Duodenal Eosinophils and Mast Cells in Functional Dyspepsia: A Systematic Review and Meta-Analysis of Case-Control Studies

Shah, Ayesha; Fairlie, Thomas; Brown, Georgia; Jones, Michael P.; Eslick, Guy D.; Duncanson, Kerith; Thapar, Nikhil; Keely, Simon; Koloski, Natasha A.; Shahi, Mohit Kumar; Walker, Marjorie M.; Talley, Nicholas J.; Holtmann, Gerald

doi:10.1016/j.cgh.2022.01.014

Cited by 33 publications

(35 citation statements)

References 75 publications

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“…59 69 In the initial reports, it was suggested that duodenal eosinophilia was a feature of PDS, 72 but a recent meta-analysis showed similar counts in the FD subgroups. 69 Nevertheless-and similar to data on mast cell on January 29, 2023 by guest. Protected by copyright.…”

Section: Immune Cell Infiltration and Activationsupporting

confidence: 85%

“…Moreover, as discussed above, IBS supernatant-induced hyperreactivity of neurons which could be blocked by histamine receptor H1 antagonists and protease inhibitors, underscoring the importance of mast cell derived soluble mediators in neuronal hyperreactivity 32 33 47. The role of mast cells in FD is less established, although a few studies have shown increased duodenal mast cell counts 59 69. Mast cell activation in FD is suggested by a study using electron microscopy showing more heterogeneous granules in duodenal mast cells in FD and evidence of increased release of histamine and tryptase from gastric biopsies 36 70.…”

Section: Immune Activationmentioning

confidence: 96%

“…In FD, however, a more prominent role has been attributed to duodenal eosinophil infiltration which has been reported by multiple groups (figure 4). 69 Duodenal eosinophils as well as their activation and degranulation were often also linked to symptoms, although only based on statistical correlations and mechanistic evidence is still largely lacking 59 69. In the initial reports, it was suggested that duodenal eosinophilia was a feature of PDS,72 but a recent meta-analysis showed similar counts in the FD subgroups 69.…”

Section: Immune Activationmentioning

confidence: 99%

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Understanding neuroimmune interactions in disorders of gut–brain interaction: from functional to immune-mediated disorders

Vanuytsel

Berčík

Boeckxstaens

2023

Gut

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Functional gastrointestinal disorders—recently renamed into disorders of gut–brain interaction—such as irritable bowel syndrome and functional dyspepsia are highly prevalent conditions with bothersome abdominal symptoms in the absence of structural abnormalities. While traditionally considered as motility disorders or even psychosomatic conditions, our understanding of the pathophysiology has evolved significantly over the last two decades. Initial observations of subtle mucosal infiltration with immune cells, especially mast cells and eosinophils, are since recently being backed up by mechanistic evidence demonstrating increased release of nociceptive mediators by immune cells and the intestinal epithelium. These mediators can activate sensitised neurons leading to visceral hypersensitivity with bothersome symptoms. The interaction between immune activation and an impaired barrier function of the gut is most likely a bidirectional one with alterations in the microbiota, psychological stress and food components as upstream players in the pathophysiology. Only few immune-targeting treatments are currently available, but an improved understanding through a multidisciplinary scientific approach will hopefully identify novel, more precise treatment targets with ultimately better outcomes.

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Section: Immune Cell Infiltration and Activationsupporting

confidence: 85%

Section: Immune Activationmentioning

confidence: 96%

Section: Immune Activationmentioning

confidence: 99%

See 1 more Smart Citation

Understanding neuroimmune interactions in disorders of gut–brain interaction: from functional to immune-mediated disorders

Vanuytsel

Berčík

Boeckxstaens

2023

Gut

View full text Add to dashboard Cite

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“…For instance, Wauters et al 56 suggested increased Streptococcus occurs with both short term use of PPI in FD subjects, and in FD subjects after long-term PPI use, and in the latter group, might ultimately be associated with increased eosinophil infiltration. Indeed, previous studies have linked density of eosinophil or mast cell infiltration into the duodenal mucosa,7 along with cytokine levels and circulating gut-homing T lymphocytes,9 with FD symptoms. Here, we have shown that the differences in relative abundances of Firmicutes ( Streptococcus ), Bacteroidota ( Prevotella ) and Fusobacteriota ( Fusobacterium ) could be linked to symptom burden in FD subjects, with those who reported the highest symptom burden also having the greatest proportions of Streptococcus .…”

