Degranulated Eosinophils Contain More Fine Nerve Fibers in the Duodenal Mucosa of Patients With Functional Dyspepsia
이민진, 정혜경, 이고은, 문영철, 박상희,
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이민진 ( Lee Min-Jin )
Ewha Womans University School of Medicine Department of Internal Medicine
정혜경 ( Jung Hye-Kyung )
Ewha Womans University School of Medicine Department of Internal Medicine
이고은 ( Lee Ko-Eun )
Ewha Womans University School of Medicine Department of Internal Medicine
문영철 ( Mun Yeung-Chul )
Ewha Womans University School of Medicine Department of Internal Medicine
박상희 ( Park Sang-Hui )
Ewha Womans University School of Medicine Department of Pathology
Abstract
Background/Aims: Functional dyspepsia (FD) is characterized as chronic recurrent upper gastrointestinal symptoms in the absence of any organic disorder. We hypothesized that duodenal low-grade inflammation activates superficial afferent nerve sprouting, thereby contributing to hypersensitivity in patients with FD.
Methods: A prospective case-control study was conducted in a tertiary referral center. FD was defined using the Rome III criteria. Standardized endoscopic biopsies were performed in the stomach and duodenum. Hematoxylin and eosin staining and immunohistochemical staining for major basic proteins were performed to detect granulated eosinophil-derived granules, and S-100 staining was performed to detect fine nerve fibers.
Results: A total of 51 patients with FD (82% female; mean age 35.8 ± 13.4 years) and 35 controls were enrolled. Activated eosinophil counts in the duodenum were significantly higher in patients with FD than in controls (41.4% vs 17.1%, P = 0.005). Microscopic duodenitis was more frequently detected in patients with FD than in controls. Fine nerve fibers were more abundant in patients with FD than in controls (45.1% vs 11.4%, P = 0.029). The abundance of fine nerve fibers highly correlated with the degree of activated eosinophils.
Conclusion: Duodenal low-grade inflammation, such as mucosal eosinophilic accumulation with degranulation, promoted mucosal enteric nerve fiber density and sprouting in patients with FD.
키워드
Duodenum; Dyspepsia; Eosinophils; Inflammation; Peripheral nervous system
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