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. 2010 Dec;6(12):772-7.

Mast cells in gastrointestinal disease

David B Ramsay, Sindu Stephen, Marie Borum, Lysandra Voltaggio, David B Doman

Mast cells in gastrointestinal disease

David B Ramsay et al. Gastroenterol Hepatol (N Y). 2010 Dec.

Abstract

The function of mast cells in allergic inflammatory reactions is well documented in the literature. Mast cells also play an important role in the regulation of gastrointestinal visceral sensitivity and vascular permeability. Several studies have noted an increased number of mast cells in the mucosa of patients with gastrointestinal diseases such as irritable bowel syndrome, mastocytic enterocolitis, and systemic mastocytosis. The role of mast cells in the symptomatology of these and other diseases has only recently been fully appreciated and could provide avenues for new therapeutic opportunities. This paper examines studies that have evaluated the role of mast cells in various gastrointestinal diseases.

Keywords: Mast cells; allergy; gastrointestinal disease; irritable bowel syndrome; mastocytosis.

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Figures

Figure 1
Figure 1
A 50-year-old white woman had a 20-year history of chronic diarrhea that had been diagnosed as medically refractory irritable bowel syndrome. Tests for inflammatory bowel disease, celiac disease, lactose intolerance, and fructose intolerance were negative, and a colonoscopy revealed grossly normal findings. A hematoxylin and eosin stain of random biopsies of the colon and terminal ileum (shown above) was normal.
Figure 2
Figure 2
A CD117 immunohistochemical stain (bronze coloring) for mast cells was obtained in the chronic diarrhea patient discussed in Figure 1. The stain (shown above) revealed more than 20 mast cells per high-power field in both the colon and terminal ileum, a finding consistent with the diagnosis of mastocytic enterocolitis. (The same cells can also be highlighted with Giemsa stain or mast-cell tryptase.) The patient experienced an immediate, sustained response to cetirizine hydrochloride (Zyrtec, McNeil) antihistamine therapy.
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