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lüll Increased capsaicin receptor TRPV1-expressing sensory fibres in irritable bowel syndrome and their correlation with abdominal pain Akbar A; Yiangou Y; Facer P; Walters JR; Anand P; Ghosh SGut 2008[Jul]; 57 (7): 923-9OBJECTIVE: The capsaicin receptor TRPV1 (transient receptor potential vanilloid type-1) may play an important role in visceral pain and hypersensitivity states. In irritable bowel syndrome (IBS), abdominal pain is a common and distressing symptom where the pathophysiology is still not clearly defined. TRPV1-immunoreactive nerve fibres were investigated in colonic biopsies from patients with IBS, and this was related to abdominal pain. METHODS: Rectosigmoid biopsies were collected from 23 IBS patients fulfilling Rome II criteria, and from 22 controls. Abdominal pain scores were recorded using a validated questionnaire. TRPV1-, substance P- and neuronal marker protein gene product (PGP) 9.5-expressing nerve fibres, mast cells (c-kit) and lymphocytes (CD3 and CD4) were quantified, following immunohistochemistry with specific antibodies. The biopsy findings were related to the abdominal pain scores. RESULTS: A significant 3.5-fold increase in median numbers of TRPV1-immunoreactive fibres was found in biopsies from IBS patients compared with controls (p<0.0001). Substance P-immunoreactive fibres (p = 0.01), total nerve fibres (PGP9.5) (p = 0.002), mast cells (c-kit) (p = 0.02) and lymphocytes (CD3) (p = 0.03) were also significantly increased in the IBS group. In multivariate regression analysis, only TRPV1-immuno-reactive fibres (p = 0.005) and mast cells (p = 0.008) were significantly related to the abdominal pain score. CONCLUSIONS: Increased TRPV1 nerve fibres are observed in IBS, together with a low-grade inflammatory response. The increased TRPV1 nerve fibres may contribute to visceral hypersensitivity and pain in IBS, and provide a novel therapeutic target.|Abdominal Pain/*metabolism/psychology[MESH]|Adult[MESH]|Aged[MESH]|Anxiety/metabolism[MESH]|Depression/metabolism[MESH]|Female[MESH]|Humans[MESH]|Immunoenzyme Techniques[MESH]|Inflammation Mediators/metabolism[MESH]|Intestinal Mucosa/metabolism[MESH]|Irritable Bowel Syndrome/*metabolism/psychology[MESH]|Male[MESH]|Middle Aged[MESH]|Nerve Fibers/*metabolism[MESH]|Neurons, Afferent/*metabolism[MESH]|Pain Measurement/methods[MESH]|TRPV Cation Channels/*metabolism[MESH] |