Clinical-histological associations in gastroparesis

Results from the Gastroparesis Clinical Research Consortium

M. Grover, C. E. Bernard, Pankaj Jay Pasricha, M. S. Lurken, M. S. Faussone-Pellegrini, T. C. Smyrk, H. P. Parkman, T. L. Abell, W. J. Snape, W. L. Hasler, R. W. Mccallum, L. Nguyen, K. L. Koch, J. Calles, Li-Ching Lee, James A Tonascia, A. Ünalp-Arida, F. A. Hamilton, G. Farrugia, Pankaj Jay Pasricha & 61 others Linda Nguyen, Nighat Ullah, William Snape, Robin Bishop, Nata De Vole, Mary Greene, Sue Louiseau, Shelly Parker, Eve Pillor, Courtney Ponsetto, Katerina Shetler, Gianrico Farrugia, Madhusudan Grover, Cheryl Bernard, Matt Lurken, K. Robert Shen, Michael Sarr, Michael Kendrick, Henry P. Parkman, Steven Kantor, Vanessa Lytes, Amiya Palit, Priyanka Sachdeva, Kellie Simmons, Sean Harbison, Richard W. McCallum, Irene Sarosiek, Reza Hejazi, Denise Vasquez, Natalia Vega, William Hasler, Michelle Atkinson, Thomas Abell, Jo Anne Fordham, Olivia Henry, Archana Kedar, Archana Valerie McNair, Danielle Spree, Kenneth Koch, Lynn Baxter, Mark L Van Natta, Samantha Culler, Laura Wilson, Katherine Yates, Frank Hamilton, Steven James, Rebecca Torrance, Rebekah Van Raaphorst, James Tonascia, Patricia Belt, Michele Donithan, Mika Green, Milana Isaacson, Linda Lee, Kevin Patrick May, Laura Miriel, Aynur Ünalp-Arida, Mark Van Natta, Ivana Vaughn, Laura Wilson, Katherine Yates

Research output: Contribution to journalArticle

Abstract

Background Cellular changes associated with diabetic (DG) and idiopathic gastroparesis (IG) have recently been described from patients enrolled in the Gastroparesis Clinical Research Consortium. The association of these cellular changes with gastroparesis symptoms and gastric emptying is unknown. The aim of this study was to relate cellular changes to symptoms and gastric emptying in patients with gastroparesis. Methods Earlier, using full thickness gastric body biopsies from 20 DG, 20 IG, and 20 matched controls, we found decreased interstitial cells of Cajal (ICC) and enteric nerves and an increase in immune cells in both DG and IG. Here, demographic, symptoms [gastroparesis cardinal symptom index score (GCSI)], and gastric emptying were related to cellular alterations using Pearson's correlation coefficients. Key Results Interstitial cells of Cajal counts inversely correlated with 4h gastric retention in DG but not in IG (r=-0.6, P=0.008, DG, r=0.2, P=0.4, IG). There was also a significant correlation between loss of ICC and enteric nerves in DG but not in IG (r=0.5, P=0.03 for DG, r=0.3, P=0.16, IG). Idiopathic gastroparesis with a myenteric immune infiltrate scored higher on the average GCSI (3.6±0.7 vs 2.7±0.9, P=0.05) and nausea score (3.8±0.9 vs 2.6±1.0, P=0.02) as compared to those without an infiltrate. Conclusions & Inferences In DG, loss of ICC is associated with delayed gastric emptying. Interstitial cells of Cajal or enteric nerve loss did not correlate with symptom severity. Overall clinical severity and nausea in IG is associated with a myenteric immune infiltrate. Thus, full thickness gastric biopsies can help define specific cellular abnormalities in gastroparesis, some of which are associated with physiological and clinical characteristics of gastroparesis.

