Mastocytic Enterocolits and the Role of Mast Cells in Functional and Inflammatory Intestinal Disorders: A Systematic Review

Abstract

Background: Chronic diarrhoea affects 5–10% of the adult population. Histologic lesions of possible diagnostic significance are found under normal colonoscopy in approximately 30% of patients affected by chronic diarrhoea. Mastocytic enterocolitis is characterized by an increase in the number of mucosal mast cells (MC) in the gut of patients with chronic intractable diarrhoea, detected by immunohistochemical staining, responding to mast-cell targeted drugs. The question arises whether to search for MC infiltration in specific subsets of patients as a matter of routine clinical practice. Summary: A systematic electronic search of the English literature up to December 2017 was performed, using Medline, EMBASE, Web of Science, Scopus, and the Cochrane Library. This revealed 9 studies reporting an increased number of MC in the gut mucosa of patients with chronic diarrhoea. No consensus was found, however, on the actual cutoff point, the overlap in range between patients and controls being too great to be of clinical significance. The available evidence does not therefore justify the routine evaluation of MC count. Key Messages: More studies are needed to better define MC count and the significance of MC degranulation in normal and pathological settings. Until these become available, the search for MC infiltration in specific subsets of patients should be restricted to research settings.

Saffron: The Golden Spice with Therapeutic Properties on Digestive Diseases

“…It would also be useful to evaluate the effect of saffron on mast cells in the intestinal mucosa of IBS patients. Mast cells increase seems to play an important role in the pathogenesis of symptoms [37]. Another important aspect would be the evaluation of the interaction of saffron components with diet FODMAP (Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols), also implicated in the symptoms of IBS patients through their action on gut microbiota [38].…”

Is mastocytic colitis a specific clinical-pathological entity?

“…6 Diagnosis was based on the presence of chronic diarrhea and abdominal pain, with normal endoscopic appearance of the colonic mucosa, associated with an increased number of intestinal mast cells (MC), assessed by specific immunehistochemical staining in biopsy specimens. 6 Subsequent studies supported this hypothesis, [7][8][9][10][11][12][13] although the increased mast cells could merely represent one of the potential mediators of inflammation. 14 Unlike other forms of microscopic colitis, mastocytic enterocolitis responds to treatment with antihistamines and/or MC membrane stabilizers.…”

“…The role of MC in other pathologic conditions is less clear, but they are likely involved in IBS, IBD, microscopic colitis, and eosinophilic colitis. 12 , 19 , 24-27 …”

“…The role of MC in other pathologic conditions is less clear, but they are likely involved in IBS, IBD, microscopic colitis, and eosinophilic colitis. 12,19,[24][25][26][27] In animal models of colitis, the activation of intestinal MC results in flare-ups of inflammation. 28 MC and their mediators, located within the muscle layer, near stenotic segments are likely involved in the fibrotic process in Crohn's disease.…”

Mast cells and eosinophils of the intestinal mucosa compared with data on food allergy and food sensitization in children with inflammatory bowel disease

“…Однако в настоящее время нет общепринятых референсных значений количества ТК в слизистой оболочке кишечника у здоровых людей. Большинство исследований рассматривают пороговое значение -20 ТК слизистой оболочки (х400 HPF) в пределах собственной пластинки на основании того, что это значение составляет +2 стандартных отклонения от показателей в общей популяции [14].…”