Mazzawi Tarek, Eikrem Øystein, Lied Gülen Arslan, Hausken Trygve
Section of Gastroenterology, Department of Medicine, Haukeland University Hospital, Bergen, Norway.
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Gastroenterol Res Pract. 2020 Feb 4;2020:3520686. doi: 10.1155/2020/3520686. eCollection 2020.
Altered densities of enteroendocrine cells play an important role in patients with irritable bowel syndrome (IBS). Uroguanylin activates guanylate cyclase-C to regulate intestinal electrolyte and water transport. . To quantify uroguanylin immunoreactive cells density in the duodenum of diarrhea-predominant IBS (IBS-D) patients compared to controls and to investigate the effect of fecal microbiota transplantation (FMT) on these cell densities. . Twelve patients with IBS-D according to Rome III criteria were included. The cause was identified as post infectious (PI, = 6) or idiopathic ( = 6). They completed the IBS-symptom questionnaire before and 3 weeks after FMT. Thirty grams of fresh feces donated from healthy relatives were diluted with 60 ml normal saline and instilled via endoscope into the duodenum. Biopsies were taken from the patients' duodenum before and 3 weeks after FMT. Duodenal biopsies taken from eight healthy controls were also included. The biopsies were immunostained for uroguanylin and quantified using computerized image analysis. . Uroguanylin immunoreactive cells were found both in duodenal villi and crypts in both controls and IBS-D patients. The densities of uroguanylin immunoreactive cells were significantly lower in the villi ( < 0.0001) and higher in the crypts ( < 0.0001) for the patients than the controls. Following FMT, the densities of uroguanylin immunoreactive cells for the total group and idiopathic subgroup decreased significantly in the duodenal crypts ( = 0.049 and 0.04, respectively) but not in the villi. No significant changes were shown in the PI-IBS subgroups. The cells density in only the crypts correlated with diarrhea ( = 0.97, = 0.001) and bloating ( = -0.91, = 0.01) in the PI-IBS subgroup before FMT and with abdominal pain ( = 0.63, = 0.03) in the total group of IBS-D patients after FMT. . Altered uroguanylin immunoreactive cells density was found in IBS-D patients compared to controls. Changes in these cells density following FMT correlated with IBS symptoms (diarrhea, bloating, and abdominal pain).
肠内分泌细胞密度改变在肠易激综合征（IBS）患者中起重要作用。尿鸟苷素激活鸟苷酸环化酶-C以调节肠道电解质和水的转运。为了量化腹泻型IBS（IBS-D）患者十二指肠中尿鸟苷素免疫反应性细胞密度并与对照组进行比较，并研究粪便微生物群移植（FMT）对这些细胞密度的影响。纳入了12例符合罗马III标准的IBS-D患者。病因确定为感染后（PI，=6）或特发性（=6）。他们在FMT前和FMT后3周完成了IBS症状问卷。从健康亲属捐赠的30克新鲜粪便用60毫升生理盐水稀释，并通过内窥镜注入十二指肠。在FMT前和FMT后3周从患者十二指肠取活检组织。还纳入了从8名健康对照者获取的十二指肠活检组织。活检组织进行尿鸟苷素免疫染色，并使用计算机图像分析进行量化。在对照组和IBS-D患者的十二指肠绒毛和隐窝中均发现了尿鸟苷素免疫反应性细胞。患者绒毛中尿鸟苷素免疫反应性细胞密度显著低于对照组（<0.0001），隐窝中则高于对照组（<0.0001）。FMT后，全组和特发性亚组十二指肠隐窝中尿鸟苷素免疫反应性细胞密度显著降低（分别为=0.049和0.04），但绒毛中未降低。PI-IBS亚组未显示出显著变化。仅在PI-IBS亚组FMT前隐窝中的细胞密度与腹泻（=0.97，=0.001）和腹胀（=-0.91，=0.01）相关，在IBS-D患者全组FMT后与腹痛（=0.63，=0.03）相关。与对照组相比，IBS-D患者中发现尿鸟苷素免疫反应性细胞密度改变。FMT后这些细胞密度的变化与IBS症状（腹泻腹胀和腹痛）相关。
