interstitial cells of Cajal counts inversely correlated with 4 h gastric retention in DG but not in IG (r = -0.6, P = 0.008, DG, r = 0.2, P = 0.4, IG). There was also a significant correlation between loss of ICC and enteric nerves in DG but not in IG (r = 0.5, P = 0.03 for DG, r = 0.3, P = 0.16, IG). Idiopathic gastroparesis with a myenteric immune infiltrate scored higher on the average GCSI (3.6 ± 0.7 vs 2.7 ± 0.9, P = 0.05) and nausea score (3.8 ± 0.9 vs 2.6 ± 1.0, P = 0.02) as compared to those without an infiltrate.
  
  
  CONCLUSIONS
  In DG, loss of ICC is associated with delayed gastric emptying. Interstitial cells of Cajal or enteric nerve loss did not correlate with symptom severity. Overall clinical severity and nausea in IG is associated with a myenteric immune infiltrate. Thus, full thickness gastric biopsies can help define specific cellular abnormalities in gastroparesis, some of which are associated with physiological and clinical characteristics of gastroparesis.
authors.affiliation: Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: M
authors.initials: M
authors.lastname: Grover
authors.forename: C E
authors.initials: CE
authors.lastname: Bernard
authors.forename: P J
authors.initials: PJ
authors.lastname: Pasricha
authors.forename: M S
authors.initials: MS
authors.lastname: Lurken
authors.forename: M S
authors.initials: MS
authors.lastname: Faussone-Pellegrini
authors.forename: T C
authors.initials: TC
authors.lastname: Smyrk
authors.forename: H P
authors.initials: HP
authors.lastname: Parkman
authors.forename: T L
authors.initials: TL
authors.lastname: Abell
authors.forename: W J
authors.initials: WJ
authors.lastname: Snape
authors.forename: W L
authors.initials: WL
authors.lastname: Hasler
authors.forename: R W
authors.initials: RW
authors.lastname: McCallum
authors.forename: L
authors.initials: L
authors.lastname: Nguyen
authors.forename: K L
authors.initials: KL
authors.lastname: Koch
authors.forename: J
authors.initials: J
authors.lastname: Calles
authors.forename: L
authors.initials: L
authors.lastname: Lee
authors.forename: J
authors.initials: J
authors.lastname: Tonascia
authors.forename: A
authors.initials: A
authors.lastname: Ünalp-Arida
authors.forename: F A
authors.initials: FA
authors.lastname: Hamilton
authors.forename: G
authors.initials: G
authors.lastname: Farrugia
mesh_terms: D000328:Adult; D000368:Aged; D017615:Enteric Nervous System / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D005746:Gastric Emptying / Q000502:physiology; D018589:Gastroparesis / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D056885:Interstitial Cells of Cajal / Q000473:pathology / Q000502:physiology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013270:Stomach / Q000473:pathology* / Q000503:physiopathology; D011795:Surveys and Questionnaires