Alterations and Significance of Duodenal Eosinophils and Chromogranin A-positive Cells in Patients With Functional Dyspepsia / 胃肠病学

ABSTRACT

Background:Epidemiological studies suggest considerable overlap between functional dyspepsia (FD) and irritable bowel syndrome (IBS).Increased duodenal eosinophil counts have been observed in patients with FD,and the density of chromogranin A (CgA)-positive cells was reduced in duodenum in patients with IBS.Aims:To investigate the alterations and significance of duodenal eosinophils and CgA-positive cells in patients with FD and FD-diarrhea-predominant IBS (IBS-D) overlap.Methods:Outpatients with FD and FD-IBS-D overlap who fulfilled Rome Ⅲ criteria from Aug.2014 to Mar.2015 at the First Affiliated Hospital of Fujian Medical University were enrolled.Biopsy specimens were collected from the duodenal bulb for HE staining and CgA immunohistochemical staining.Eosinophils and CgA-positive cells were counted,and their associations with clinical symptoms were analyzed.Results:Twenty-eight FD patients and twelve FD-IBS-D overlap patients were enrolled in this study.Duodenal bulb eosinophil counts were significantly higher in FD-IBS-D overlap patients than in FD patients [(43.83 ± 7.34)/5HPF vs.(22.90 ± 8.93)/5HPF,P ＜ 0.05],while the density of duodenal bulb CgA-positive cells were significantly lower in FD-IBS-D overlap patients than in FD patients [(13.03 ±5.87)/HPF vs.(19.85 ± 9.18)/HPF,P ＜ 0.05].Spearman correlation coefficient analysis revealed that duodenal eosinophil counts were positively correlated with lower gastrointestinal symptoms such as abdominal pain/discomfort and diarrhea,whereas no correlations were found between density of duodenal CgA-positive cells and both upper and lower gastrointestinal symptoms.Conclusions:Duodenal bulb eosinophil counts are increased and CgA-positive cells are reduced in FD-IBS-D overlap patients than in non-overlap FD patients,which may implicate the difference in clinical symptoms between these two functional gastrointestinal disorders.