Morphological manifestations of irritable bowel syndrome

Main Article Content

Yu.M. Stepanov
I.Ya. Budzak
Yu.A. Gaidar

Abstract

The article presents modern data on morphological changes in the intestinal mucosa in patients with irritable bowel syndrome. There were analyzed the studies of different years on the morphological manifestations of irritable bowel syndrome. It has been shown that this pathology has an unusual low-grade inflammation. Mast cells play an important role in these inflammatory disorders, they have an effect on motility disorders, visceral hypersensitivity and other pathogenetic factors of irritable bowel syndrome. Disorders of intercellular tight junctions in this category of patients were also analyzed. The role of proteins involved in intercellular contacts (occludin, claudin, ZO) has been characterized. An analysis of the studies investigating these disorders has been carried out. The article provides examples of the analysis of biopsies in patients with irritable bowel syndrome using various methods of their assessment.

Article Details

How to Cite
Stepanov, Y., Budzak, I., & Gaidar, Y. (2021). Morphological manifestations of irritable bowel syndrome. GASTROENTEROLOGY, 55(2), 108–114. https://doi.org/10.22141/2308-2097.55.2.2021.233635
Section
Reviews and Lections

References

Lacy BE, Pimentel M, Brenner DM, et al. ACG Clinical Guideline: Management of Irritable Bowel Syndrome. Am J Gastroenterol. 2021 Jan 1;116(1):17-44. doi: 10.14309/ajg.0000000000001036.

Alzahrani MA, Alshamrani AS, Ahmasani IM, et al. Coronavirus disease 2019 pandemic stress and its effects on irritable bowel syndrome patients in Saudi Arabia. Medicine (Baltimore). 2020 Dec 18;99(51):e23711. doi: 10.1097/MD.0000000000023711.

Lee YJ, Park KS. Irritable bowel syndrome: emerging paradigm in pathophysiology. World J Gastroenterol. 2014 Mar 14;20(10):2456-69. doi: 10.3748/wjg.v20.i10.2456.

Nasef NA, Mehta S. Role of Inflammation in Pathophysiology of Colonic Disease: An Update. Int J Mol Sci. 2020 Jul 3;21(13):4748. doi: 10.3390/ijms21134748.

Sinagra E, Pompei G, Tomasello G, et al. Inflammation in irritable bowel syndrome: Myth or new treatment target? World J Gastroenterol. 2016 Feb 21;22(7):2242-55. doi: 10.3748/wjg.v22.i7.2242.

Matricon J, Meleine M, Gelot A, et al. Review article: Associations between immune activation, intestinal permeability and the irritable bowel syndrome. Aliment Pharmacol Ther. 2012 Dec;36(11-12):1009-31. doi: 10.1111/apt.12080.

Lee KN, Lee OY. The Role of Mast Cells in Irritable Bowel Syndrome. Gastroenterol Res Pract. 2016;2016:2031480. doi: 10.1155/2016/2031480.

Gué M, Del Rio-Lacheze C, Eutamene H, Théodorou V, Fioramonti J, Buéno L. Stress-induced visceral hypersensitivity to rectal distension in rats: role of CRF and mast cells. Neurogastroenterol Motil. 1997 Dec;9(4):271-9. doi: 10.1046/j.1365-2982.1997.d01-63.x.

Hiatt RB, Katz L. Mast cells in inflammatory conditions of the gastrointestinal tract. Am J Gastroenterol. 1962 May;37:541-5.

O'Sullivan M, Clayton N, Breslin NP, et al. Increased mast cells in the irritable bowel syndrome. Neurogastroenterol Motil. 2000 Oct;12(5):449-57. doi: 10.1046/j.1365-2982.2000.00221.x.

Piche T, Saint-Paul MC, Dainese R, et al. Mast cells and cellularity of the colonic mucosa correlated with fatigue and depression in irritable bowel syndrome. Gut. 2008 Apr;57(4):468-73. doi: 10.1136/gut.2007.127068.

