Lee Eun Hye, Yang Hye Ran, Lee Hye Seung
Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea.
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
J Neurogastroenterol Motil. 2016 Jul 30;22(3):459-69. doi: 10.5056/jnm15174.
BACKGROUND/AIMS: Abdominal pain-related functional gastrointestinal disorder (AP-FGID) is common in children and adults. However, the mechanism of AP-FGID is not clearly known. Recently, micro-inflammation, especially eosinophilia in the gastrointestinal tract, was suggested in the pathophysiology of AP-FGID in adults. The aim of this study was to evaluate the association of gastric and duodenal eosinophilia with pediatric AP-FGID.
In total, 105 pediatric patients with AP-FGID were recruited and classified into 4 subgroups based on the Rome III criteria. Eosinophil counts in the gastric and duodenal tissues of children with AP-FGID were compared to those from normal pathology references or those of children with Helicobacter pylori infection. Tissue eosinophil counts were also compared among the 4 subtypes of AP-FGID.
Eosinophil counts in the gastric antrum and body were significantly higher in children with AP-FGID than normal reference values. Duodenal eosinophil counts were higher in children with AP-FGID, but not significantly when compared with normal reference values. There were no significant differences in eosinophil counts of the stomach or duodenum among the 4 subtypes of AP-FGID. Eosinophils counts in the gastric antrum and body were significantly higher in children with H. pylori infection than in those with AP-FGID. Duodenal eosinophilia was prominent in cases of H. pylori infection, but not statistically significant when compared with AP-FGID.
Our study revealed that gastric eosinophilia is associated with AP-FGID in children, regardless of the subtype of functional abdominal pain. This suggests some contribution of gastrointestinal eosinophils in the development of pediatric AP-FGID.
背景/目的:腹痛相关的功能性胃肠病(AP-FGID)在儿童和成人中都很常见。然而,AP-FGID的发病机制尚不清楚。最近,有研究提示微炎症,尤其是胃肠道嗜酸性粒细胞增多,在成人AP-FGID的病理生理学中发挥作用。本研究旨在评估胃和十二指肠嗜酸性粒细胞增多与儿童AP-FGID之间的关联。
共招募了105例患有AP-FGID的儿科患者,并根据罗马III标准将其分为4个亚组。将AP-FGID患儿胃和十二指肠组织中的嗜酸性粒细胞计数与正常病理对照或幽门螺杆菌感染患儿的计数进行比较。还对AP-FGID的4种亚型之间的组织嗜酸性粒细胞计数进行了比较。
AP-FGID患儿胃窦和胃体中的嗜酸性粒细胞计数显著高于正常参考值。AP-FGID患儿十二指肠嗜酸性粒细胞计数较高,但与正常参考值相比无显著差异。AP-FGID的4种亚型之间胃或十二指肠的嗜酸性粒细胞计数无显著差异。幽门螺杆菌感染患儿胃窦和胃体中的嗜酸性粒细胞计数显著高于AP-FGID患儿。幽门螺杆菌感染病例中十二指肠嗜酸性粒细胞增多明显,但与AP-FGID相比无统计学意义。
我们的研究表明,无论功能性腹痛的亚型如何,胃嗜酸性粒细胞增多与儿童AP-FGID相关。这提示胃肠道嗜酸性粒细胞在儿童AP-FGID的发生发展中起到了一定作用。