Open AccessDownregulation of mucosal mast cell activation and immune response in diarrhoea‐irritable bowel syndrome by oral disodium cromoglycate: A pilot study
Author(s) -
Lobo Beatriz,
Ramos Laura,
Martínez Cristina,
Guilarte Mar,
GonzálezCastro Ana M,
AlonsoCotoner Carmen,
Pigrau Marc,
Torres Inés,
RodiñoJaneiro Bruno K,
SalvoRomero Eloisa,
Fortea Marina,
PardoCamacho Cristina,
Guagnozzi Danila,
Azpiroz Fernando,
Santos Javier,
Vicario María
Publication year - 2017
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640617691690
Subject(s) - irritable bowel syndrome , medicine , immune system , mast cell , abdominal pain , gastroenterology , innate immune system , immunology , placebo , pathology , alternative medicine
Background and goal Diarrhoea‐predominant irritable bowel syndrome (IBS‐D) exhibits intestinal innate immune and mucosal mast cell (MC) activation. MC stabilisers have been shown to improve IBS symptoms but the mechanism is unclear. Our primary aim was to investigate the effect of oral disodium cromoglycate (DSCG) on jejunal MC activation and specific innate immune signalling pathways in IBS‐D, and secondarily, its potential clinical benefit. Study Mucosal MC activation (by ultrastructural changes, tryptase release and gene expression) and innate immune signalling (by protein and gene expression) were quantified in jejunal biopsies from healthy (HS; n = 16) and IBS‐D subjects after six months of either treatment with DSCG (600 mg/day, IBS‐D‐DSCG group; n = 18) or without treatment (IBS‐D‐NT group; n = 25). All IBS‐D patients recorded abdominal pain and bowel habits at baseline and in the last 10 days prior to jejunal sampling. Results IBS‐D‐NT exhibited significant MC activation and over‐expression of immune‐related genes as compared to HS, whereas in IBS‐D‐DSCG MC activity and gene expression were similar to HS. Furthermore, DSCG significantly reduced abdominal pain and improved stool consistency. Conclusion Oral DSCG modulates mucosal immune activity and improves gut symptoms in IBS‐D patients. Future placebo‐controlled clinical trials are needed for confirmation of clinical benefit of DSCG for IBS‐D.