Increased chromogranin a cell density in the large intestine of patients with irritable bowel syndrome after receiving dietary guidance.

Tarek Mazzawi,Magdy El-Salhy,Trygve Hausken,Doris Gundersen

doi:10.1155/2015/823897

Abstract

The large intestine contains five types of endocrine cells that regulate its functions by sensing its luminal contents and releasing specific hormones. Chromogranin A (CgA) is a common marker for the gastrointestinal endocrine cells, and it is abnormal in irritable bowel syndrome (IBS) patients. Most IBS patients relate their symptoms to certain food elements. The present study investigated the effect of dietary guidance on the total endocrine cells of the large intestine as detected by CgA in 13 IBS patients. Thirteen control subjects were also included. Each patient received three sessions of dietary guidance. Colonoscopies were performed on controls and patients (at baseline and at 3–9 months after receiving guidance). Biopsy samples from the colon and rectum were immunostained for CgA and quantified by computerized image analysis. The densities of CgA cells in the total colon (mean ± SEM) among the controls and the IBS patients before and after receiving dietary guidance were 83.3 ± 10.1, 38.6 ± 3.7, and 64.7 ± 4.2 cells/mm2, respectively (P = 0.0004), and were unchanged in the rectum. In conclusion, the increase in CgA cell density after receiving dietary guidance may reflect a change in the densities of the large intestinal endocrine cells causing an improvement in the IBS symptoms.

Highlights

Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) disorder that is present in almost one-third of consultations with gastroenterologists [1, 2]
The same dietary guidance normalizes the gastric endocrine cells [41, 42], and the present study investigated whether dietary guidance affects the total endocrine cells of the large intestine as detected by Chromogranin A (CgA)
Of the 46 patients recruited in the study, 24 lost their motivation to continue participating in the study and withdrew their consent due to symptom improvement as a consequence of receiving dietary guidance and/or being unwilling for a second colonoscopy to be performed

Summary

Introduction

Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) disorder that is present in almost one-third of consultations with gastroenterologists [1, 2]. The GI endocrine cells comprise almost 1% of all epithelial cells in the GI tract and are considered the largest endocrine organ in the body [11,12,13]. These cells project specialized microvilli into the lumen, which sense its contents (mainly nutrients) and release specific hormones into the lamina propria [14,15,16,17,18,19,20,21,22,23,24,25,26]. The large intestines, namely, the colon and rectum, contain five types of endocrine cell: serotonin-, peptideYY-, somatostatin-, oxyntomodulin- (enteroglucagon-), and pancreatic-polypeptide-producing cells [27,28,29]

Methods

Results

Conclusion