Mucosal Mast Cell Distribution in the Gastrointestinal Tract of Children: A Preliminary Study for Establishing Reference Values.
Journal
Journal of pediatric gastroenterology and nutrition
ISSN: 1536-4801
Titre abrégé: J Pediatr Gastroenterol Nutr
Pays: United States
ID NLM: 8211545
Informations de publication
Date de publication:
01 01 2022
01 01 2022
Historique:
pubmed:
26
10
2021
medline:
26
2
2022
entrez:
25
10
2021
Statut:
ppublish
Résumé
The physiological number and distribution of mast cells (MCs) in the pediatric gastrointestinal (GI) tract is not well defined and reference values of normality are missing. To define a physiological and disease defining cut-off, a systematic histological exploration of MC distribution from the esophagus to the rectum in healthy as well as in patients with gastrointestinal food allergies (GFA) was performed. Nine pediatric subjects that exhibited unremarkable histopathological evaluations or underwent endoscopy for surveillance reasons after a previous polypectomy of single colonic juvenile polyps served as reference cohort. In all of these subjects, a chronic inflammatory disease (eg, inflammatory bowel disease, celiac disease) or allergy was excluded. In addition, a group of 15 patients with gastrointestinal complaints suspected to be caused by a GFA were investigated. Immunohistochemistry was performed from all biopsies using CD117 (c-Kit) as a reliable marker to identify MCs in the lamina propria. There were distinct differences of MC counts in all parts of the pediatric GI tract. The highest counts of MCs in both symptomatic patients and control cohort, were found in the duodenum, terminal ileum, cecum and ascending colon. The lowest counts were found in the esophagus. Significant disparities between GFA and healthy subjects were found in the gastric corpus (22.1 ± 4.0/ high power field [HPF] vs 32.0 ± 10.1/HPF; P = 0.034) and ascending colon (44.8 ± 10.4/HPF vs 60.4 ± 24.3/HPF; P = 0.047). Mucosal MC counts in the pediatric GI tract are higher than previously reported, with a considerable overlap between healthy and GFA patients. These results provide detailed information on distribution and numbers of MCs in pediatric allergic patients while allowing estimates of physiological values in childhood for the first time. With regard to diagnostic procedures in GFA further laboratory parameters have to be integrated.
Identifiants
pubmed: 34694267
doi: 10.1097/MPG.0000000000003338
pii: 00005176-202201000-00009
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
46-53Informations de copyright
Copyright © 2021 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.
Déclaration de conflit d'intérêts
Conflicts of Interest: C. Ehrsam, A. Hoerning, C. Geppert, M. Raithel, R. Rieker, and A. Hartmann have no conflict of interest to declare.
Références
Saad AG. Normal quantity and distribution of mast cells and eosinophils in the pediatric colon. Pediatr Dev Pathol 2011; 14:294–300.
Chernetsova E, Sullivan K, de Nanassy J, et al. Histologic analysis of eosinophils and mast cells of the gastrointestinal tract in healthy Canadian children. Hum Pathol 2016; 54:55–63.
Mir SA, Schady D, Olive AP, et al. Mucosal mast cell counts in pediatric eosinophilic gastrointestinal disease. Pediatr Allergy Immunol 2014; 25:94–95.
Abonia JP, Blanchard C, Butz BB, et al. Involvement of mast cells in eosinophilic esophagitis. J Allergy Clin Immunol 2010; 126:140–149.
Bischoff SC. Role of mast cells in allergic and non-allergic immune responses: comparison of human and murine data. Nat Rev Immunol 2007; 7:93–104.
Bischoff SC. Physiological and pathophysiological functions of intestinal mast cells. Semin Immunopathol 2009; 31:185–205.
Akin C. Mast cell activation syndromes. J Allergy Clin Immunol 2017; 140:349–355.
Theoharides TC, Valent P, Akin C. Mast cells, mastocytosis, and related disorders. N Engl J Med 2015; 373:1885–1886.
Bischoff SC, Kramer S. Human mast cells, bacteria, and intestinal immunity. Immunol Rev 2007; 217:329–337.
Wouters MM, Vicario M, Santos J. The role of mast cells in functional GI disorders. Gut 2016; 65:155–168.
Barbara G, Wang B, Stanghellini V, et al. Mast cell-dependent excitation of visceral-nociceptive sensory neurons in irritable bowel syndrome. Gastroenterology 2007; 132:26–37.
Gui XY. Mast cells: a possible link between psychological stress, enteric infection, food allergy and gut hypersensitivity in the irritable bowel syndrome. J Gastroenterol Hepatol 1998; 13:980–989.
Vanuytsel T, van Wanrooy S, Vanheel H, et al. Psychological stress and corticotropin-releasing hormone increase intestinal permeability in humans by a mast cell-dependent mechanism. Gut 2014; 63:1293–1299.
Giancola F, Volta U, Repossi R, et al. Mast cell-nerve interactions correlate with bloating and abdominal pain severity in patients with non-celiac gluten /wheat sensitivity. Neurogastroenterol Motil 2020; 32:e13814.