Section: Discussionmentioning

confidence: 99%

“…More recently, evidence for potential mechanisms that may underlie functional changes and symptoms in FD have emerged. Increased permeability of the duodenal mucosa has been observed,6 along with low level inflammation, characterised by the presence of eosinophils and in some cases mast cells 7. These cells are capable of releasing mediators that may alter epithelial permeability and intestinal sensorimotor function 8.…”

Section: Introductionmentioning

confidence: 99%

Alterations to the duodenal microbiota are linked to gastric emptying and symptoms in functional dyspepsia

Shanahan

Kang

Staudacher

et al. 2022

Gut

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ObjectiveFunctional dyspepsia (FD) is a complex disorder, with debilitating epigastric symptoms. Evidence suggests alterations in gastrointestinal (GI) motility, visceral hypersensitivity, permeability and low-level immune activation in the duodenum may play a role. However, we still have a relatively poor understanding of how these factors interact to precipitate the onset of FD symptoms which are frequently meal related. The duodenal microbiota, in combination with specific dietary substrates, may be important mediators in disease pathophysiology; however, these interlinked factors have not been thoroughly investigated in FD.DesignEighty-six individuals (56 FD, 30 controls) undergoing endoscopy were consecutively recruited and underwent detailed clinical assessment, including upper GI symptoms, gastric emptying and dietary assessment. Duodenal biopsies were obtained aseptically, and the mucosa-associated microbiota (MAM) analysed via 16S rRNA gene amplicon sequencing.ResultsThe relative abundances of predominant members of the Firmicutes, Bacteroidota and Fusobacteriota phyla were linked to symptom burden in FD. Inverse relationships between the relative abundances of Streptococcus and Prevotella, and the relative abundance of Veillonella spp with gastric emptying time, were also observed. No significant differences in long-term nutrient intake or diet quality were found between FD and controls, and there appeared to be limited association between habitual diet and duodenal MAM profiles.ConclusionThis study suggests a link between the duodenal MAM, gastric emptying and FD symptoms, and this is largely independent of long-term dietary intake.

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Correlation between anxiety and decreased quality of life in patients with non‐esophageal eosinophilic gastrointestinal diseases

Tanaka,

Kanamori,

Sawada

et al. 2023

JGH Open

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Background and AimMental status such as anxiety and depression in patients with non‐esophageal eosinophilic gastrointestinal diseases (non‐EoE EGIDs) has not been studied. The aim of this study was to evaluate whether patients with non‐EoE EGIDs had mental disorders and decreased mental‐health‐related quality of life (QOL) similar to those in patients with disorders of gut–brain interaction (DGBI).MethodsWe enrolled patients with non‐EoE EGIDs and DGBI visiting the Osaka Metropolitan University Hospital, and the measures listed below were compared between the groups. We collected data using the following questionnaires: hospital anxiety and depression scale, and short form (SF)‐8 including mental component summary (MCS)‐8.ResultsWe evaluated 21 and 17 patients with non‐EoE EGIDs and DGBI, respectively. The anxiety score was not significantly different between the groups. The proportion of patients with possible anxiety was not significantly different between the groups (19.0% vs 33.3%). These results show that patients with non‐EoE EGIDs had anxiety that might be equivalent to that of patients with DGBI. The depression score and proportion of patients with possible depression in the non‐EoE EGID group tended to be lower than those in the DGBI group. MCS‐8 scores were not significantly different between the non‐EoE EGID and DGBI groups, which might imply an equivalent decrease in mental‐health‐related QOL in both groups of patients. In patients with non‐EoE EGIDs, the anxiety score had a significant inverse association with the MCS‐8 score.ConclusionsPatients with non‐EoE EGIDs may have anxiety that correlates with decreased mental‐health‐related QOL.

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Duodenal Eosinophils and Mast Cells in Functional Dyspepsia: A Systematic Review and Meta-Analysis of Case-Control Studies

Cited by 33 publications

References 75 publications

Understanding neuroimmune interactions in disorders of gut–brain interaction: from functional to immune-mediated disorders

Understanding neuroimmune interactions in disorders of gut–brain interaction: from functional to immune-mediated disorders

Alterations to the duodenal microbiota are linked to gastric emptying and symptoms in functional dyspepsia

Correlation between anxiety and decreased quality of life in patients with non‐esophageal eosinophilic gastrointestinal diseases

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