Korean J Gastroenterol.  2022 Jul;80(1):28-33. 10.4166/kjg.2022.036.

Eosinophil and Mast Cell Counts in the Stomach and Duodenum of Patients with Functional Dyspepsia without a Helicobacter pylori infection

• Min YW
• Lee H
• Ahn S
• Song KH
• Park JK
• Shin CM
• Huh KC
• Functional Dyspepsia Study Group Under the Korean Society of Neurogastroenterology and Motility

• KMID: 2532164
• DOI: http://doi.org/10.4166/kjg.2022.036

Abstract

Background/Aims
Symptom-based subtyping of functional dyspepsia (FD) is used to segregate patients into groups with homogenous pathophysiological mechanisms. This study examined whether subtyping could reflect the duodenal and gastric microinflammation in FD patients.
Methods
Twenty-one FD patients without Helicobacter pylori infection were recruited. An endoscopic biopsy was performed in the duodenum 2nd portion, stomach antrum, and body. The eosinophil and mast cell counts per high-power field (×40) were investigated by H&E and c-kit staining, respectively. The degree of inflammatory cell infiltration, atrophy, and intestinal metaplasia was also determined by H&E staining in the stomach. The baseline characteristics and eosinophil and mast cell infiltrations were compared among the three groups (epigastric pain syndrome, postprandial distress syndrome, and overlap).
Results
According to the symptom assessment, seven subjects were classified into the epigastric pain syndrome group, 10 into the postprandial syndrome group, and four into the overlap group. The baseline variables were similar in the three groups. Eosinophil infiltration was more prominent in the duodenum than in the stomach. In contrast, mast cell infiltration was similar in the duodenum and stomach. The eosinophil counts in the duodenum were similar in the three groups. The eosinophil counts in the stomach and mast cell counts in the duodenum and stomach were also similar in the three groups.
Conclusions
Duodenal eosinophil infiltration was prominent in FD patients, but the eosinophil counts were similar regardless of the symptom-based subtypes of FD. Hence, the current symptom-based subtyping of FD does not reflect duodenal eosinophil and mast cell infiltration.

Keyword

Duodenum; Dyspepsia; Eosinophils; Mast cells; Upper gastrointestinal tract

Figure

• 

  Fig. 1 Eosinophil and mast cell counts according to symptom-based subtypes of functional dyspepsia. Comparison of the eosinophil counts in the (A) duodenum, (B) stomach antrum, (C) stomach body and of mast cell counts, in the (D) duodenum, and (E) stomach antrum according to symptom-based subtypes of functional dyspepsia showed no significant difference among the groups. (F) The stomach body mast cell count was higher in the overlap group than in the EPS and PDS groups. EPS, epigastric pain syndrome; PDS, postprandial stress syndrome.

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