| Background and ObjectivesFunctional dyspepsia (FD) is a functional syndrome thought to originate in the gastro-duodenal region, and the symptoms of FD is described as epigastric pain, epigastric burni-ng, postprandial fullness and early satiation.FD is in the absence of any organic, systemic, or metabolic disease that is likely to explain the symptoms. FD was divided into two subgr-oups, which were epigastric pain syndrome (EPS) and postprandial distress syndrome (PD-S). So far, the etiology and pathogenesis of FD is not fully clear, and maybe involved in many aspects and fields.Eosinophils and mast cells are important immune cells in the gastrointestinal mucosa, and has an important regulatory role on gastrointestinal function. Degranulated eosinophils can lead to nerve stimulation and smooth muscle contraction, resulting in gastrointestinal symptoms, such as abdominal pain and distension. Mast cells can release a variety of med-iators such as5-HT(5-HT), nitric oxide(NO), vasoactive intestinal peptide (VIP) which can regulate gastrointestinal motility and visceral sensation. Related research reports, Com-pared with healthy volunteers, the immune cells such as acidophilic granulocyte, mast cells in the gastric and duodenum of FD patients are increased.Current studies suggest that the duodenum may be the key parts where symptoms originate.FD patients had anomaly in duodenal power, paresthesia and various neurotrans-mitters released by enteric nerves play an important role on regulating gastrointestinal motility and sensory. Research has shown that the enteric nervous system and brain-gut axis may be involved in the duodenal dysfunction of FD. The Central nervous system and enteric nervous system can produce a variety of neurotransmitters, such like NO and VIP In the network regulation of brain gut axis in FD. These neurotransmitter play an important role on the sense of the gastrointestinal tract and functions when they are under the conditions of inflammation and immune activation. Epithelium and vascular endothelium and nerve cells can express NO,5-HT and substance P in intestinal inflammation, and these neurotransmitters will play an excitation effect on the gastro-duodenal dynamic, and has an important role on the gastrointestinal visceral sensation. Transmitter in the enteric nervous system disorders may be the important mechanism of functional dyspepsia.Research shows some patients with FD have acute infection of previous medical history and we call it post-infection functional dyspepsia. It’s that the symptoms of FD, such as after early satiety, abdominal distension, burning sensation in the upper abdomen and other symptoms are come from6to12months later of acute or chronic gastrointestinal infections. Studies show that this is associated with delayed gastric emptying and gastric movement regulation damaged. However, there is a lot of controversy of the potential relationship between gastrointestinal tract infection and digestive system symptoms in each subtype of FD. It is found that local T lymphocyte proliferation, CD4+cells and macroph-age counts increase in the duodenum of PI-FD. All these prompt termination of impaired ability of the inflammatory response in the immune system after acute injury.This study compared the difference of duodenal mucosal mast cells, eosinophils betw-een PI-FD and FD.MethodsSelection patients as the subjects who came for doctors of digestive internal medicine in Tai An center hospital between October2011and October2012. According to the Rome III criteria assessment, Patients with acute or chronic gastroenteritis were followed for6to12months, who happened bloating, early satiety and postprandial full bilge unwell, abdo-minal pain, were as the experimental group and this group has a total of28cases.39pati-ents with functional dyspepsia were selected as control group,21healthy volunteers as blank group. HE staining and acidophilic granulocyte count mucosa, toluidine blue stain-ing counting the total number of mast cells and activation rate after upper pliers duodenal bulb and decline period of mucosal tissue. Three groups of related variables, such as duod-enal mucosal mast cells, eosinophils get through statistical analysis and compare the differ-ence of duodenal immune cells between PI-FD and FD.ResultsThe mast cell count in ball Duodenum of five period of mucosa at high magnification view in PI-FD,FD and the control group is124.91±14.31、120.26±13.75、105.29±20.81,and the result of PI-FD, FD are both significantly higher than that of the control group (P<0.05),and compared to FD group, the count of mast cell in PI-FD group is higher. The mast cell count in Duodenal descending segment of five period of mucosa at high magnification view in PI-FD,FD and the control group is125.28±12.04、121.32±13.53、107.62±17.64, and the result of PI-FD, FD are both significantly higher than that of the control group (P<0.05),and compared to FD group,the count of mast cell in PI-FD group is higher.The eosinophils count in ball Duodenum of five period of mucosa at high magnifyat-ion view in PI-FD,FD and the control group is21.62±6.26、21.46±5.03、19.38±5.06,and compared with each other they have not significant change (P>0.05). The eosinophils count in Duodenal descending segment of five period of mucosa at high magnification view in PI-FD,FD and the control group is25.23±5.18、23.65±5.71、19.38±5.06, and the result of PI-FD, FD are both significantly higher than that of the control group (P<0.05),and compared to FD group,the count of eosinophils in PI-FD group is higher.Conclusions1. Duodenal immune may be involved in the pathogenesis of FD.2. There is duodenal immune activition in FD, and gastrointestinal infections may be involved in the pathogenesis of FD as the initiative factor of duodenal immune activition.The significance of studyThis topic studies the relationship between infection and functional dyspepsia, offers a new way for the research of the pathogenesis of FD, at the same time for the work of clinical treatment of FD tip play an important role. |
PDF Full Text Request