Original languageEnglish (US)
JournalNeurogastroenterology and Motility
Volume24
Issue number6
DOIs
StatePublished - Jun 2012

Fingerprint

Gastroparesis
Research
Interstitial Cells of Cajal
Gastric Emptying
Stomach
Nausea
Biopsy

Keywords

  • Clinical symptoms
  • Enteric nervous system
  • Gastric emptying
  • Gastroparesis
  • Interstitial cells of Cajal
  • Macrophages

ASJC Scopus subject areas

  • Endocrine and Autonomic Systems
  • Gastroenterology
  • Physiology

Cite this

Clinical-histological associations in gastroparesis : Results from the Gastroparesis Clinical Research Consortium. / Grover, M.; Bernard, C. E.; Pasricha, Pankaj Jay; Lurken, M. S.; Faussone-Pellegrini, M. S.; Smyrk, T. C.; Parkman, H. P.; Abell, T. L.; Snape, W. J.; Hasler, W. L.; Mccallum, R. W.; Nguyen, L.; Koch, K. L.; Calles, J.; Lee, Li-Ching; Tonascia, James A; Ünalp-Arida, A.; Hamilton, F. A.; Farrugia, G.; Pasricha, Pankaj Jay; Nguyen, Linda; Ullah, Nighat; Snape, William; Bishop, Robin; De Vole, Nata; Greene, Mary; Louiseau, Sue; Parker, Shelly; Pillor, Eve; Ponsetto, Courtney; Shetler, Katerina; Farrugia, Gianrico; Grover, Madhusudan; Bernard, Cheryl; Lurken, Matt; Shen, K. Robert; Sarr, Michael; Kendrick, Michael; Parkman, Henry P.; Kantor, Steven; Lytes, Vanessa; Palit, Amiya; Sachdeva, Priyanka; Simmons, Kellie; Harbison, Sean; McCallum, Richard W.; Sarosiek, Irene; Hejazi, Reza; Vasquez, Denise; Vega, Natalia; Hasler, William; Atkinson, Michelle; Abell, Thomas; Fordham, Jo Anne; Henry, Olivia; Kedar, Archana; McNair, Archana Valerie; Spree, Danielle; Koch, Kenneth; Baxter, Lynn; Van Natta, Mark L; Culler, Samantha; Wilson, Laura; Yates, Katherine; Hamilton, Frank; James, Steven; Torrance, Rebecca; Van Raaphorst, Rebekah; Tonascia, James; Belt, Patricia; Donithan, Michele; Green, Mika; Isaacson, Milana; Lee, Linda; May, Kevin Patrick; Miriel, Laura; Ünalp-Arida, Aynur; Van Natta, Mark; Vaughn, Ivana; Wilson, Laura; Yates, Katherine.

In: Neurogastroenterology and Motility, Vol. 24, No. 6, 06.2012.

