Functional gastrointestinal disorders and mast cells: implications for therapy

被引:128
作者
Barbara, G [1 ]
Stanghellini, V [1 ]
De Giorgio, R [1 ]
Corinaldesi, R [1 ]
机构
[1] Univ Bologna, Dept Internal Med & Gastroenterol, Bologna, Italy
关键词
abdominal pain; functional bowel disorders; irritable bowel syndrome; mast cells; neuro-immune interactions; sensory neurons;
D O I
10.1111/j.1365-2982.2005.00685.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The pathophysiology of functional gastrointestinal disorders is poorly understood. Accepted common mechanisms include psychosocial factors, abnormal gastrointestinal motility and disturbed visceral sensory perception, but the underlying causes remain unclear. Mast cells (MCs) are immunocytes widely distributed throughout the gastrointestinal tract. Several stimuli (e.g. allergens, neuropeptides and stress) lead to MC activation with consequent mediator release (e.g. histamine, tryptase and prostanoids). The MC mediators interact with nerves supplying the gut leading to altered gut physiology and increased sensory perception. The intestinal mucosa of irritable bowel syndrome patients contains on average an increased number of MCs. These cells release an increased amount of mediators in close vicinity to mucosal innervation. The MC activation and their close proximity to nerve fibres is correlated with the severity of perceived abdominal painful sensations. These data provide a strong basis for considering MCs as important participants in visceral hypersensitivity and pain perception in irritable bowel syndrome. Inhibition of MC function may ameliorate irritable bowel symptoms. Novel drugs with an increased potential in the control of MC function (e.g., anti-IgE antibodies, the intracellular protein tyrosine kinase inhibitor Syk) and mediator release (e.g., second generation antihistamines, proteinase-activated receptor antagonists) may be useful pharmacological tools for these common disorders.
引用
收藏
页码:6 / 17
页数:12
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