Original article—alimentary tractAlterations in Mucosal Immunity Identified in the Colon of Patients With Irritable Bowel Syndrome
Section snippets
Participants and Collection of Colon Biopsy Samples
Our study included 36 IBS patients (21 IBS-D and 15 IBS-C) and 25 healthy controls. IBS participants were recruited by mail from an administrative database of 752 patients with IBS who reside within a 150-mile radius of Rochester, MN. All patients fulfilled the Rome II criteria for IBS diagnosis12 and had undergone clinical examination and investigation to exclude other gastrointestinal disorders. Predominant bowel dysfunction was confirmed at the time of the study by means of a validated bowel
Participants
Table 1 summarizes the information on participants in the study.
Histologic Assessment of Mucosal Biopsy Specimens
H&E-stained sigmoid biopsy specimens were normal in most healthy subjects and patients with IBS-C and IBS-D. One healthy subject and 2 patients with IBS-D had focal acute colitis. Melanosis coli was observed in 3 patients with IBS-C and in 1 patient with IBS-D. The thickness of the subepithelial collagen layer was at the upper limit of normal (ie, 10 μm) in 1 healthy subject, in 1 patient with IBS-C, and in 2 patients with IBS-D.
Discussion
This study shows the differential expression of several genes in the colonic mucosa of IBS patients. Many of these genes are directed toward the host defense mechanisms against microbiological pathogens; the well-established properties of the genes and their potential role in IBS are described in the supplementary Discussion section (see supplementary material online at www.cghjournal.org).25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38 A pictorial summary of these genes is provided in
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Dr Camilleri is supported in part by grants DK 54681 and 02638 (studies in irritable bowel syndrome) and by RR024150 (Mayo Clinic CTSA) from the National Institutes of Health. This work was supported by a research grant from Johnson & Johnson Pharmaceutical Research & Development.
A provisional patent application has been filed by the authors’ employers, Mayo Clinic and Janssen Pharmaceutica n.v., for the use of the discovered molecular signatures to diagnose IBS. The following authors were employees of Johnson & Johnson Pharmaceutical Research & Development, a division of Janssen Pharmaceutica n.v. at the time when the study was performed and the manuscript drafted: Jeroen Aerssens, Willem Talloen, Leen Thielemans, Hinrich W. H. Göhlmann, Ilse Van den Wyngaert, Theo Thielemans, and Bernard Coulie.