Duodenal eosinophilia and the link to anxiety : a population-based endoscopic study
Ronkainen, Jukka; Aro, Pertti; Jones, Mike; Walker, Marjorie M.; Agréus, Lars; Andreasson, Anna; Talley, Nicholas J. (2021-03-09)
Ronkainen, J., Aro, P., Jones, M., Walker, M.M., Agréus, L., Andreasson, A. and Talley, N.J. (2021), Duodenal eosinophilia and the link to anxiety: A population-based endoscopic study. Neurogastroenterology & Motility, 33: e14109. https://doi.org/10.1111/nmo.14109
© 2021 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Ronkainen, J., Aro, P., Jones, M., Walker, M.M., Agréus, L., Andreasson, A. and Talley, N.J. (2021), Duodenal eosinophilia and the link to anxiety: A population-based endoscopic study. Neurogastroenterology & Motility, 33: e14109, which has been published in final form at https://doi.org/10.1111/nmo.14109. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
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https://urn.fi/URN:NBN:fi-fe2022020317541
Tiivistelmä
Abstract
Introduction: The concept of gut-to-brain communication via microbial or inflammatory pathways is gaining increased attention but genuine pathology directly linking gut perturbation to anxiety is lacking. We hypothesized that duodenal eosinophilia, as known to occur in functional dyspepsia (FD), may be an underlying cause of anxiety and may help explain the striking association between FD and anxiety.
Methods: Randomly selected subjects from the national population register of Sweden completed the validated Abdominal Symptom Questionnaire; 1000 completed esophagogastroduodenoscopy and the Hospital Anxiety and Depression Scale questionnaire. Duodenal biopsies were obtained from 1st (D1) and 2nd portion (D2). Eligible subjects who underwent endoscopy (n = 887) were invited to participate in a 10-year follow-up study with the same questionnaires. Among endoscopy normal subjects, FD was identified by Rome criteria, and controls were symptom free. Duodenal eosinophilia was based on pre-defined cut-offs. Finding are reported as odds ratios (ORs) with 95% confidence interval and p-value.
Results: The study population comprised 89 cases with FD and 124 healthy controls (mean age 62 years, SD 12, 34% male). Clinical anxiety at follow-up was elevated in those with D1 eosinophilia at baseline considering either new-onset anxiety (OR = 4.5, 95% CI 0.8, 23.8; p = 0.08) or follow-up anxiety adjusting for baseline anxiety (OR = 4.51 (95% CI 1.03, 19.81; p = 0.046).
Conclusions: Duodenal eosinophilia may potentially be a mechanism linked to anxiety independent of FD.
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