The Role of Endocrine Cells of the Colon, Secreting Vasoactive Intestinal Polypeptide, Somatostatin and Motilin, in Irritable Bowel Syndrome, Occurring with Diarrhea and Constipation

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Abstract

Background. Disorders in the production of neuroendocrine peptides in the digestive tract can cause changes in, intestinal motility and the formation of visceral hypersensitivity, characteristic of patients with irritable bowel syndrome (IBS). From this standpoint, of particular interest is the study of the role of a number of major endocrine cells (EC) of the colon, secreting motilin, vasoactive intestinal polypeptide, and somatostatin, in IBS. Aims — to evaluate the density of ECs with different hormonal activities that secrete motilin, vasoactive intestinal polypeptide and somatostatin in the mucosa of the sigmoid colon in patients with IBS that occurs with constipation and diarrhea. Materials and methods. 85 patients with IBS were examined. The first group included 44 patients with diarrhea (IBSd), the second group included 41 patients with constipation (IBSc). The comparison group consisted of 36 practically healthy people. The diagnosis of IBS was based on the Rome IV criteria. Patients and healthy people were examined according to a single program, including clinical, instrumental (colonoscopy, ultrasound examination of the abdominal organs), laboratory (clinical blood test, feces for calprotectin and antibodies to gliadin in the presence of diarrhea), morphological and immunohistochemical methods. Results. The clinical picture of IBS corresponded to the classical manifestations of this pathology. Among patients with IBSc, there was a more frequent feeling of incomplete emptying of the intestine after defecation, compared with patients with IBSd (p < 0.05). Among patients with IBSd, there was a statistically significant increase in the number of ECs producing motilin and vasoactive intestinal polypeptide, as well as a lower density of ECs secreting somatostatin, compared with the control group (p < 0.05). In the IBSc group, there was a decrease in the number of ECs producing motilin, vasoactive intestinal polypeptide and an increase in the number of ECs producing somatostatin, compared with the control group (p < 0.05). Conclusions. An increase in the number of cells producing motilin, vasoactive intestinal polypeptide and a decrease in the number of cells observed for the production of somatostatin in the mucosa of the sigmoid colon is characteristic of the manifestation of IBSd. At the same time, an increase in ECs secreting motilin, vasoactive intestinal polypeptide and an increase in cellular elements producing somatostatin reveals manifestations of IBSс.

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About the authors

Igor' V. Maev

A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Email: igormaev@rambler.ru
ORCID iD: 0000-0001-6114-564X
Russian Federation, Moscow

Mikhail A. Osadchuk

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: osadchuk.mikhail@yandex.ru
ORCID iD: 0000-0003-0485-6802
Russian Federation, Moscow

Valeriya O. Burdina

CLINIC LMS

Email: valeria18_86@mail.ru
Russian Federation, Moscow

Ekaterina D. Mironova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: yek.mironova1995@yandex.ru
ORCID iD: 0000-0003-3268-2408
Russian Federation, Moscow

Maksim M. Osadchuk

Moscow City Polyclinic No. 52

Author for correspondence.
Email: maxlife2004@mail.ru
ORCID iD: 0000-0002-8417-5849
Russian Federation, Moscow

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Supplementary files

Supplementary Files
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1. Fig. 1. The number of endocrine cells in the mucous membrane of the sigmoid colon producing motilin (A), vasoactive intestinal polypeptide (B) and somatostatin (C), per 1 mm2. The first group — patients with irritable bowel syndrome with diarrhea (n = 44); the second group — patients with irritable bowel syndrome with constipation (n = 41); control group — n = 36. * p < 0.05 between the first and second groups; ** p < 0.05 between the first and third groups; ^ p < 0.05 between the second and third groups.

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2. Fig. 2. Sigmoid colon of a patient with irritable bowel syndrome with constipation. Immunohistochemical method (× 200). Vasoactive intestinal polypeptide in the cells of the colon mucosa

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3. Fig. 3. Sigmoid colon of a patient with irritable bowel syndrome with constipation. Immunohistochemical method (× 200). Motilin in the cells of the mucous membrane of the large intestine

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4. Fig. 4. Sigmoid colon of a patient with irritable bowel syndrome with constipation. Immunohistochemical method (× 200). Somatostatin in the cells of the colon mucosa

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5. Fig. 5. Analysis of the severity of clinical symptoms of irritable bowel syndrome in the study groups, %. The first group — patients with irritable bowel syndrome with diarrhea (n = 44); the second group — patients with irritable bowel syndrome with constipation (n = 41). * p < 0.05 between the first and second groups

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