Gastric Mucosal Immune Profiling and Dysregulation in Idiopathic Gastroparesis, 2021, Gottfried-Blackmore et al

Abstract
INTRODUCTION:
It is unclear how immune perturbations may influence the pathogenesis of idiopathic gastroparesis, a prevalent functional disorder of the stomach which lacks animal models. Several studies have noted altered immune characteristics in the deep gastric muscle layer associated with gastroparesis, but data are lacking for the mucosal layer, which is endoscopically accessible. We hypothesized that immune dysregulation is present in the gastroduodenal mucosa in idiopathic gastroparesis and that specific immune profiles are associated with gastroparesis clinical parameters.

METHODS:
In this cross-sectional prospective case-control study, routine endoscopic biopsies were used for comprehensive immune profiling by flow cytometry, multicytokine array, and gene expression in 3 segments of the stomach and the duodenal bulb. Associations of immune endpoints with clinical parameters of gastroparesis were also explored.

RESULTS:
The gastric mucosa displayed large regional variation of distinct immune profiles. Furthermore, several-fold increases in innate and adaptive immune cells were found in gastroparesis. Various immune cell types showed positive correlations with duration of disease, proton pump inhibitor dosing, and delayed gastric emptying.

DISCUSSION:
This initial observational study showed immune compartmentalization of the human stomach mucosa and significant immune dysregulation at the level of leukocyte infiltration in idiopathic gastroparesis patients that extends to the duodenum. Select immune cells, such as macrophages, may correlate with clinicopathological traits of gastroparesis. This work supports further mucosal studies to advance our understanding of gastroparesis pathophysiology.

https://journals.lww.com/ctg/Fullte...al_Immune_Profiling_and_Dysregulation.12.aspx

 

Are these researchers saying it is functional to mean MUS or emotionally based or do they mean something else. It is so confusing.

If there are physical changes it can't be FND by definition and if it is caused by immune changes it is not idiopathic but immunological surely.

Gastroparesis can happen in ME so it is an important finding for us.

 

I have seen the term "functional" used in gastroenterology many times.

My guess is that 'functional' (non-organic) is used in this case because it lacks a proper biomarker?

 

Absolutely, gastroparesis can be a manifestation of GI autonomic dysfunction. I know many who have this.

 

Thank you @Mij for posting this.

I've read this disease can occur after a virus. Who knows, maybe one of those viruses is EBV.

Odd that other diseases which can follow viruses, such as it seems gastroparesis does, are thought of as biomedical, but ME which can follow a virus is still questioned by some.

 

@DokaGirl

My best friend passed away from ME related comorbidities after 18 years of illness from a viral infection. He had autonomic failure and severe gastroparesis.

He was an athletic healthy 35 yr old when he became ill.

 

@Mij

That is very sad your best friend passed away, so young, and so cruelly after being vibrantly healthy.

Absolutely, gastroparesis can be a very severe biomedical disease.

I understand from experience how difficult this disease can be. My n=1 experience with digestive issues is that they have been believed as biomedical, sometimes without any testing. ME was not.

Medical science seems to have neglected a whole host of viral caused illnesses.

(There may not have been any testing for gastroparesis way back when.)

 

@DokaGirl

The good news regarding Long-Covid is that it is bringing more attention to post-infectious POTS and dysautonomia related illnesses.