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, 34 (4), 967-74

Stomach Antral Endocrine Cells in Patients With Irritable Bowel Syndrome

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Stomach Antral Endocrine Cells in Patients With Irritable Bowel Syndrome

Magdy El-Salhy et al. Int J Mol Med.

Abstract

To the best of our knowledge, stomach antral endocrine cells have not previously been investigated in patients with irritable bowel syndrome (IBS). Thus, in the present study, 76 patients with IBS were examined (designated as IBS-total). Diarrhoea was the predominant symptom in 26 of these patients (IBS-D), while in 21 patients, the predominant symptoms were both diarrhoea and constipation (IBS-M) and in 29 patients the predominant symptom was constipation (IBS-C). Forty-three healthy subjects were enrolled as the controls. Stomach antral biopsy samples obtained from all of the subjects were immunostained using the avidin-biotin-complex method for serotonin, gastrin, somatostatin and serotonin transporter (SERT). The immunopositive cell densities and immunoreactivity intensities were determined by computer-aided image analysis. The density of the serotonin-immunoreactive cells was significantly decreased in the IBS-M patients and increased in the IBS-C patients relative to the controls. The immunoreactivity intensity did not differ significantly between the controls and IBS-total. The density of the gastrin-immunoreactive cells was significantly greater in the IBS-D, IBS-M and IBS-C patients than in the controls. The immunoreactivity intensity of gastrin was significantly greater in the IBS-D patients than in the controls. The density of the somatostatin-immunoreactive cells cells was significantly lower in the IBS-total, IBS-D, IBS-M and IBS-C patients than in the controls. The immunoreactivity intensities of both somatostatin and SERT did not differ significantly between the controls and IBS-total. The increase in gastrin cell density and the decrease in somatostatin cell density in all IBS subtypes may cause high levels of gastric secretion, which may in turn contribute to the high incidence of dyspepsia and gastro-oesophageal reflux observed in patients with IBS.

Figures

Figure 1
Figure 1
(A) Densities of serotonin-immunoreactive cells and (B) serotonin immunoreactivity intensities in the stomach antrum of the controls and IBS-total, IBS-D, IBS-M and IBS-C patients. *P<0.05, **P<0.01 vs. controls. IBS, irritable bowel syndrome; IBS-total, all 76 patients with IBS in this study; IBS-D, diarrhoea was the predominant symptom in 26 of these patients; IBS-M, predominant symptoms were both diarrhoea and constipation in 21 patients; IBS-C, predominant symptom was constipation in 29 patients.
Figure 2
Figure 2
Antral serotonin-immunoreactive cells in (A) a control subject, in (B) a patient with IBS-M and in (C) a patient with IBS-C. IBS, irritable bowel syndrome; IBS-M, predominant symptoms were both diarrhoea and constipation; IBS-C, predominant symptom was constipation.
Figure 3
Figure 3
(A) Densities of gastrin-immunoreactive cells and (B) gastrin immunoreactivity intensities in the stomach antrum of the controls and IBS-total, IBS-D, IBS-M and IBS-D patients. *P<0.05, **P<0.01, ***P< 0.0001 vs. controls. IBS, irritable bowel syndrome; IBS-total, all 76 patients with IBS in this study; IBS-D, diarrhoea was the predominant symptom in 26 of these patients; IBS-M, predominant symptoms were both diarrhoea and constipation in 21 patients; IBS-C, predominant symptom was constipation in 29 patients.
Figure 4
Figure 4
Gastrin-immunoreactive cells in the stomach antrum of (A) a control subject, (B) a patient with IBS-D and (C) a patient with IBS-C. The immunoreactivity intensity is highest in the patient with IBS-D. IBS, irritable bowel syndrome; IBS-D, diarrhoea was the predominant symptom; IBS-C, predominant symptom was constipation.
Figure 5
Figure 5
(A) Somatostatin-immunoreactive cell densities and (B) somatostatin immunoreactivity intensities in IBS-total, IBS-D, IBS-M and IBS-D patients. *P<0.05, **P<0.01 vs. controls. IBS, irritable bowel syndrome; IBS-total, all 76 patients with IBS in this study; IBS-D, diarrhoea was the predominant symptom in 26 of these patients; IBS-M, predominant symptoms were both diarrhoea and constipation in 21 patients; IBS-C, predominant symptom was constipation in 29 patients.
Figure 6
Figure 6
Stomach antral somatostatin-immunoreactive cells in (A) a control subject and in (B) a patient with IBS-C. IBS, irritable bowel syndrome; IBS-C, predominant symptom was constipation.
Figure 7
Figure 7
SERT immunoreactivity intensities in IBS-total, IBS-D, IBS-M and IBS-D patients. IBS, irritable bowel syndrome; IBS-total, all 76 patients with IBS in this study; IBS-D, diarrhoea was the predominant symptom in 26 of these patients; IBS-M, predominant symptoms were both diarrhoea and constipation in 21 patients; IBS-C, predominant symptom was constipation in 29 patients.
Figure 8
Figure 8
SERT immunoreactivities in the stomach antral epithelium in (A) a control subject and (B) in a patient with IBS-D. IBS, irritable bowel syndrome; IBS-D, diarrhoea was the predominant symptom.

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