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Intestinal immune activation in presumed post‐infectious functional dyspepsia
Author(s) -
Kindt S.,
Tertychnyy A.,
De Hertogh G.,
Geboes K.,
Tack J.
Publication year - 2009
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/j.1365-2982.2009.01299.x
Subject(s) - gastroenterology , medicine , crypt , cd8 , immune system , stomach , cd68 , irritable bowel syndrome , inflammation , hyperplasia , immunology , immunohistochemistry
Functional dyspepsia (FD) symptoms may develop after an acute gastroenteritis. In post‐infectious (PI) irritable bowel syndrome, persisting low‐grade colonic inflammation and increased enterochromaffine cells (EC) counts have been reported. The aim was to compare signs of inflammation and EC hyperplasia on duodenal biopsies in presumed PI‐FD and unspecified‐onset (U‐)FD. Duodenal biopsies were obtained in 12 U‐FD and 12 PI‐FD (on average 13 months after the acute event) patients. The presence of intra‐epithelial, intravillar, and the number of CD3, CD4, CD8 and CD68+ cells per crypts, and the mean number of Chromogranine A (CA) positive cells per villus were compared. We also measured gastric emptying and assessed proximal stomach function with a barostat. Data are shown as mean ± SEM. Focal aggregates of T cells and focal CD8+ aggregates, were found in PI‐FD but not in U‐FD patients (respectively 5/12 vs 0/12, P = 0.02 and 5/9 vs 0/11, P < 0.01). In patients with focal aggregates, gastric emptying was delayed (189 ± 37 min vs 98 ± 11 min, P = 0.002). The number of CD4+ cells per crypt (0.52 ± 1.6 vs 1.22 ± 2.18, P = 0.04), and the number of intravillar CD4+ cells (0.5 ± 0.2 vs 2.7 ± 0.7, P = 0.01) were reduced, while the number of CD68+ cells per crypt was increased (0.64 ± 0.13 vs 0.40 ± 0.05, P = 0.03) in PI‐FD. The number of EC and CA were comparable. PI‐FD is associated with persisting focal T‐cell aggregates, decreased CD4+ cells and increased macrophage counts surrounding the crypts. This may indicate impaired ability of the immune system to terminate the inflammatory response after acute insult.