Abstract

DUQUE, Carolina Perez  and  LIMA, Margarida. Role of Neuropeptides in Gastrointestinal Manifestations of Systemic Mastocytosis and Similarities with Irritable Bowel Syndrome. Medicina Interna [online]. 2022, vol.29, n.1, pp.40-46.  Epub Apr 01, 2022. ISSN 0872-671X.  https://doi.org/10.24950/rspmi.2022.01.301.

Systemic mastocytosis (SM) is a rare myeloproliferative neoplasm characterized by the extracutaneous proliferation of clonal MC in the bone marrow or other extramedullary sites with or without cutaneous involvement. GastrointestinaI (GI) manifestations, consisting of abdominal pain, diarrhea and malabsorption with various degrees of severity, are frequent in patients with SM and can result from mediator release or direct MC infiltration of the GI tract. Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by chronic and recurrent abdominal pain or discomfort associated with defecation or change in bowel habit. The interaction between immune system and neuropeptides and the enhancement of an inflammatory mucosal response with an increase in immune cells is a key feature of IBS. Previous evidence shows that there is an increased number of MC in the intestinal and colonic mucosa of IBS patients. MC are present in the GI and their activation has been associated to some pro-secretory neurotransmitters such as substance P and vasoactive intestinal peptide in the proximity of enteric nerves suggesting a bidirectional regulatory pathway with neurocrine control of MC activation. Research concerning the role of enteric MC in both SM and IBS is still scarce as well as their link to neuro-peptides. Likewise, more evidence is needed regarding MC and neuropeptides interaction in order to further comprehend the pathophysiology of the GI manifestations of SM and IBS, and the boundaries between these pathologies. In this review we hypothesize that GI symptoms SM and in IBS have similar mechanisms and mediators, with a special focus in the role of mucosal MC and neuropeptides.

Keywords : Diarrhea; Gastrointestinal Tract; Irritable Bowel Syndrome; Mast Cells; Mastocytosis, Systemic; Neuropeptides; Substance P; Vasoactive Intestinal Peptide..

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