Research output: Contribution to journalArticle

Grover, M, Bernard, CE, Pasricha, PJ, Lurken, MS, Faussone-Pellegrini, MS, Smyrk, TC, Parkman, HP, Abell, TL, Snape, WJ, Hasler, WL, Mccallum, RW, Nguyen, L, Koch, KL, Calles, J, Lee, L-C, Tonascia, JA, Ünalp-Arida, A, Hamilton, FA, Farrugia, G, Pasricha, PJ, Nguyen, L, Ullah, N, Snape, W, Bishop, R, De Vole, N, Greene, M, Louiseau, S, Parker, S, Pillor, E, Ponsetto, C, Shetler, K, Farrugia, G, Grover, M, Bernard, C, Lurken, M, Shen, KR, Sarr, M, Kendrick, M, Parkman, HP, Kantor, S, Lytes, V, Palit, A, Sachdeva, P, Simmons, K, Harbison, S, McCallum, RW, Sarosiek, I, Hejazi, R, Vasquez, D, Vega, N, Hasler, W, Atkinson, M, Abell, T, Fordham, JA, Henry, O, Kedar, A, McNair, AV, Spree, D, Koch, K, Baxter, L, Van Natta, ML, Culler, S, Wilson, L, Yates, K, Hamilton, F, James, S, Torrance, R, Van Raaphorst, R, Tonascia, J, Belt, P, Donithan, M, Green, M, Isaacson, M, Lee, L, May, KP, Miriel, L, Ünalp-Arida, A, Van Natta, M, Vaughn, I, Wilson, L & Yates, K 2012, 'Clinical-histological associations in gastroparesis: Results from the Gastroparesis Clinical Research Consortium', Neurogastroenterology and Motility, vol. 24, no. 6. https://doi.org/10.1111/j.1365-2982.2012.01894.x
Grover, M. ; Bernard, C. E. ; Pasricha, Pankaj Jay ; Lurken, M. S. ; Faussone-Pellegrini, M. S. ; Smyrk, T. C. ; Parkman, H. P. ; Abell, T. L. ; Snape, W. J. ; Hasler, W. L. ; Mccallum, R. W. ; Nguyen, L. ; Koch, K. L. ; Calles, J. ; Lee, Li-Ching ; Tonascia, James A ; Ünalp-Arida, A. ; Hamilton, F. A. ; Farrugia, G. ; Pasricha, Pankaj Jay ; Nguyen, Linda ; Ullah, Nighat ; Snape, William ; Bishop, Robin ; De Vole, Nata ; Greene, Mary ; Louiseau, Sue ; Parker, Shelly ; Pillor, Eve ; Ponsetto, Courtney ; Shetler, Katerina ; Farrugia, Gianrico ; Grover, Madhusudan ; Bernard, Cheryl ; Lurken, Matt ; Shen, K. Robert ; Sarr, Michael ; Kendrick, Michael ; Parkman, Henry P. ; Kantor, Steven ; Lytes, Vanessa ; Palit, Amiya ; Sachdeva, Priyanka ; Simmons, Kellie ; Harbison, Sean ; McCallum, Richard W. ; Sarosiek, Irene ; Hejazi, Reza ; Vasquez, Denise ; Vega, Natalia ; Hasler, William ; Atkinson, Michelle ; Abell, Thomas ; Fordham, Jo Anne ; Henry, Olivia ; Kedar, Archana ; McNair, Archana Valerie ; Spree, Danielle ; Koch, Kenneth ; Baxter, Lynn ; Van Natta, Mark L ; Culler, Samantha ; Wilson, Laura ; Yates, Katherine ; Hamilton, Frank ; James, Steven ; Torrance, Rebecca ; Van Raaphorst, Rebekah ; Tonascia, James ; Belt, Patricia ; Donithan, Michele ; Green, Mika ; Isaacson, Milana ; Lee, Linda ; May, Kevin Patrick ; Miriel, Laura ; Ünalp-Arida, Aynur ; Van Natta, Mark ; Vaughn, Ivana ; Wilson, Laura ; Yates, Katherine. / Clinical-histological associations in gastroparesis : Results from the Gastroparesis Clinical Research Consortium. In: Neurogastroenterology and Motility. 2012 ; Vol. 24, No. 6.
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abstract = "Background Cellular changes associated with diabetic (DG) and idiopathic gastroparesis (IG) have recently been described from patients enrolled in the Gastroparesis Clinical Research Consortium. The association of these cellular changes with gastroparesis symptoms and gastric emptying is unknown. The aim of this study was to relate cellular changes to symptoms and gastric emptying in patients with gastroparesis. Methods Earlier, using full thickness gastric body biopsies from 20 DG, 20 IG, and 20 matched controls, we found decreased interstitial cells of Cajal (ICC) and enteric nerves and an increase in immune cells in both DG and IG. Here, demographic, symptoms [gastroparesis cardinal symptom index score (GCSI)], and gastric emptying were related to cellular alterations using Pearson's correlation coefficients. Key Results Interstitial cells of Cajal counts inversely correlated with 4h gastric retention in DG but not in IG (r=-0.6, P=0.008, DG, r=0.2, P=0.4, IG). There was also a significant correlation between loss of ICC and enteric nerves in DG but not in IG (r=0.5, P=0.03 for DG, r=0.3, P=0.16, IG). Idiopathic gastroparesis with a myenteric immune infiltrate scored higher on the average GCSI (3.6±0.7 vs 2.7±0.9, P=0.05) and nausea score (3.8±0.9 vs 2.6±1.0, P=0.02) as compared to those without an infiltrate. Conclusions & Inferences In DG, loss of ICC is associated with delayed gastric emptying. Interstitial cells of Cajal or enteric nerve loss did not correlate with symptom severity. Overall clinical severity and nausea in IG is associated with a myenteric immune infiltrate. Thus, full thickness gastric biopsies can help define specific cellular abnormalities in gastroparesis, some of which are associated with physiological and clinical characteristics of gastroparesis.",
keywords = "Clinical symptoms, Enteric nervous system, Gastric emptying, Gastroparesis, Interstitial cells of Cajal, Macrophages",
author = "M. Grover and Bernard, {C. E.} and Pasricha, {Pankaj Jay} and Lurken, {M. S.} and Faussone-Pellegrini, {M. S.} and Smyrk, {T. C.} and Parkman, {H. P.} and Abell, {T. L.} and Snape, {W. J.} and Hasler, {W. L.} and Mccallum, {R. W.} and L. Nguyen and Koch, {K. L.} and J. Calles and Li-Ching Lee and Tonascia, {James A} and A. {\"U}nalp-Arida and Hamilton, {F. A.} and G. Farrugia and Pasricha, {Pankaj Jay} and Linda Nguyen and Nighat Ullah and William Snape and Robin Bishop and {De Vole}, Nata and Mary Greene and Sue Louiseau and Shelly Parker and Eve Pillor and Courtney Ponsetto and Katerina Shetler and Gianrico Farrugia and Madhusudan Grover and Cheryl Bernard and Matt Lurken and Shen, {K. Robert} and Michael Sarr and Michael Kendrick and Parkman, {Henry P.} and Steven Kantor and Vanessa Lytes and Amiya Palit and Priyanka Sachdeva and Kellie Simmons and Sean Harbison and McCallum, {Richard W.} and Irene Sarosiek and Reza Hejazi and Denise Vasquez and Natalia Vega and William Hasler and Michelle Atkinson and Thomas Abell and Fordham, {Jo Anne} and Olivia Henry and Archana Kedar and McNair, {Archana Valerie} and Danielle Spree and Kenneth Koch and Lynn Baxter and {Van Natta}, {Mark L} and Samantha Culler and Laura Wilson and Katherine Yates and Frank Hamilton and Steven James and Rebecca Torrance and {Van Raaphorst}, Rebekah and James Tonascia and Patricia Belt and Michele Donithan and Mika Green and Milana Isaacson and Linda Lee and May, {Kevin Patrick} and Laura Miriel and Aynur {\"U}nalp-Arida and {Van Natta}, Mark and Ivana Vaughn and Laura Wilson and Katherine Yates",
year = "2012",
month = "6",
doi = "10.1111/j.1365-2982.2012.01894.x",
language = "English (US)",
volume = "24",
journal = "Neurogastroenterology and Motility",
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TY - JOUR

