目的:炎症性肠病(IBD),嗜酸性粒细胞性胃肠道疾病(EGID),和功能性腹痛障碍(FAPD)在临床上表现出非特异性胃肠道(GI)症状,并且在与嗜酸性粒细胞相关的发病机制方面也有一些相似之处。因此,我们旨在通过研究外周血和胃肠道组织中的嗜酸性粒细胞以及嗜酸性粒细胞阳离子蛋白(ECP),来评估嗜酸性粒细胞在IBD中的作用,而非EGID和FAPD.
方法:纳入患有慢性胃肠道症状且接受内镜活检的儿科患者。全血细胞计数,炎症标志物,免疫球蛋白E(IgE),血清ECP水平,对内镜和组织病理学检查结果进行回顾性分析.
结果:共包括387例患者:179例EGID,107与IBD,和82与FAPD。外周绝对嗜酸性粒细胞计数(AEC),总IgE,IBD和EGID的血清ECP均明显高于FAPD(均p<0.05)。除食道外,三组胃肠道各段组织嗜酸性粒细胞计数差异有统计学意义(p<0.05)。在上升的组织嗜酸性粒细胞计数中观察到显着差异,乙状结肠,直肠在EGID和IBD之间(p<0.05)。胃和十二指肠的外周和组织嗜酸性粒细胞在EGID和IBD中均显示出正相关(均p<0.001)。
结论:嗜酸性粒细胞相关标志物升高,与FAPD相比,IBD和EGID中胃肠道受影响区域的组织嗜酸性粒细胞浸润增加,提示嗜酸性粒细胞可能在两种疾病的发病机制中起着共同的重要作用。
OBJECTIVE: Inflammatory bowel disease (IBD), eosinophilic gastrointestinal disease (EGID), and functional abdominal pain disorder (FAPD) present with nonspecific gastrointestinal (GI) symptoms clinically and also have some similarities in pathogeneses associated with eosinophils. Therefore, we aimed to evaluate the role of eosinophils in IBD compared to EGID and FAPD by investigating eosinophils in peripheral blood and GI tissue and eosinophil cationic protein (ECP).
METHODS: Pediatric patients with chronic GI symptoms who underwent endoscopic biopsies were enrolled. Complete blood cell counts, inflammatory markers, immunoglobulin E (IgE), serum ECP levels, and endoscopic and histopathologic findings were retrospectively reviewed.
RESULTS: A total of 387 patients were included: 179 with EGID, 107 with IBDs, and 82 with FAPD. Peripheral absolute eosinophil count (AEC), total IgE, and serum ECP were significantly higher in both IBD and EGID than in FAPD (all p < 0.05). Statistically significant differences were noted among the three groups in tissue eosinophil counts in each segment of GI tract except for the esophagus (p < 0.05). Significant differences were observed in tissue eosinophil counts in the ascending, sigmoid colon, and rectum between EGID and IBD (p < 0.05). Peripheral and tissue eosinophils in the stomach and duodenum revealed positive correlation in both EGID and IBD (both p < 0.001).
CONCLUSIONS: Elevated eosinophil-related markers, as well as increased tissue eosinophilic infiltration in the affected areas of the GI tract in both IBD and EGID compared to FAPD, suggest that eosinophils might play a common important role in the pathogeneses of both diseases.