Clinical-histological associations in gastroparesis: Results from the Gastroparesis Clinical Research Consortium

M. Grover, C. E. Bernard, P. J. 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, L. Lee, J. Tonascia, A. Ünalp-Arida, F. A. Hamilton, G. Farrugia, Nighat UllahRobin Bishop, Nata De Vole, Mary Greene, Sue Louiseau, Shelly Parker, Eve Pillor, Courtney Ponsetto, Katerina Shetler, K. Robert Shen, Michael Sarr, Michael Kendrick, Steven Kantor, Vanessa Lytes, Amiya Palit, Priyanka Sachdeva, Kellie Simmons, Sean Harbison, Irene Sarosiek, Reza Hejazi, Denise Vasquez, Natalia Vega, Michelle Atkinson, Jo Anne Fordham, Olivia Henry, Archana Kedar, Archana Valerie McNair, Danielle Spree, Lynn Baxter, Samantha Culler, Judy Hooker, Paula Stuart, Steven James, Rebecca Torrance, Rebekah Van Raaphorst, Patricia Belt, Michele Donithan, Mika Green, Milana Isaacson, Kevin Patrick May, Laura Miriel, 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)
Pages (from-to)531-e249
JournalNeurogastroenterology and Motility
Volume24
Issue number6
DOIs
StatePublished - Jun 1 2012

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Keywords

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

ASJC Scopus subject areas

  • Physiology
  • Endocrine and Autonomic Systems
  • Gastroenterology

Cite this

Grover, M., Bernard, C. E., Pasricha, P. J., 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, L., Tonascia, J., Ünalp-Arida, A., Hamilton, F. A., Farrugia, G., ... Yates, K. (2012). Clinical-histological associations in gastroparesis: Results from the Gastroparesis Clinical Research Consortium. Neurogastroenterology and Motility, 24(6), 531-e249. https://doi.org/10.1111/j.1365-2982.2012.01894.x