Anxiety and depression are associated with increased counts and degranulation of duodenal mast cells in functional dyspepsia.

BACKGROUND Patients with functional dyspepsia (FD) have increased risks for psychological dysfunction than healthy peoples. This study aimed to explore the roles of psychosocial factors and duodenal mast cells in the pathogenesis of FD. MATERIAL AND METHODS We prospectively included 48 FD patients and 21 age- and sex-match healthy volunteers. There were 23 patients with postprandial distress syndrome (PDS) and 25 patients with epigastric pain syndrome (EPS). The Hospital Anxiety Depression Scale (HADS) was administered to evaluate their psychosocial status. Upper endoscopy was performed with biopsy of the mucosa from the bulb of duodenum. Mast cells counts and degranulation rates were identified by toluidine blue staining. The relationship among the scores of HADS-A (anxiety) and HADS-D (depression) and the mast cell counts and degranulation rates were analyzed. RESULTS The scores of HADS-A and HADS-D were significantly higher in PDS and EPS patients than the normal controls (P<0.05). The mast cell counts and degranulation rates in the duodenum were significantly increased in PDS and EPS patients than the controls (P<0.05). In either PDS or EPS patients, the HADS-A and HADS-D scores were positively correlated with the mast cell counts and degranulation rate. CONCLUSION FD patients had significantly higher risks for anxiety and depression, which may lead to FD through the increased mast cell counts and degranulation.