Implications of eosinophilia in the normal duodenal biopsy – an association with allergy and functional dyspepsia

Abstract

SUMMARY BackgroundAllergy and functional gastrointestinal disorders have been associated with eosinophilia in duodenal mucosa.

Immune Activation in Irritable Bowel Syndrome: Can Neuroimmune Interactions Explain Symptoms?

“…However, several studies have linked eosinophil numbers with functional dyspepsia, a functional GI disorder associated with upper abdominal discomfort and disordered motility ( 79,80 ). Little is known about the eff ects eosinophilderived mediators have on GI nerves.…”

Analysis of Gastric and Duodenal Eosinophils in Children with Abdominal Pain Related Functional Gastrointestinal Disorders According to Rome III Criteria

“…19,20 Platelet aggregating factor, leukotrienes, and IL-13 are also able to act directly on the smooth muscle cells, thereby increasing contractility and reactivity. 19,20 Thus, the accumulation and degranulation of eosinophils gives rise to neural stimulation and smooth muscle contraction, which consequently produces gastrointestinal symptoms, such as abdominal cramps, abdominal discomfort, and flatulence. 16,19,20,48 According to a study by Schappi et al, 49 children with atopic FD demonstrated increased eosinophils and mast cells within the antrum, and these cells degranulated rapidly after a cow's milk challenge unlike in children with non-atopic FD.…”

“…16,46 With the release of cytokines, such as IL-4, IL-5, and IL-13 from type 2 T helper cells during the inflammatory response, activated eosinophils are ready for massive degranulation. 11,16,20,47 Degranulation contents, such as the nerve growth factor, have a direct influence on sensory nerves, and major basic proteins can induce vagal nerve muscarinic receptor 2 dysfunction. 19,20 Platelet aggregating factor, leukotrienes, and IL-13 are also able to act directly on the smooth muscle cells, thereby increasing contractility and reactivity.…”

“…11,16,20,47 Degranulation contents, such as the nerve growth factor, have a direct influence on sensory nerves, and major basic proteins can induce vagal nerve muscarinic receptor 2 dysfunction. 19,20 Platelet aggregating factor, leukotrienes, and IL-13 are also able to act directly on the smooth muscle cells, thereby increasing contractility and reactivity. 19,20 Thus, the accumulation and degranulation of eosinophils gives rise to neural stimulation and smooth muscle contraction, which consequently produces gastrointestinal symptoms, such as abdominal cramps, abdominal discomfort, and flatulence.…”

“…In adult FD patients, gastric eosinophil counts tend not to be significantly increased, but the duodenal eosinophil count and duodenal degranulation is prominently increased. 13,[16][17][18][19][20][21] On the other hand, several studies also show increased infiltration and degranulation of gastric and duodenal mast cells in adult FD patients. 16,[22][23][24] In adult patients with IBS, most studies demonstrate increased infiltration of mast cells in all parts of the duodenum, 14 jejunum, 25 ileum, 26 and colon, 12,[27][28][29][30][31] with the exception of a few studies.…”