The 2009 Walker paper evaluates the mast cell count in patients with irritable bowel syndrome (both diarrhea and constipation predominant forms) and functional dyspepsia (indigestion, upper abdominal pain). This study recorded the total count of mast cells in five fields. Additionally, two biopsies from different sections of the duodenum were taken for each patient. I performed some calculations to convert it to mast cells/hpf to be comparable to other data presented in this series.
Mast cells were identified using an antibody to CD117, the CKIT receptor found on the surface of all mast cells. This paper found that the average mast cell count for each patient (averaged between two biopsy sites) was 33/hpf for functional dyspepsia; 45/hpf average for both types of irritable bowel syndrome; 42.7/hpf for irritable bowel syndrome with predominant diarrhea; 47.7/hpf for irritable bowel syndrome with predominant constipation. The control group of healthy patients demonstrated an average cell count of 29.4/hpf, with a maximum cell count of 46.5 mast cells/hpf. See Table 9 for details.
| Table 9: Mast cell count in stomach of patients with irritable bowel syndrome and functional dyspepsia | ||||||||||
| Walker MM, et al. Duodenal mastocytosis, eosinophilia and intraepithelial lymphocytosis as possible disease markers in the irritable bowel syndrome and functional dyspepsia. Aliment Pharmacol Ther 2009; 29 (7): 765-773. | ||||||||||
| Microscopy method: 400x magnification, mast cells counted in 5 hpf and totaled
*Note: I made some calculations to yield information that would be comparable to other research (mast cells/hpf).
This paper provided total cell counts in 5 hpf for two biopsies for each patient. For example, patient A had two biopsies with one having 50 mast cells/hpf and the other having 30 mast cells/hpf. I divided each cell count by 5 to give mast cells/hpf. (50/5 = 10 for biopsy 1; 30/5 = 6 for biopsy 2). I added these together (10+6 = 16) and divided by 2 to get the average (16/2 = 8 mast cells/hpf). |
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| Visualization: CD117 (IHC) | ||||||||||
| Sample type | Study group: Functional dyspepsia | Study group: Irritable bowel syndrome (both diarrhea and constipation groups) | Study group: Irritable bowel syndrome, diarrhea | Study group: Irritable bowel syndrome, constipation | Control group: Healthy controls | |||||
| Duodenum | Average | Range | Average | Range | Average | Range | Average | Range | Average | Range |
| 33 mast cells/hpf | 39.2-65.4 mast cells/hpf | 45 mast cells/hpf | 22.2-74.8 mast cells/hpf | 42.7 mast cells/hpf | 22.2-65.5 mast cells/hpf | 47.7 mast cells/hpf | 29.7-74.8 mast cells/hpf | 29.4 mast cells/hpf | 15.2-46.5 mast cells/hpf | |
| Diffuse scattered cells, no clusters. | Diffuse scattered cells, no clusters. | Diffuse scattered cells, no clusters. | Diffuse scattered cells, no clusters. | Diffuse scattered cells, no clusters. | ||||||
A 2012 paper by Zare-Mirzaie evaluated colonic tissue of patients with chronic diarrhea. Cells were detected by two methods: an antibody to tryptase, and through the use of a simple stain, toluidine blue. The counts presented in table 10 were found using the antibody to tryptase. Cells were counted in 10 hpf and averaged.
| Table 10: Mast cell count in colon of patients with chronic diarrhea | ||||||
| Zare-Mirzaie A, et al. Analysis of colonic mucosa mast cell count in patients with chronic diarrhea. Saudi J Gastroenterol 2012; 18 (5): 322-326. | ||||||
| Microscopy method: 400x magnification, mast cells counted in 10 hpf and averaged | ||||||
| Visualization: Tryptase, toluidine blue | ||||||
| Sample type | Study group: Chronic diarrhea | Control group A:
Healthy controls |
Control group B:
No control group |
|||
| Colon | Average | Range | Average | Range | Average | Range |
| 21.3 ± 4.8 mast cells/hpf | 17-24 mast cells/hpf | 14.2 ± 3.4 mast cells/hpf | 11-17 mast cells/hpf | N/A | N/A | |
| Diffuse scattered cells, no clusters. | Diffuse scattered cells, no clusters. | |||||
A 2007 paper by Guilarte mentioned mast cell counts in the jejunum (small intestine) of patients with chronic diarrhea. Cells were detected with an antibody to CD117. The cells were counted in 10 hpf and averaged. Please note the correct use of the term “mast cell hyperplasia” rather than “mastocytosis.” See Table 11 for details.
| Table 11: Mast cell count in colon of patients with diarrhea predominant irritable bowel syndrome | ||||||
| Guilarte M, et al. Diarrhoea-predominant IBS patients show mast cell activation and hyperplasia in the jejunum. Gut 2007; 56: 203-209.
|
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| Microscopy method: 400x magnification, mast cells counted in 8 hpf and averaged | ||||||
| Visualization: CD117 | ||||||
| Sample type | Study group: Irritable bowel syndrome, diarrhea | Control group A: Healthy controls | ||||
| Jejunum | Average | Range | Average | Range | ||
| 34 mast cells/hpf | 15.3 mast cells/hpf | |||||
A 2014 paper by Vivinus-Nebot assessed mast cell counts in the colon of patients with persistent GI symptoms in quiescent (inactive) inflammatory bowel diseases. Cells were detected with an antibody to CD117. The cells were counted in 3 hpf and averaged. The mast cell counts in this paper were uniformly low. This implies that mast cells are involved more directly in the inflammatory GI processes, rather than specifically in diarrhea or constipation. See Table 12 for details.
| Table 12: Mast cell count in colon of patients with inactive inflammatory bowel conditions | ||||||||
| Vivinus-Nebot M, et al. Functional bowel symptoms in quiescent inflammatory bowel diseases: role of epithelial barrier disruption and low-grade inflammation. Gut 2014; 63: 744-752. | ||||||||
| Microscopy method: 400x magnification, mast cells counted in 3 hpf and averaged | ||||||||
| Visualization: CD117 | ||||||||
| Sample type | Study group: Irritable bowel syndrome, constipation | Study group: Irritable bowel syndrome, diarrhea | Study group: Irritable bowel syndrome, mixed | Study group: Quiescent Crohn’s disease with irritable bowel syndrome type symptoms | ||||
| Colon | Average | Range | Average | Range | Average | Range | Average | Range |
| 12 mast cells/hpf | 9-16 mast cells/hpf | 12 mast cells/hpf | 10-15 mast cells/hpf | 12 mast cells/hpf | 10-17 mast cells/hpf | 12 mast cells/hpf
|
6-16 mast cells/hpf | |
| Distribution not stated. | Distribution not stated. | Distribution not stated. | Distribution not stated. | |||||
| Sample type | Study group: Quiescent Crohn’s disease | Study group: Quiescent ulcerative colitis with irritable bowel syndrome type symptoms | Study group: Quiescent ulcerative colitis | Study group: Healthy controls | ||||
| Colon | Average | Range | Average | Range | Average | Range | Average | Range |
| 12 mast cells/hpf | 4-16 mast cells/hpf | 12 mast cells/hpf | 9-15 mast cells/hpf | 10 mast cells/hpf | 5-15 mast cells/hpf | 6 mast cells/hpf | 2-9 mast cells/hpf | |
| Distribution not stated. | Distribution not stated. | Distribution not stated. | Distribution not stated. | |||||
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