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. 2022 Nov 1;75(5):572-577.
doi: 10.1097/MPG.0000000000003588. Epub 2022 Oct 28.

Identifying Mast Cells in Gastrointestinal Biopsies in Pediatric Irritable Bowel Patients

Syed Ahsan Rizvi  1 , Chukwuemeka Oriala  2 , Jessina Thomas  1 , Shuan Li  2 , Yamen Smadi  1
Affiliations

Identifying Mast Cells in Gastrointestinal Biopsies in Pediatric Irritable Bowel Patients

Syed Ahsan Rizvi et al. J Pediatr Gastroenterol Nutr. .

Abstract

Objectives: Mast cells (MCs) have been proposed to be involved in the pathophysiology of irritable bowel syndrome (IBS). Nonetheless, the quantity and distribution of MCs in the gastrointestinal tract of pediatric patients with IBS are not well defined. This study aimed to compare the number of MCs in children with and without IBS and to establish histopathological reference values in pediatrics.

Methods: Forty-nine participants with IBS were prospectively enrolled and classified into IBS with atopy (n = 29) and IBS without atopy (n = 20). As our retrospective control group, we selected 42 individuals with a history of polyposis syndrome or gastroesophageal reflux disease with normal histopathology. Retrospective selection of the control cohort was performed in a manner similar to previously published adult and pediatric studies. MCs were prospectively stained immunohistochemically on specimens from the stomach, duodenum, terminal ileum, and descending colon of both groups.

Results: The IBS group showed significantly more MCs per high-power field (MCs/HPF) in the stomach, duodenum, terminal ileum, and descending colon ( P < 0.001), irrespective of their atopic status. Optimal MC cutoff values for IBS are ≥20.5 MCs/HPF in the stomach (area under the curve [AUC] = 0.84); ≥23.0 MCs/HPF in the duodenum (AUC = 0.79); ≥33.5 MCs/HPF in the terminal ileum (AUC = 0.82); and ≥22.5 MCs/HPF in the descending colon (AUC = 0.86).

Conclusions: Pediatric patients with IBS showed increased numbers of MCs in the stomach, duodenum, terminal ileum, and descending colon when compared with controls. Further trials are needed to explain the role of MCs in pediatric IBS, which might facilitate the development of targeted therapeutic interventions.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

FIGURE 1.
FIGURE 1.
Photomicrographs of tryptase staining in the stomach, duodenum, terminal ileum, and descending colon. All images are ×400 original magnification. (A1) Tryptase staining in IBS stomach. (A2) Tryptase staining in stomach control. (B1) Tryptase staining in IBS duodenum. (B2) Tryptase staining in duodenum control. (C1). Tryptase staining in IBS terminal ileum. (C2) Tryptase staining in terminal ileum control. (D1) Tryptase staining in IBS descending colon. (D2) Tryptase staining in descending colon control. IBS = irritable bowel syndrome.
See this image and copyright information in PMC

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