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Comparative Study
. 2023 Oct;38(10):1778-1786.
doi: 10.1111/jgh.16250. Epub 2023 Jun 6.

Comparison of pancreatic enzyme abnormalities and protease-activated receptor-2-positive eosinophils in the duodenum of patients with functional dyspepsia-irritable bowel syndrome overlap with functional dyspepsia alone in Asian populations

Seiji Futagami  1 , Takaomi Kessoku  2   3 , Yuki Kasai  2 , Takuma Higurashi  2 , Atsushi Nakajima  2 , Shuhei Agawa  1 , Hiroshi Yamawaki  1 , Ken Nakamura  1 , Mayu Habiro  1 , Rie Kawawa  1 , Nobue Ueki  1 , Sakura Higashida  1 , Yoshiyuki Watanabe  1   4 , Hiroshi Yamato  5 , Takatsugu Yamamoto  5 , Yusuke Takasaki  6 , Koichi Ito  6 , Mariko Hojo  6 , Hiroyuki Isayama  6 , Norio Motoda  7 , Ryuji Ohashi  7 , Kewin Tien Ho Siah  8   9 , Carissa Kahmun Ng  10 , Kok-Ann Gwee  9   10   11
Affiliations
Comparative Study

Comparison of pancreatic enzyme abnormalities and protease-activated receptor-2-positive eosinophils in the duodenum of patients with functional dyspepsia-irritable bowel syndrome overlap with functional dyspepsia alone in Asian populations

Seiji Futagami et al. J Gastroenterol Hepatol. 2023 Oct.

Abstract

Background and aim: Some patients with functional gastrointestinal disorders exhibit pancreatic dysfunctions and pancreatic enzyme abnormalities. Thus, we aimed to clarify whether significant differences in clinical characteristics, prevalence of pancreatic enzyme abnormalities, duodenal inflammation, and protease-activated receptor 2 (PAR2) expression levels related to hypersensitivity exist between functional dyspepsia (FD) alone and FD-irritable bowel syndrome (IBS) overlap group.

Methods: Ninety-three patients based on the Rome IV criteria, FD alone (n = 44) and FD overlapped with IBS (n = 49) group were enrolled. The patients scored their own clinical symptoms after consuming high-fat meals. Serum trypsin, PLA2, lipase, p-amylase, and elastase-1 levels were measured. PAR2, eotaxin-3, and TRPV4 mRNA levels in duodenum were determined using real-time polymerase chain reaction methods. PRG2- and PAR2 in the duodenum were evaluated using immunostaining.

Results: FD score and global GSRS in patients with FD-IBS overlap were significantly higher than FD alone. Although the prevalence of pancreatic enzyme abnormalities in patients with FD alone was significantly (P < 0.01) higher than that in FD-IBS overlap, the ratio of aggravation of clinical symptoms following high-fat intake in patients with FD-IBS overlap was significantly higher (P = 0.007) than that in patients with FD alone. PAR2- and PRG2-double positive cells were localized in the degranulated eosinophils in the duodenum of patients with FD-IBS overlap. The number of PAR2- and PRG2-double positive cells in FD-IBS overlap was significantly (P < 0.01) higher than FD alone.

Conclusions: Pancreatic enzyme abnormalities and PAR2 expression on degranulated eosinophils infiltrations in the duodenum may be associated with the pathophysiology of patients with FD-IBS overlap in Asian populations.

Keywords: FD-IBS overlap; degranulated eosinophil; functional dyspepsia (FD); irritable bowel syndrome (IBS); protease activated receptor 2 (PAR2).

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References

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