Mazzawi T, Hausken T, Gundersen D, El-Salhy M
Division of Gastroenterology, Department of Medicine, Stord Hospital, Stord, Norway.
Division of Gastroenterology, Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Eur J Clin Nutr. 2016 Feb;70(2):175-81. doi: 10.1038/ejcn.2015.191. Epub 2015 Nov 25.
BACKGROUND/OBJECTIVES: To determine the large intestinal endocrine cell types affected following dietary guidance in patients with irritable bowel syndrome (IBS).
SUBJECTS/METHODS: The study included 13 IBS patients and 13 control subjects. The patients received three sessions of individualized dietary guidance. Both the control subjects and the patients were scheduled for colonoscopies at baseline and again for the patients at 3-9 months after dietary guidance. Biopsy samples were taken from the colon and rectum and were immunostained for all types of large intestinal endocrine cells. The endocrine cells were quantified using computerized image analysis.
The daily total consumption (mean±s.e.m. values) of fruits and vegetables rich in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) decreased significantly from 16.2±5.3 g before receiving dietary guidance to 9.2±3.2 g after receiving dietary guidance (P=0.02). In the total colon, the densities of serotonin cells were 46.8±8.9, 10.5±2.1 and 22.6±3.2 cells/mm(2) in control subjects and in IBS patients before and after receiving dietary guidance, respectively (P=0.007); the corresponding densities of peptide YY cells were 11.6±1.8, 10.8±1.7 and 16.8±2.1 cells/mm(2), respectively (P=0.06). The cell densities for both serotonin and peptide YY did not change significantly in the rectum. The densities of somatostatin cells in the rectum were 13.5±3.0, 13.2±3.0, and 22.3±3.2 cells/mm(2) for control subjects and for IBS patients before and after receiving dietary guidance, respectively (P=0.01).
The densities of the large intestinal endocrine cells tend to normalize following dietary guidance that may have contributed to the improvement of the patients with IBS symptoms.
背景/目的：确定肠易激综合征（IBS）患者接受饮食指导后受影响的大肠内分泌细胞类型。
受试者/方法：该研究纳入了13名IBS患者和13名对照受试者。患者接受了三次个性化饮食指导。对照受试者和患者在基线时均安排进行结肠镜检查，患者在饮食指导后3 - 9个月再次进行结肠镜检查。从结肠和直肠采集活检样本，并对所有类型的大肠内分泌细胞进行免疫染色。使用计算机图像分析对内分泌细胞进行定量。
富含可发酵低聚糖、二糖、单糖和多元醇（FODMAPs）的水果和蔬菜的每日总摄入量（均值±标准误）从接受饮食指导前的16.2±5.3克显著降至接受饮食指导后的9.2±3.2克（P = 0.02）。在整个结肠中，5-羟色胺细胞的密度在对照受试者中为46.8±8.9个/mm²，在接受饮食指导前和后的IBS患者中分别为10.5±2.1个/mm²和22.6±3.2个/mm²（P = 0.007）；相应的肽YY细胞密度分别为11.6±1.8个/mm²、10.8±1.7个/mm²和16.8±2.1个/mm²（P = 0.06）。5-羟色胺和肽YY的细胞密度在直肠中均无显著变化。直肠中生长抑素细胞的密度在对照受试者中为13.5±3.0个/mm²，在接受饮食指导前和后的IBS患者中分别为13.2±3.0个/mm²和22.3±3.2个/mm²（P = 0.01）。
饮食指导后大肠内分泌细胞的密度趋于正常化，这可能有助于改善IBS患者的症状。