Bischoff SC. Mast cells in gastrointestinal disorders. Eur J Pharmacol 2016; 778:139.
Ravanbakhsh N, Kesavan A. The role of mast cells in pediatric gastrointestinal disease. Ann Gastroenterol 2019; 32:338–345.
Frieling T, Meis K, Kolck UW, et al. Evidence for mast cell activation in patients with therapy-resistant irritable bowel syndrome. Z Gastroenterol 2011; 49:191–194.
Dollberg L, Gurevitz M, Freier S. Gastrointestinal mast cells in health, and in coeliac disease and other conditions. Arch Dis Child 1980; 55:702–705.
Platzgummer S, Bizzaro N, Bilo MB, et al. Recommendations for the use of tryptase in the diagnosis of anaphylaxis and clonal mast cell disorders. Eur Ann Allergy Clin Immunol 2020; 52:51–61.
Jogie-Brahim S, Min HK, Fukuoka Y, et al. Expression of alpha-tryptase and beta-tryptase by human basophils. J Allergy Clin Immunol 2004; 113:1086–1092.
Schwartz LB, Irani AM, Roller K, et al. Quantitation of histamine, tryptase, and chymase in dispersed human T and TC mast cells. J Immunol 1987; 138:2611–2615.
Elieh Ali Komi D, Wohrl S, Bielory L. Mast cell biology at molecular level: a comprehensive review. Clin Rev Allergy Immunol 2020; 58:342–365.
Lennartsson J, Jelacic T, Linnekin D, et al. Normal and oncogenic forms of the receptor tyrosine kinase kit. Stem Cells 2005; 23:16–43.
Bashashati M, Moossavi S, Cremon C, et al. Colonic immune cells in irritable bowel syndrome: a systematic review and meta-analysis. Neurogastroenterol Motil 2018; 30:
Simon AK, Hollander GA, McMichael A. Evolution of the immune system in humans from infancy to old age. Proc Biol Sci 2015; 282:20143085.
Valent P, Horny HP, Escribano L, et al. Diagnostic criteria and classification of mastocytosis: a consensus proposal. Leuk Res 2001; 25:603–625.
Braverman DZ, Dollberg L, Shiner M. Clinical, histological, and electron microscopic study of mast cell disease of the small bowel. Am J Gastroenterol 1985; 80:30–37.
Jakate S, Demeo M, John R, et al. Mastocytic enterocolitis: increased mucosal mast cells in chronic intractable diarrhea. Arch Pathol Lab Med 2006; 130:362–367.
Hahn HP, Hornick JL. Immunoreactivity for CD25 in gastrointestinal mucosal mast cells is specific for systemic mastocytosis. Am J Surg Pathol 2007; 31:1669–1676.
Doyle LA, Sepehr GJ, Hamilton MJ, et al. A clinicopathologic study of 24 cases of systemic mastocytosis involving the gastrointestinal tract and assessment of mucosal mast cell density in irritable bowel syndrome and asymptomatic patients. Am J Surg Pathol 2014; 38:832–843.
Nolte S, Zlobec I, Lugli A, et al. Construction and analysis of tissue microarrays in the era of digital pathology: a pilot study targeting CDX1 and CDX2 in a colon cancer cohort of 612 patients. J Pathol Clin Res 2017; 3:58–70.
Hamilton MJ, Frei SM, Stevens RL. The multifaceted mast cell in inflammatory bowel disease. Inflamm Bowel Dis 2014; 20:2364–2378.
Frossi B, Tripodo C, Guarnotta C, et al. Mast cells are associated with the onset and progression of celiac disease. J Allergy Clin Immunol 2017; 139:1266.e1–1274.e1.
Aceves SS, Chen D, Newbury RO, et al. Mast cells infiltrate the esophageal smooth muscle in patients with eosinophilic esophagitis, express TGF-β1, and increase esophageal smooth muscle contraction. J Allergy Clin Immunol 2010; 126:1198.e4–204.e4.
Nelson M, Zhang X, Pan Z, et al. Mast cell effects on esophageal smooth muscle and their potential role in eosinophilic esophagitis and achalasia. Am J Physiol Gastrointest Liver Physiol 2021; 320:G319–G327.
Bolton SM, Kagalwalla AF, Arva NC, et al. Mast cell infiltration is associated with persistent symptoms and endoscopic abnormalities despite resolution of eosinophilia in pediatric eosinophilic esophagitis. Am J Gastroenterol 2020; 115:224–233.
Martin LJ, Franciosi JP, Collins MH, et al. Pediatric Eosinophilic Esophagitis Symptom Scores (PEESS v2.0) identify histologic and molecular correlates of the key clinical features of disease. J Allergy Clin Immunol 2015; 135:1519.e8–1528.e8.
Mowat AM, Agace WW. Regional specialization within the intestinal immune system. Nat Rev Immunol 2014; 14:667–685.