title: Neuroimmune interactions at different intestinal sites are related to abdominal pain symptoms in children with IBS.
abstract: BACKGROUND
  Neuroimmune interactions and inflammation have been proposed as factors involved in sensory-motor dysfunction and symptom generation in adult irritable bowel syndrome (IBS) patients. In children with IBS and healthy controls, we measured ileocolonic mast cell infiltration and fecal calprotectin and evaluated the relationships between these parameters and abdominal pain symptoms and stooling pattern.
  
  
  METHODS
  Irritable bowel syndrome patients diagnosed according to Pediatric Rome III criteria and healthy controls kept a 2-week pain/stooling diary. Ileocolonic mucosal mast cells (MC) and MC in close proximity to nerve fibers (MC-NF) were identified immunohistochemically and quantified. Fecal calprotectin concentration was measured.
  
  
  RESULTS
  21 IBS patients and 10 controls were enrolled. The MC-NF count was significantly higher in the ileum (p = 0.01), right colon (p = 0.04), and left colon (p < 0.001) of IBS patients compared with controls. No differences in fecal calprotectin concentration were noted. Abdominal pain intensity score correlated with ileal MC count (r(s) = 0.47, p = 0.030) and right colon MC-NF count (r(s) = 0.52, p = 0.015). In addition, children with IBS with >3 abdominal pain episodes/week had greater ileal (p = 0.002) and right colonic (p = 0.01) MC counts and greater ileal (p = 0.05) and right colonic (p = 0.016) MC-NF counts than children with less frequent pain. No relationship was found between MC and MC-NF and fecal calprotectin or stooling pattern.
  
  
  CONCLUSIONS
  Mast cells-nerve fibers counts are increased in the ileocolonic mucosa of children with IBS. Mast cells and MC-NF counts are related to the intensity and frequency of abdominal pain.
authors.affiliation: Department of Pediatrics, Pediatric Gastroenterology Unit, "Sapienza" University of Rome, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Di Nardo
authors.forename: G
authors.initials: G
authors.lastname: Barbara
authors.forename: S
authors.initials: S
authors.lastname: Cucchiara
authors.forename: C
authors.initials: C
authors.lastname: Cremon
authors.forename: R J
authors.initials: RJ
authors.lastname: Shulman
authors.forename: S
authors.initials: S
authors.lastname: Isoldi
authors.forename: L
authors.initials: L
authors.lastname: Zecchi
authors.forename: L
authors.initials: L
authors.lastname: Drago
authors.forename: S
authors.initials: S
authors.lastname: Oliva
authors.forename: R
authors.initials: R
authors.lastname: Saulle
authors.forename: M R
authors.initials: MR
authors.lastname: Barbaro
authors.forename: L
authors.initials: L
authors.lastname: Stronati
mesh_terms: D015746:Abdominal Pain / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007422:Intestines / Q000473:pathology; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis; D008297:Male; D008407:Mast Cells / Q000473:pathology; D009412:Nerve Fibers / Q000473:pathology; D015213:Neuroimmunomodulation
chemical_list: D039841:Leukocyte L1 Antigen Complex
keywords: children; functional gastrointestinal disorders; inflammation; irritable bowel syndrome