Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Apr;1(1):36-42.
doi: 10.5415/apallergy.2011.1.1.36. Epub 2011 Apr 26.

Irritable bowel syndrome - An inflammatory disease involving mast cells

Hamish Philpott  1 , Peter Gibson, Frank Thien
Affiliations

Irritable bowel syndrome - An inflammatory disease involving mast cells

Hamish Philpott et al. Asia Pac Allergy. 2011 Apr.

Abstract

Irritable bowel syndrome (IBS) is traditionally defined as a functional disorder - that is the presence of symptoms in the absence of demonstrable pathological abnormalities. In recent times, low grade inflammatory infiltrates in both the small and large bowel of some patients with IBS - often rich in mast cells, along with serological markers of low grade inflammation have focussed attention on IBS as an inflammatory disease. The observation that mast cells often lie in close association to enteric neurons, and in-vitro and in-vivo animal studies demonstrating that mast cell mediators may influence enteric motility provides a biologically plausible causal mechanism in IBS. Pilot studies on patients with IBS using the mast cell stabiliser sodium cromoglycate ('proof of concept') have been encouraging. The essential question remains why mast cells infiltrate the bowel of IBS patients. A disturbance of the 'brain-gut axis' is the current favoured hypothesis, whereby childhood stress or psychiatric comorbidity act via neuro-immune mechanisms to modulate low grade inflammation. An alternative hypothesis is that food allergy may be responsible. Serum specific IgE, and skin prick tests are not elevated in IBS patients, suggesting type 1 IgE mediated food allergy is not the cause. However questionnaire based studies indicate IBS patients have higher rates of atopic disease, and increased bronchial reactivity to methacholine has been demonstrated. In this review, we highlight the potential role of mast cells in IBS, and current and future research directions into this intriguing condition.

Keywords: Atopy; IBS; Immunology; Inflammation; Mast cells.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
The Brain - Gut axis in irritable bowel syndrome (IBS).
Fig. 2
Fig. 2
Proposed dualistic treatment model of irritable bowel syndrome.
See this image and copyright information in PMC

References

    1. Spiller R, Aziz Q, Creed F, Emmanuel A, Houghton L, Hungin P, Jones R, Kumar D, Rubin G, Trudgill N, Whorwell P Clinical Services Committee of the British Society of Gastroenterology. Guidelines on the irritable bowel syndrome: mechanisms and practical management. Gut. 2007;56:1770–1798. - PMC - PubMed
    1. Mayer EA, Collins SM. Evolving pathophysiologic models of functional gastrointestinal disorders. Gastroenterology. 2002;122:2032–2048. - PubMed
    1. Ohman L, Simrén M. Pathogenesis of IBS: role of inflammation, immunity and neuroimmune interactions. Nat Rev Gastroenterol Hepatol. 2010;7:163–173. - PubMed
    1. Lobo B, Vicario M, Martinez C, Ramos L, Alonso C, Guilarte M, de Torres I, Saperas E, Santos J. Clinical benefit in IBS after disodium cromoglycate involves mast cell mediated recovery of healthy-like innate immunity genes expression profile in the jejunal mucosa. Gastroenterology. 2009;136:A-30.
    1. Barbara G, Wang B, Stanghellini V, de Giorgio R, Cremon C, Di Nardo G, Trevisani M, Campi B, Geppetti P, Tonini M, Bunnett NW, Grundy D, Corinaldesi R. Mast cell-dependent excitation of visceral-nociceptive sensory neurons in irritable bowel syndrome. Gastroenterology. 2007;132:26–37. - PubMed