Quantitation of Colonic Cells as Severity Markers in Patients with Irritable Bowel Syndrome

Mohammad Bagher Miri; Amir Sadeghi; Afshin Moradi; Mohammad Rostami-Nejad; Hamid Asadzadeh Aghdaei; Mohammad Javad Ehsani Ardekani; Mohammad Taghi Safari; Mohammad Reza Zali

doi:10.22086/gmj.v0i0.1063

Quantitation of Colonic Cells as Severity Markers in Patients with Irritable Bowel Syndrome

Galen Med J. 2018 May 26:7:e1063. doi: 10.22086/gmj.v0i0.1063. eCollection 2018.

Authors

Mohammad Bagher Miri¹, Amir Sadeghi¹, Afshin Moradi², Mohammad Rostami-Nejad³, Hamid Asadzadeh Aghdaei³, Mohammad Javad Ehsani Ardekani¹, Mohammad Taghi Safari¹, Mohammad Reza Zali¹

Affiliations

¹ IBS Department, Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
² Department of Pathology, Shohada Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran.
³ Celiac disease Department, Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Background: Irritable bowel syndrome (IBS) is the most common gastrointestinal syndrome. Routine histopathology and immunohistochemistry (IHC) evaluations have shown an increase in the number of different inflammatory cells in the colon of IBS patients. In this study, we have compared the number of intraepithelial lymphocytes (IELs), eosinophils, mast cells and CD3+ T cells, in IBS patients and normal subjects.

Materials and methods: In 2016, seventynine patients with IBS and seventy-nine healthy subjects who underwent colonoscopy for other non-specific causes and with no pathologic findings, were enrolled in this cross-sectional study. Biopsy specimens obtained from the colon were stained, using IHC methods to determine the number of IELs, eosinophils, mast cells and CD3+ T cells. Quantitative and qualitative variables were compared between the two groups, using a Chi-square test and Student's t-test.

Results: Seventy-nine patients with IBS, 79.7% females with a mean age of 42.5±14.6 years, were recruited, as the case group, and seventy-nine individuals, 51.9% females with a mean age of 39.7±18.9 years, were enrolled as controls. The average number of IELs per high power fields (hpf) was found to be higher in the IBS group, and this difference was statistically significant (32.8±11.8 vs. 28.6±12.9; P=0.034). Also, the mean count/hpf of CD3+ T lymphocytes (23.1±7.9 vs. 20.2±8.1; P=0.024) and mast cells (7.6±3.1 vs. 6.6±3.0; P=0.041) were significantly higher in the IBS group, compared to the control group. The number of eosinophils was higher in the IBS group, but the differences were not statistically significant (P=0.066).

Conclusion: According to the results, we suggest that analysis of immune cells and IELs in intestinal biopsies might be an appropriate method for diagnosis of IBS.

Keywords: Biopsy; Intra-epithelial Lymphocytes; Irritable Bowel Syndrome.