Magdy El-Salhy1,2,3, Tanisa Patcharatrakul4,5, Jan Gunnar Hatlebakk2,3, Trygve Hausken2,3,5, Odd Helge Gilja2,3,6, Sutep Gonlachanvit4,5. 1. a Department of Medicine, Section for Gastroenterology , Stord Helse-Fonna Hospital , Stord , Norway. 2. b Department of Clinical Medicine , University of Bergen , Bergen , Norway. 3. c Department of Medicine , National Centre for Functional Gastrointestinal Disorders, Haukeland University Hospital , Bergen , Norway. 4. d Division of Gastroenterology, Department of Medicine Faculty of Medicine , GI Motility Research Unit, Chulalongkorn University , Bangkok , Thailand. 5. e Thai Red Cross Society , King Chulalongkorn Memorial Hospital , Bangkok , Thailand. 6. f Department of Medicine , National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital , Bergen , Norway.
Abstract
OBJECTIVE: Patients with irritable bowel syndrome (IBS) in Asia show distinctive differences from those in the western world. The gastrointestinal endocrine cells appear to play an important role in the pathophysiology of IBS. The present study aimed at studying the density of chromogranin A (CgA) cells in the large intestine of Thai and Norwegian IBS patients. METHODS: Thirty Thai IBS patients and 20 control subjects, and 47 Norwegian IBS patients and 20 control subjects were included. A standard colonoscopy was performed in both the patients and controls, and biopsy samples were taken from the colon and the rectum. The biopsy samples were stained with hematoxylin-eosin and immunostained for CgA. The density of CgA cells was determined by computerized image analysis. RESULTS: In the colon and rectum, the CgA cell densities were far higher in both IBS and healthy Thai subjects than in Norwegians. The colonic CgA cell density was lower in Norwegian IBS patients than in controls, but did not differ between Thai IBS patients and controls. In the rectum, the CgA cell densities in both Thai and Norwegian patients did not differ from those of controls. CONCLUSIONS: The higher densities of CgA cells in Thai subjects than Norwegians may be explained by a higher exposure to infections at childhood and the development of a broad immune tolerance, by differences in the intestinal microbiota, and/or differing diet habits. The normal CgA cell density in Thai IBS patients in contrast to that of Norwegians may be due to differences in pathophysiology.
OBJECTIVE:Patients with irritable bowel syndrome (IBS) in Asia show distinctive differences from those in the western world. The gastrointestinal endocrine cells appear to play an important role in the pathophysiology of IBS. The present study aimed at studying the density of chromogranin A (CgA) cells in the large intestine of Thai and Norwegian IBSpatients. METHODS: Thirty Thai IBSpatients and 20 control subjects, and 47 Norwegian IBSpatients and 20 control subjects were included. A standard colonoscopy was performed in both the patients and controls, and biopsy samples were taken from the colon and the rectum. The biopsy samples were stained with hematoxylin-eosin and immunostained for CgA. The density of CgA cells was determined by computerized image analysis. RESULTS: In the colon and rectum, the CgA cell densities were far higher in both IBS and healthy Thai subjects than in Norwegians. The colonic CgA cell density was lower in Norwegian IBSpatients than in controls, but did not differ between Thai IBSpatients and controls. In the rectum, the CgA cell densities in both Thai and Norwegian patients did not differ from those of controls. CONCLUSIONS: The higher densities of CgA cells in Thai subjects than Norwegians may be explained by a higher exposure to infections at childhood and the development of a broad immune tolerance, by differences in the intestinal microbiota, and/or differing diet habits. The normal CgA cell density in Thai IBSpatients in contrast to that of Norwegians may be due to differences in pathophysiology.
Authors: Robert J Shulman; Lena Öhman; Mats Stridsberg; Kevin Cain; Magnus Simrén; Margaret Heitkemper Journal: Neurogastroenterol Motil Date: 2018-10-09 Impact factor: 3.598