T1 - Clinical-histological associations in gastroparesis

T2 - Results from the Gastroparesis Clinical Research Consortium

AU - Grover, M.

AU - Bernard, C. E.

AU - Pasricha, Pankaj Jay

AU - Lurken, M. S.

AU - Faussone-Pellegrini, M. S.

AU - Smyrk, T. C.

AU - Parkman, H. P.

AU - Abell, T. L.

AU - Snape, W. J.

AU - Hasler, W. L.

AU - Mccallum, R. W.

AU - Nguyen, L.

AU - Koch, K. L.

AU - Calles, J.

AU - Lee, Li-Ching

AU - Tonascia, James A

AU - Ünalp-Arida, A.

AU - Hamilton, F. A.

AU - Farrugia, G.

AU - Pasricha, Pankaj Jay

AU - Nguyen, Linda

AU - Ullah, Nighat

AU - Snape, William

AU - Bishop, Robin

AU - De Vole, Nata

AU - Greene, Mary

AU - Louiseau, Sue

AU - Parker, Shelly

AU - Pillor, Eve

AU - Ponsetto, Courtney

AU - Shetler, Katerina

AU - Farrugia, Gianrico

AU - Grover, Madhusudan

AU - Bernard, Cheryl

AU - Lurken, Matt

AU - Shen, K. Robert

AU - Sarr, Michael

AU - Kendrick, Michael

AU - Parkman, Henry P.

AU - Kantor, Steven

AU - Lytes, Vanessa

AU - Palit, Amiya

AU - Sachdeva, Priyanka

AU - Simmons, Kellie

AU - Harbison, Sean

AU - McCallum, Richard W.

