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http://www.ncbi.nlm.nih.gov/entrez/query.f...t_uids=12454854Full-thickness biopsy of the jejunum reveals inflammation and enteric neuropathy in irritable bowel syndrome.Tornblom H, Lindberg G, Nyberg B, Veress B.Karolinska Institutet Department of Medicine, Huddinge University Hospital, Stockholm, Sweden. hans.tornblom###gastro.hs.sll.seBACKGROUND & AIMS: Irritable bowel syndrome (IBS) is regarded as a functional bowel disorder. Few studies have looked for histopathologic changes in the gut and only then in biopsy specimens from intestinal mucosa. Because bowel function is governed mainly by nerve plexuses in the bowel wall, we have investigated full-thickness bowel biopsy specimens in patients with severe IBS. METHODS: We used a laparoscopy-assisted technique to obtain full-thickness biopsy specimens from the proximal jejunum. Tissue specimens were investigated with light microscopy using routine stainings and immunohistochemical techniques. Horizontal sectioning was done to visualize large areas of the myenteric plexus. Fifteen autopsy specimens were used as controls regarding the myenteric plexus. Colorectal adenoma controls with terminal ileum biopsy specimens and full-thickness jejunal biopsy specimens from patients with degenerative enteric neuropathy were used as control groups for intraepithelial lymphocyte counts. RESULTS: Ten patients (2 males, 8 females) were studied. In 9 patients, we found low-grade infiltration of lymphocytes in the myenteric plexus. Lymphocytes had peri- and intraganglionic location. The mean number of lymphocytes per ganglion ranged from 1.9 to 7.1 per patient, with an overall mean of 3.4. No intraganglionic lymphocytes were found in the control group and only a few periganglionic lymphocytes (mean, 0.2). Four patients had concomitant intraepithelial lymphocytosis. Neuron degeneration was evident in 6 of 9 patients with and 1 patient without ganglionic lymphocyte infiltration. CONCLUSIONS: Our findings indicate that inflammation and neuronal degeneration in the myenteric plexus are involved in the pathogenesis of IBS.
 

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http://www.docguide.com/news/content.nsf/n...5256C8F00214155DGReview Some Irritable Bowel Patients Genetically Predisposed To Produce Less Interleukin-10A DGReview of :"Interleukin 10 genotypes in irritable bowel syndrome: evidence for an inflammatory component?"Gut01/13/2003By Elda HauschildtSome patients with irritable bowel syndrome (IBS) could be genetically predisposed to produce lower amounts of the anti-inflammatory cytokine, interleukin-10 (IL-10), suggest preliminary research results from the United Kingdom."This lends some support to the hypothesis that there may be an inflammatory or genetic component in some cases of this condition," say investigators from University Hospital of South Manchester and the University of Manchester in Manchester. They suggest further studies in specific IBS subgroups are justified.The researchers explain that inflammation could play a role in the pathogenesis of IBS in some patients, including those who develop symptoms after a dysenteric illness. A possible mechanism is persistent inflammation resulting from an imbalance of cytokines that regulate the inflammatory response.Their study was designed to establish whether there is a genetic predisposition to an altered pattern of anti-inflammatory cytokine production in some IBS patients.DNA was extracted from 230 IBS patients and 450 healthy, ethnically matched controls. The researchers then determined allele and genotype frequencies for IL-10 at the site concerned with the production in lymphocytes. They also examined codons 10 and 25 in transforming growth factor-beta(1) [TGF-beta(1)] in a smaller group of participants.Results indicate that the IBS patients had significantly reduced frequencies of the high producer genotype for IL-10 (21%) compared with controls (32%).The investigators found no apparent relationship with any particular IBS bowel-habit subgroup and note genotypes for TGF-beta(1) were not altered. Gut, 2003;52:91-93. "Interleukin 10 genotypes in irritable bowel syndrome: evidence for an inflammatory component?"
 
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