Mucosal Th17 Cells Are Increased in Pediatric Functional Dyspepsia Associated with Chronic Gastritis
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ORIGINAL ARTICLE
Mucosal Th17 Cells Are Increased in Pediatric Functional Dyspepsia Associated with Chronic Gastritis Meenal Singh1 · Vivekanand Singh2 · Jennifer V. Schurman3 · Craig A. Friesen1 Received: 16 July 2019 / Accepted: 31 December 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Chronic gastritis is a common histologic finding in children with functional dyspepsia (FD). While Th17 cells have been implicated in other forms of gastritis, they have not been evaluated in chronic gastritis. Aims The aim of the current study was to assess Th17 cells in children with FD with and without chronic gastritis. Methods Densities were determined for Th17 cells, eosinophils, and mast cells, respectively, in both the gastric antrum and the duodenum. Densities were compared between five groups: FD with chronic gastritis (N = 20), FD without chronic gastritis (N = 20), Helicobacter pylori-associated gastritis (N = 10), Crohn’s gastritis (N = 10), and normal controls (N = 10). Th17 densities were also compared between patients with and without early satiety. Results FD with chronic gastritis was associated with higher Th17 cell density as compared to normal controls and comparable to both H. pylori-associated gastritis and Crohn’s gastritis. Eosinophil and mast cell densities were higher in FD patients with chronic gastritis as compared to either FD without gastritis or normal controls. Th17 density was higher in patients reporting early satiety but not in those with epigastric pain. Conclusions FD with chronic gastritis is associated with higher Th17 cell, eosinophil, and mast cell density as compared to FD without chronic gastritis or normal controls. Chronic gastritis demonstrated Th17 cell density similar to that seen in other conditions where Th17 cells are believed to play a pathogenic role. Th17 cells may represent another therapeutic target in these patients. Keywords Functional dyspepsia · Th17 cells · Eosinophils · Mast cells · Chronic gastritis
Introduction * Craig A. Friesen [email protected] Meenal Singh [email protected] Vivekanand Singh [email protected] Jennifer V. Schurman [email protected] 1
Division of Gastroenterology, Hepatology, and Nutrition, Children’s Mercy Kansas City, 2401 Gillham Road, Kansas City, MO 64108, USA
2
Department of Pathology and Laboratory Medicine, Children’s Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, USA
3
Division of Developmental and Behavioral Sciences, Children’s Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, USA
Chronic or recurrent abdominal pain affects a significant proportion of the pediatric population [1, 2]. The majority of children with chronic abdominal pain will report symptoms that fit into specific diagnoses within the broad array of functional gastrointestinal disorders (FGIDs) as defined by the Rome criteria [3, 4]. There are four pain-related FGIDs with one of the two most common being functional dyspepsia (FD) [5]. The most recent revision of pediatric Rome criteria (Rome IV)
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