AU - Sarosiek, Irene

AU - Hejazi, Reza

AU - Vasquez, Denise

AU - Vega, Natalia

AU - Hasler, William

AU - Atkinson, Michelle

AU - Abell, Thomas

AU - Fordham, Jo Anne

AU - Henry, Olivia

AU - Kedar, Archana

AU - McNair, Archana Valerie

AU - Spree, Danielle

AU - Koch, Kenneth

AU - Baxter, Lynn

AU - Van Natta, Mark L

AU - Culler, Samantha

AU - Wilson, Laura

AU - Yates, Katherine

AU - Hamilton, Frank

AU - James, Steven

AU - Torrance, Rebecca

AU - Van Raaphorst, Rebekah

AU - Tonascia, James

AU - Belt, Patricia

AU - Donithan, Michele

AU - Green, Mika

AU - Isaacson, Milana

AU - Lee, Linda

AU - May, Kevin Patrick

AU - Miriel, Laura

AU - Ünalp-Arida, Aynur

AU - Van Natta, Mark

AU - Vaughn, Ivana

AU - Wilson, Laura

AU - Yates, Katherine

PY - 2012/6

Y1 - 2012/6

N2 - Background Cellular changes associated with diabetic (DG) and idiopathic gastroparesis (IG) have recently been described from patients enrolled in the Gastroparesis Clinical Research Consortium. The association of these cellular changes with gastroparesis symptoms and gastric emptying is unknown. The aim of this study was to relate cellular changes to symptoms and gastric emptying in patients with gastroparesis. Methods Earlier, using full thickness gastric body biopsies from 20 DG, 20 IG, and 20 matched controls, we found decreased interstitial cells of Cajal (ICC) and enteric nerves and an increase in immune cells in both DG and IG. Here, demographic, symptoms [gastroparesis cardinal symptom index score (GCSI)], and gastric emptying were related to cellular alterations using Pearson's correlation coefficients. Key Results Interstitial cells of Cajal counts inversely correlated with 4h gastric retention in DG but not in IG (r=-0.6, P=0.008, DG, r=0.2, P=0.4, IG). There was also a significant correlation between loss of ICC and enteric nerves in DG but not in IG (r=0.5, P=0.03 for DG, r=0.3, P=0.16, IG). Idiopathic gastroparesis with a myenteric immune infiltrate scored higher on the average GCSI (3.6±0.7 vs 2.7±0.9, P=0.05) and nausea score (3.8±0.9 vs 2.6±1.0, P=0.02) as compared to those without an infiltrate. Conclusions & Inferences In DG, loss of ICC is associated with delayed gastric emptying. Interstitial cells of Cajal or enteric nerve loss did not correlate with symptom severity. Overall clinical severity and nausea in IG is associated with a myenteric immune infiltrate. Thus, full thickness gastric biopsies can help define specific cellular abnormalities in gastroparesis, some of which are associated with physiological and clinical characteristics of gastroparesis.

AB - Background Cellular changes associated with diabetic (DG) and idiopathic gastroparesis (IG) have recently been described from patients enrolled in the Gastroparesis Clinical Research Consortium. The association of these cellular changes with gastroparesis symptoms and gastric emptying is unknown. The aim of this study was to relate cellular changes to symptoms and gastric emptying in patients with gastroparesis. Methods Earlier, using full thickness gastric body biopsies from 20 DG, 20 IG, and 20 matched controls, we found decreased interstitial cells of Cajal (ICC) and enteric nerves and an increase in immune cells in both DG and IG. Here, demographic, symptoms [gastroparesis cardinal symptom index score (GCSI)], and gastric emptying were related to cellular alterations using Pearson's correlation coefficients. Key Results Interstitial cells of Cajal counts inversely correlated with 4h gastric retention in DG but not in IG (r=-0.6, P=0.008, DG, r=0.2, P=0.4, IG). There was also a significant correlation between loss of ICC and enteric nerves in DG but not in IG (r=0.5, P=0.03 for DG, r=0.3, P=0.16, IG). Idiopathic gastroparesis with a myenteric immune infiltrate scored higher on the average GCSI (3.6±0.7 vs 2.7±0.9, P=0.05) and nausea score (3.8±0.9 vs 2.6±1.0, P=0.02) as compared to those without an infiltrate. Conclusions & Inferences In DG, loss of ICC is associated with delayed gastric emptying. Interstitial cells of Cajal or enteric nerve loss did not correlate with symptom severity. Overall clinical severity and nausea in IG is associated with a myenteric immune infiltrate. Thus, full thickness gastric biopsies can help define specific cellular abnormalities in gastroparesis, some of which are associated with physiological and clinical characteristics of gastroparesis.

KW - Clinical symptoms

KW - Enteric nervous system

KW - Gastric emptying

KW - Gastroparesis

KW - Interstitial cells of Cajal

KW - Macrophages

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U2 - 10.1111/j.1365-2982.2012.01894.x

DO - 10.1111/j.1365-2982.2012.01894.x

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JO - Neurogastroenterology and Motility

JF - Neurogastroenterology and Motility

SN - 1350-1925

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