J Neurogastroenterol Motil.  2019 Apr;25(2):212-221. 10.5056/jnm18176.

Degranulated Eosinophils Contain More Fine Nerve Fibers in the Duodenal Mucosa of Patients With Functional Dyspepsia

Affiliations
  • 1Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea. junghk@ewha.ac.kr
  • 2Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.
  • 3Department of Pathology, College of Medicine, Ewha Womans University, Seoul, Korea.

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.

Keyword

Duodenum; Dyspepsia; Eosinophils; Inflammation; Peripheral nervous system

MeSH Terms

Biopsy
Case-Control Studies
Duodenitis
Duodenum
Dyspepsia*
Eosine Yellowish-(YS)
Eosinophils*
Female
Hematoxylin
Humans
Hypersensitivity
Inflammation
Mucous Membrane*
Nerve Fibers*
Peripheral Nervous System
Prospective Studies
Stomach
Tertiary Care Centers
Eosine Yellowish-(YS)
Hematoxylin
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