Increased Mast Cell Counts and Degranulation in Microscopic Colitis

Chi, Zhikai; Xu, Jin; Saxena, Romil

doi:10.1155/2020/9089027

Cited by 7 publications

(6 citation statements)

References 26 publications

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“…Mast cells have been shown to have an association with multiple gastrointestinal tract diseases, including chronic diarrhea of unknown etiology with normal colonoscopy [ 97 ], diarrhea-predominant irritable bowel syndrome [ 98 ], and IBD [ 93 ]. Chi studied the pathology tissue of 64 patients, consisting of 29 patients with collagenous colitis, 35 patients with lymphocytic colitis, and 20 control patients [ 99 ]. There was a higher number of mast cells in the lamina propria of patients with collagenous colitis (mean highest mast cell count 39/high power field (HPF) and lymphocytic colitis (30/HPF) compared to the control (23/HPF) with a p -value < 0.01 [ 99 ].…”

Section: Fecal Biomarkersmentioning

confidence: 99%

“…Chi studied the pathology tissue of 64 patients, consisting of 29 patients with collagenous colitis, 35 patients with lymphocytic colitis, and 20 control patients [ 99 ]. There was a higher number of mast cells in the lamina propria of patients with collagenous colitis (mean highest mast cell count 39/high power field (HPF) and lymphocytic colitis (30/HPF) compared to the control (23/HPF) with a p -value < 0.01 [ 99 ]. The patients with collagenous colitis had increased tryptase levels compared to the control patients, 40% compared to 10%, respectively, with a p -value of <0.01 [ 99 ].…”

Section: Fecal Biomarkersmentioning

confidence: 99%

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Microscopic Colitis: Pathogenesis and Diagnosis

Songtanin

Chen

Nugent

2023

JCM

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Microscopic colitis is a type of inflammatory bowel disease and is classified as either collagenous colitis or lymphocytic colitis. The typical presentation is chronic watery diarrhea. The disease occurs more frequently in women aged 60–65 years and is increasing in incidence. The pathophysiology of microscopic colitis remains poorly understood and has not been well-described with possible several pathogeneses. To date, the diagnosis of microscopic colitis depends on histological tissue obtained during colonoscopy. Other non-invasive biomarkers, such as inflammatory markers and fecal biomarkers, have been studied in microscopic colitis, but the results remains inconclusive. The approach to chronic diarrhea is important and being able to differentiate chronic diarrhea in patients with microscopic colitis from other diseases, such as inflammatory bowel disease, functional diarrhea, and malignancy, by using non-invasive biomarkers would facilitate patient management. The management of microscopic colitis should be based on each individual’s underlying pathogenesis and involves budesonide, bile acid sequestrants, or immunosuppressive drugs in refractory cases. Cigarette smoking and certain medications, especially proton pump inhibitors, should be eliminated, when possible, after the diagnosis is made.

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Section: Fecal Biomarkersmentioning

confidence: 99%

Section: Fecal Biomarkersmentioning

confidence: 99%

Microscopic Colitis: Pathogenesis and Diagnosis

Songtanin

Chen

Nugent

2023

JCM

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“…25 Increased numbers of MC, and high levels of extracellular tryptase, a marker of degranulation, have been reported as well in collagenous colitis. 26 IBS represents the most common cause of chronic non-bloody diarrhea in western countries, but the occurrence and role of MC in IBS are debated. Thus, MC in biopsies from IBS-D patients is not routinely investigated.…”

Section: Introductionmentioning

confidence: 99%

“…The role of MC in other pathologic conditions is less clear, but they are likely involved in IBS, IBD, microscopic colitis, and eosinophilic colitis. 12,19,[24][25][26][27] In animal models of colitis, the activation of intestinal MC results in flare-ups of inflammation. 28 MC and their mediators, located within the muscle layer, near stenotic segments are likely involved in the fibrotic process in Crohn's disease.…”

Section: Introductionmentioning

confidence: 99%

Is mastocytic colitis a specific clinical-pathological entity?

et al. 2022

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The number of intestinal mast cells (MC) is increased in several types of colitis, but the mucosa of patients with chronic non-bloody diarrhea has not been studied. The current study sought to determine the relationship between MC counts and degranulation and the severity of symptoms in patients with chronic loose stools. Following a negative laboratory workup for the most common causes of chronic diarrhea, patients with chronic non-bloody loose stools were included in the study. Patients with macroscopic evidence of inflammation or organic disease were excluded after endoscopy with biopsies. Biopsies from the 179 patients in the study were stained with hematoxylin and eosin and anti-CD117 c-kit antibodies. Immunohistochemistry was used to assess the degree of MC degranulation. Out of the 179 patients, 128 had normal histologic findings suggestive of irritable bowel syndrome and were used as controls. Twenty-four presented with abnormally high MC counts (≥40 MC x HPF), 23 with ≥20 intraepithelial lymphocytes x HPF suggesting lymphocytic colitis, and 4 had both (≥40 MC and ≥20 intraepithelial lymphocytes x HPF). In the patients with high MC counts, figures were significantly higher in the right colon versus the left colon (p=0.016), but degranulation did not differ in the right versus the left colon (p=0.125). No age or sex-related difference was observed (p=0.527 and p=0.859 respectively). The prevalence of abdominal pain and bloating did not differ in the three groups (p=0.959 and p=0.140, respectively). Patients with lymphocytic colitis (p=0.008) and those with high MC counts (p=0.025) had significantly higher evacuation rates compared to controls. There was no difference between these two groups (p=0.831). Mast cell degranulation was not associated with the number of evacuations, abdominal pain, or bloating (p=0.51; p=0.41; p=0.42, respectively). The finding that a significantly higher number of evacuations was linked to increased MC in the colonic mucosa of a subset of patients with otherwise normal laboratory and endoscopic findings suggests that "mastocytic colitis" may be a new clinical-pathological entity responsible for chronic non-bloody diarrhea. Prospective studies with a larger number of patients, as well as endoscopic and histological follow-up, are needed to confirm this hypothesis.

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“…However, less examined histopathological parameters could also correlate with disease activity and treatment response. The numbers of mast cells, 5 enteroendocrine cells 6 and the composition of different subgroups of T lymphocytes have been shown to be changed in patients with microscopic colitis 7 . Further characterisation of these specific subgroups might reveal a relationship with disease activity.…”

mentioning

confidence: 99%