Alterations of Mast Cells in the Esophageal Mucosa of the Patients With Non-Erosive Reflux Disease

BACKGROUND Mast cells (MCs) are widely distributed in the gastrointestinal tract, which could be involved in visceral hypersensitivity and gut dysmotility. Whether esophageal MCs play a role in non-erosive reflux disease (NERD) has yet to be determined. The aim of this study was to characterize esophageal MCs distribution, degranulation, and ultrastructure. METHODS The esophageal mucosa at 5 cm above the end of esophagus was obtained from 26 NERD and 14 healthy volunteers (control) by gastroscopy. Immunohistochemistry was performed and average MC counts per high-power field (HPF) and the percentage of degranulated MCs were obtained. The ultrastructure of MCs was observed by transmission electron microscope (TEM). RESULTS More MCs were observed in NERD (7.23 ± 2.41 cells/HPF) as compared with controls (3.79 ± 1.67 cells/HPF) (P < 0.01) and the percentage of degranulated MCs in NERD was also significantly higher than controls (26.85 ± 8.79% vs 11.5 ± 4.18%, P < 0.01). Under TEM, more Golgi apparatus, mitochondria and endoplasmic reticulum were found in MCs in patients with NERD. Special secreting particles were also found in cytoplasm, more vacuoles were left after MCs degranulation in patients with NERD. CONCLUSIONS Our results indicate that increased numbers of MCs and MCs activation may be involved in the pathogenesis of NERD.