Correlation Between Low-grade Inflammation And Visceral Sensitivity In Patients With Functional Dyspepsia

BackgroundFunctional dyspepsia(FD)is the most common functional gastrointestinal disease,affecting patients’ quality of life,consuming large amounts of medical resources,and bringing huge economic and social pressures.However,the pathogenesis of FD is still unclear and may involve in many respects,therefore,exploring its pathogenesis is of great significance for the diagnosis and treatment of this disease.Inflammatory cells in the gastrointestinal mucosa include eosinophils(EO),mast cells(MC),lymphocytes,etc.,in which eosinophils and mast cells are degranulated by two types.Cells that release relevant inflammatory mediators,such as Major basic protein(MPO),tryptase,serotonin,etc.,have important regulatory significance for gastrointestinal sensation,movement,and mucosal barrier function.Some studies have found that gastroduodenal eosinophilia is closely related to FD,especially Postprandial distress syndrome(PDS).Inflammatory cells can cause downstream effects and stimulate local mucosa through self-activation and mediator release.The afferent nerve sends a pain signal,long-term abnormality will make the afferent nerve sensitive,and even induce changes in brain function,and affect the function of the gastrointestinal tract through the bidirectional action of the brain-gut axis;In the current study,the visceral sensitivity test of patients with functional gastrointestinal disease(FGIDs)showed that the severity of gastrointestinal symptoms gradually increased with the increase of visceral sensitivity;in addition,serum/plasma cytokines The expression level has been widely recognized in FGIDs.The imbalance between pro-inflammatory cytokines and anti-inflammatory cytokines promotes the development and progression of inflammation,counteracting the Enteric nervous system(ENS)and the Central nervous system(CNS),causing abnormal changes in mental psychology,is conducive to the persistence of symptoms,but the specific conditions of cytokines in the mucosa are still unclear.Therefore,this study aimed to investigate the low-grade inflammation of the gastroduodenal,visceral sensitivity and mucosal cytokine expression in FD,and whether there is a correlation between the three,providing new ideas for the diagnosis and treatment of FD.Method1.Choose to visit the Second Department of Digestive Internal Medicine of Tai’an Central Hospital from 2017.10—2018.10,and meet the ROME IV diagnostic criteria of 36 people.According to the ROME IV diagnostic criteria,it is divided into: Postprandial Discomfort Syndrome and Epigastric Pain Syndrome 2 groups,20 and 16 respectively;and20 healthy subjects in our hospital were selected as the control group.The study was approved by the ethics committee and all subjects signed informed consent;2.The drinking water load test was carried out in the FD group and the control group meeting the inclusion criteria,and the amount of drinking water(ml)was defined as the initial perception threshold(W1)when the upper abdomen first sensed the sensation(blocking,swelling,etc.).The amount of drinking water(ml)that is apparently persistent,painless,moderate upper abdominal fullness,etc.,is defined as the Discomfort threshold(W2);3.Patients in the FD group and the control group underwent endoscopy and biopsy,duodenal bulb(D1),Duodenal descending(D2),and Gastric antrum(G)2 mucosa,placed in formalin solution;4.After the embedded mucosa was treated with paraffin fixation,HE staining and toluidine staining were performed to observe the number of eosinophils and mast cells in every 5 high magnification microscopes.Immunohistochemical method was used to measure IL-10 in mucosa(Interleukin 10),IL-1β(Interleukin 1β),IL-6(Interleukin 6)expression of three inflammatory mediators.Result1.The initial perception threshold and discomfort threshold of FD group were lower than the control group,and there were statistical significance(P<0.05).2.The counts of D1,D2 and G in eosinophils in FD group were significantly higher than those in the control group(P<0.05).The G site of mast cells was higher than that in the control group,and it was statistically significant(P<0.05),and eosinophils are associated with initial sensory thresholds and discomfort thresholds.3.IL-10 in the PDS group D1,G sites were significantly lower than the control group,and statistically significant(P <0.05).The pro-inflammatory cytokine IL-1β in the PDS,EPS group D1,D2 sites were higher than the control group and was statistically significant(P<0.05),the G site was higher in the PDS group than in the control group,and it was statistically significant(P<0.05).The IL-6 level in the EPS group was significantly higher than that in the control group,and statistically significant(P <0.05).Conclusion1.The visceral sensitivity of FD patients is significantly higher than that of healthy people.2.FD patients with gastric duodenal mucosa eosinophils and visceral high sensitivity.3.There is an imbalance between pro-inflammatory cytokines and anti-inflammatory cytokines in the gastrointestinal mucosa of patients with FD.