Cremon C, Gargano L, Morselli-Labate AM, et al. Mucosal immune activation in irritable bowel syndrome: gender-dependence and association with digestive symptoms. Am J Gastroenterol. 2009 Feb;104(2):392-400. doi: 10.1038/ajg.2008.94.

Barbara G, Stanghellini V, De Giorgio R, et al. Activated mast cells in proximity to colonic nerves correlate with abdominal pain in irritable bowel syndrome. Gastroenterology. 2004 Mar;126(3):693-702. doi: 10.1053/j.gastro.2003.11.055.

Buhner S, Li Q, Vignali S, et al. Activation of human enteric neurons by supernatants of colonic biopsy specimens from patients with irritable bowel syndrome. Gastroenterology. 2009 Oct;137(4):1425-34. doi: 10.1053/j.gastro.2009.07.005.

Balestra B, Vicini R, Cremon C, et al. Colonic mucosal mediators from patients with irritable bowel syndrome excite enteric cholinergic motor neurons. Neurogastroenterol Motil. 2012 Dec;24(12):1118-e570. doi: 10.1111/nmo.12000.

Groschwitz KR, Ahrens R, Osterfeld H, et al. Mast cells regulate homeostatic intestinal epithelial migration and barrier function by a chymase/Mcpt4-dependent mechanism. Proc Natl Acad Sci U S A. 2009 Dec 29;106(52):22381-6. doi: 10.1073/pnas.0906372106.

Martínez C, Vicario M, Ramos L, et al. The jejunum of diarrhea-predominant irritable bowel syndrome shows molecular alterations in the tight junction signaling pathway that are associated with mucosal pathobiology and clinical manifestations. Am J Gastroenterol. 2012 May;107(5):736-46. doi: 10.1038/ajg.2011.472.

Sun H, Ma Y, An S, Wang Z. Altered gene expression signatures by calcitonin gene-related peptide promoted mast cell activity in the colon of stress-induced visceral hyperalgesia mice. Neurogastroenterol Motil. 2021 Jun;33(6):e14073. doi: 10.1111/nmo.14073.

Alonso C, Guilarte M, Vicario M, et al. Acute experimental stress evokes a differential gender-determined increase in human intestinal macromolecular permeability. Neurogastroenterol Motil. 2012 Aug;24(8):740-6, e348-9. doi: 10.1111/j.1365-2982.2012.01928.x.

Akbar A, Yiangou Y, Facer P, Walters JR, Anand P, Ghosh S. Increased capsaicin receptor TRPV1-expressing sensory fibres in irritable bowel syndrome and their correlation with abdominal pain. Gut. 2008 Jul;57(7):923-9. doi: 10.1136/gut.2007.138982.

Di Nardo G, Barbara G, Cucchiara S, et al. Neuroimmune interactions at different intestinal sites are related to abdominal pain symptoms in children with IBS. Neurogastroenterol Motil. 2014 Feb;26(2):196-204. doi: 10.1111/nmo.12250.

Cremon C, Carini G, Wang B, et al. Intestinal serotonin release, sensory neuron activation, and abdominal pain in irritable bowel syndrome. Am J Gastroenterol. 2011 Jul;106(7):1290-8. doi: 10.1038/ajg.2011.86.

Ohman L, Isaksson S, Lindmark AC, et al. T-cell activation in patients with irritable bowel syndrome. Am J Gastroenterol. 2009 May;104(5):1205-12. doi: 10.1038/ajg.2009.116.

Lee KJ, Kim YB, Kim JH, Kwon HC, Kim DK, Cho SW. The alteration of enterochromaffin cell, mast cell, and lamina propria T lymphocyte numbers in irritable bowel syndrome and its relationship with psychological factors. J Gastroenterol Hepatol. 2008 Nov;23(11):1689-94. doi: 10.1111/j.1440-1746.2008.05574.x.

