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United European Gastroenterol J. 2017 Oct;5(6):887-897. doi: 10.1177/2050640617691690. Epub 2017 Jan 29.

Downregulation of mucosal mast cell activation and immune response in diarrhoea-irritable bowel syndrome by oral disodium cromoglycate: A pilot study.

United European gastroenterology journal

Beatriz Lobo, Laura Ramos, Cristina Martínez, Mar Guilarte, Ana M González-Castro, Carmen Alonso-Cotoner, Marc Pigrau, Inés de Torres, Bruno K Rodiño-Janeiro, Eloisa Salvo-Romero, Marina Fortea, Cristina Pardo-Camacho, Danila Guagnozzi, Fernando Azpiroz, Javier Santos, María Vicario

Affiliations

  1. Laboratory of Neuro-Immuno-Gastroenterology, Digestive System Research Unit, Vall d'Hebron Institut de Recerca VHIR; Department of Gastroenterology, Hospital Universitari Vall d'Hebron and Universitat Autònoma de Barcelona (Department of Medicine) Barcelona, Spain.
  2. Department of Human Molecular Genetics, Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany.
  3. Allergy Unit, Hospital Universitari Vall d'Hebron and Universitat Autònoma de Barcelona (Department of Medicine) Barcelona, Spain.
  4. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD). Instituto de Salud Carlos III, Subdirección General de Investigación Sanitaria, Ministerio de Economía, Industria y Competitividad, Spain.
  5. Department of Pathology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.

PMID: 29026603 PMCID: PMC5625876 DOI: 10.1177/2050640617691690

Abstract

BACKGROUND AND GOAL: Diarrhoea-predominant irritable bowel syndrome (IBS-D) exhibits intestinal innate immune and mucosal mast cell (MC) activation. MC stabilisers have been shown to improve IBS symptoms but the mechanism is unclear. Our primary aim was to investigate the effect of oral disodium cromoglycate (DSCG) on jejunal MC activation and specific innate immune signalling pathways in IBS-D, and secondarily, its potential clinical benefit.

STUDY: Mucosal MC activation (by ultrastructural changes, tryptase release and gene expression) and innate immune signalling (by protein and gene expression) were quantified in jejunal biopsies from healthy (HS;

RESULTS: IBS-D-NT exhibited significant MC activation and over-expression of immune-related genes as compared to HS, whereas in IBS-D-DSCG MC activity and gene expression were similar to HS. Furthermore, DSCG significantly reduced abdominal pain and improved stool consistency.

CONCLUSION: Oral DSCG modulates mucosal immune activity and improves gut symptoms in IBS-D patients. Future placebo-controlled clinical trials are needed for confirmation of clinical benefit of DSCG for IBS-D.

Keywords: Diarrhea-predominant irritable bowel syndrome; Toll-like receptors; disodium cromoglycate; intestinal innate immunity; mast cell

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