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Title: Neuroimmune interactions at different intestinal sites are related to abdominal pain symptoms in children with IBS

item DI NARDO, G - University Of Rome Sapienza
item BARBARA, G - University Of Bologna, Italy
item CUCCHIARA, S - University Of Rome Sapienza
item CREMON, C - University Of Bologna, Italy
item SHULMAN, R - Children'S Nutrition Research Center (CNRC)
item ISOLDI, S - University Of Rome Sapienza
item ZECCHI, L - University Of Bologna, Italy
item OLIVA, S - University Of Rome Sapienza
item SAULLE, R - University Of Rome Sapienza
item BARBARO, M - University Of Bologna, Italy

Submitted to: Neurogastroenterology & Motility
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/23/2013
Publication Date: 2/1/2014
Citation: Di Nardo, G., Barbara, G., Cucchiara, S., Cremon, C., Shulman, R.J., Isoldi, S., Zecchi, L., Oliva, S., Saulle, R., Barbaro, M.R. 2013. Neuroimmune interactions at different intestinal sites are related to abdominal pain symptoms in children with IBS. Neurogastroenterology & Motility. 26:196-204.

Interpretive Summary: Many children suffer from abdominal pain of an unknown cause. In this study we examined intestinal biopsies from children to look for signs of inflammation which sometimes can be caused by reactions to the food in the diet. The inflammation can lead to abdominal pain and stooling problems after eating. We have found evidence that some children have changes in the neural network in the intestine related to inflammation. Our results will help us understand how components of the diet can cause intestinal symptoms in some children.

Technical Abstract: Neuroimmune interactions and inflammation have been proposed as factors involved in sensory-motor dysfunction and symptom generation in adult irritable bowel syndrome (IBS) patients. In children with IBS and healthy controls, we measured ileocolonic mast cell infiltration and fecal calprotectin and evaluated the relationships between these parameters and abdominal pain symptoms and stooling pattern. Irritable bowel syndrome patients diagnosed according to Pediatric Rome III criteria and healthy controls kept a 2-week pain/stooling diary. Ileocolonic mucosal mast cells (MC) and MC in close proximity to nerve fibers (MC-NF) were identified immunohistochemically and quantified. Fecal calprotectin concentration was measured. 21 IBS patients and 10 controls were enrolled. The MC-NF count was significantly higher in the ileum (p = 0.01), right colon (p = 0.04), and left colon (p 0.001) of IBS patients compared with controls. No differences in fecal calprotectin concentration were noted. Abdominal pain intensity score correlated with ileal MC count (r(s) = 0.47, p = 0.030) and right colon MC-NF count (r(s) = 0.52, p = 0.015). In addition, children with IBS with 3 abdominal pain episodes/week had greater ileal (p = 0.002) and right colonic (p = 0.01) MC counts and greater ileal (p = 0.05) and right colonic (p = 0.016) MC-NF counts than children with less frequent pain. No relationship was found between MC and MC-NF and fecal calprotectin or stooling pattern. Mast cells-nerve fibers counts are increased in the ileocolonic mucosa of children with IBS. Mast cells and MC-NF counts are related to the intensity and frequency of abdominal pain.