Singh M, Singh V, Schurman JV, Colombo JM, Friesen CA. The relationship between mucosal inflammatory cells, specific symptoms, and psychological functioning in youth with irritable bowel syndrome. Sci Rep. 2020 Jul 20;10(1):11988. doi: 10.1038/s41598-020-68961-9.

Sinagra E, Morreale GC, Mohammadian G, et al. New therapeutic perspectives in irritable bowel syndrome: Targeting low-grade inflammation, immuno-neuroendocrine axis, motility, secretion and beyond. World J Gastroenterol. 2017 Sep 28;23(36):6593-6627. doi: 10.3748/wjg.v23.i36.6593.

Piche T, Barbara G, Aubert P, et al. Impaired intestinal barrier integrity in the colon of patients with irritable bowel syndrome: involvement of soluble mediators. Gut. 2009 Feb;58(2):196-201. doi: 10.1136/gut.2007.140806.

Zhou Q, Zhang B, Verne GN. Intestinal membrane permeability and hypersensitivity in the irritable bowel syndrome. Pain. 2009 Nov;146(1-2):41-6. doi: 10.1016/j.pain.2009.06.017.

Santos J, Yang PC, Söderholm JD, Benjamin M, Perdue MH. Role of mast cells in chronic stress induced colonic epithelial barrier dysfunction in the rat. Gut. 2001 May;48(5):630-6. doi: 10.1136/gut.48.5.630.

Bertiaux-Vandaële N, Youmba SB, Belmonte L, et al. The expression and the cellular distribution of the tight junction proteins are altered in irritable bowel syndrome patients with differences according to the disease subtype. Am J Gastroenterol. 2011 Dec;106(12):2165-73. doi: 10.1038/ajg.2011.257.

Martínez C, González-Castro A, Vicario M, Santos J. Cellular and molecular basis of intestinal barrier dysfunction in the irritable bowel syndrome. Gut Liver. 2012 Jul;6(3):305-15. doi: 10.5009/gnl.2012.6.3.305.

Turner JR. Intestinal mucosal barrier function in health and disease. Nat Rev Immunol. 2009 Nov;9(11):799-809. doi: 10.1038/nri2653.

Garrett WS, Gordon JI, Glimcher LH. Homeostasis and inflammation in the intestine. Cell. 2010 Mar 19;140(6):859-70. doi: 10.1016/j.cell.2010.01.023.

Spiller RC, Jenkins D, Thornley JP, Hebden JM, Wright T, Skinner M, Neal KR. Increased rectal mucosal enteroendocrine cells, T lymphocytes, and increased gut permeability following acute Campylobacter enteritis and in post-dysenteric irritable bowel syndrome. Gut. 2000 Dec;47(6):804-11. doi: 10.1136/gut.47.6.804.

Zhou Q, Zhang B, Verne GN. Intestinal membrane permeability and hypersensitivity in the irritable bowel syndrome. Pain. 2009 Nov;146(1-2):41-6. doi: 10.1016/j.pain.2009.06.017.

Martínez C, Vicario M, Ramos L, et al. The jejunum of diarrhea-predominant irritable bowel syndrome shows molecular alterations in the tight junction signaling pathway that are associated with mucosal pathobiology and clinical manifestations. Am J Gastroenterol. 2012 May;107(5):736-46. doi: 10.1038/ajg.2011.472.

Cheng P, Yao J, Wang C, Zhang L, Kong W. Molecular and cellular mechanisms of tight junction dysfunction in the irritable bowel syndrome. Mol Med Rep. 2015 Sep;12(3):3257-3264. doi: 10.3892/mmr.2015.3808.

Zhang M, Chen CY, Hu Y, Lyu B. [The relationship between adherens junction and tight junction and clinical symptoms in patients with diarrhea predominant irritable bowel syndrome]. Zhonghua Nei Ke Za Zhi. 2020 Jan 1;59(1):40-46. Chinese. doi: 10.3760/cma.j.issn.0578-1426.2020.01.007.