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Colonic Immune Cells in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis Publisher Pubmed



Bashashati M1 ; Moossavi S2, 3 ; Cremon C4 ; Barbaro MR4 ; Moraveji S1 ; Talmon G5, 6 ; Rezaei N7 ; Hughes PA8 ; Bian ZX9 ; Choi CH10 ; Lee OY11 ; Coeffier M12 ; Chang L13 ; Ohman L14 Show All Authors
Authors
  1. Bashashati M1
  2. Moossavi S2, 3
  3. Cremon C4
  4. Barbaro MR4
  5. Moraveji S1
  6. Talmon G5, 6
  7. Rezaei N7
  8. Hughes PA8
  9. Bian ZX9
  10. Choi CH10
  11. Lee OY11
  12. Coeffier M12
  13. Chang L13
  14. Ohman L14
  15. Schmulson MJ15
  16. Mccallum RW1
  17. Simren M16, 17
  18. Sharkey KA18
  19. Barbara G4
Show Affiliations
Authors Affiliations
  1. 1. Division of Gastroenterology, Department of Internal Medicine, Texas Tech University Health Sciences Center/Paul L. Foster School of Medicine, El Paso, TX, United States
  2. 2. Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
  4. 4. Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research, University of Bologna, Bologna, Italy
  5. 5. Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, United States
  6. 6. Fred and Pamela Buffet Cancer Center, Omaha, NE, United States
  7. 7. Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Centre for Nutritional and Gastrointestinal Diseases, Department of Medicine, University of Adelaide and South Australian Health Medical Health Research Institute, Adelaide, SA, Australia
  9. 9. School of Chinese Medicine, Hong Kong Baptist University, Kowloon Tong, Hong Kong
  10. 10. Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea
  11. 11. Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
  12. 12. Normandie Univ, INSERM unit 1073 “Nutrition, inflammation and brain-gut axis�, Institute for Research and Innovation in Biomedicine, Rouen Medical University and Rouen University Hospital, Rouen, France
  13. 13. G Oppenheimer Center of Neurobiology of Stress and Resilience, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
  14. 14. Departments of Internal Medicine and Clinical Nutrition and Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  15. 15. Laboratorio de Higado, Pancreas y Motilidad (HIPAM), Unidad de Investigacion en Medicina Experimental, Facultad de Medicina-Universidad Nacional Autonoma de Mexico (UNAM), Hospital General de Mexico, Mexico City, Mexico
  16. 16. Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  17. 17. Center for Functional GI and Motility Disorders, University of North Carolina, Chapel Hill, NC, United States
  18. 18. Hotchkiss Brain Institute and Snyder Institute for Chronic Diseases, Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada

Source: Neurogastroenterology and Motility Published:2018


Abstract

Background & Aims: Increases in mucosal immune cells have frequently been observed in irritable bowel syndrome (IBS) patients. However, this finding is not completely consistent between studies, possibly due to a combination of methodological variability, population differences and small sample sizes. We performed a meta-analysis of case–control studies that compared immune cell counts in colonic biopsies of IBS patients and controls. Methods: PubMed and Embase were searched in February 2017. Results were pooled using standardized mean difference (SMD) and were considered significant when zero was not within the 95% confidence interval (CI). Heterogeneity was assessed based on I2 statistics where I2 ≤ 50% and I2 > 50% indicated fixed and random effect models, respectively. Key Results: Twenty-two studies on 706 IBS patients and 401 controls were included. Mast cells were increased in the rectosigmoid (SMD: 0.38 [95% CI: 0.06-0.71]; P =.02) and descending colon (SMD: 1.69 [95% CI: 0.65-2.73]; P =.001) of IBS patients. Increased mast cells were observed in both constipation (IBS-C) and diarrhea predominant IBS (IBS-D). CD3+ T cells were increased in the rectosigmoid (SMD: 0.53 [95% CI: 0.21-0.85]; P =.001) and the descending colon of the IBS patients (SMD: 0.79, 95% CI [0.28-1.30]; P =.002). This was possibly in relation to higher CD4+ T cells in IBS (SMD: 0.33 [95% CI: 0.01-0.65]; P =.04) as there were no differences in CD8+ T cells. Conclusions & Inferences: Mast cells and CD3+ T cells are increased in colonic biopsies of patients with IBS vs non-inflamed controls. These changes are segmental and sometimes IBS-subtype dependent. The diagnostic value of the quantification of colonic mucosal cells in IBS requires further investigation. © 2017 John Wiley & Sons Ltd
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