Volume 31, Issue 4 e13542
ORIGINAL ARTICLE

Prospective study evaluating immune-mediated mechanisms and predisposing factors underlying persistent postinfectious abdominal complaints

Morgane V. Florens

Morgane V. Florens

Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium

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Sander Van Wanrooy

Sander Van Wanrooy

Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium

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James Dooley

James Dooley

Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium

Autoimmune Genetics Laboratory, VIB, Leuven, Belgium

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Javier Aguilera-Lizarraga

Javier Aguilera-Lizarraga

Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium

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Winde Vanbrabant

Winde Vanbrabant

Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium

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Mira M. Wouters

Mira M. Wouters

Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium

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Lukas Van Oudenhove

Lukas Van Oudenhove

Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium

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Willy E. Peetermans

Willy E. Peetermans

Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium

Laboratory for Clinical Infectious and Inflammatory Disorders, KU Leuven, Leuven, Belgium

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Adrian Liston

Adrian Liston

Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium

Autoimmune Genetics Laboratory, VIB, Leuven, Belgium

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Guy E. Boeckxstaens

Corresponding Author

Guy E. Boeckxstaens

Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium

Correspondence

Guy E. Boeckxstaens, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium.

Email: [email protected]

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First published: 18 January 2019
Citations: 3

Funding information

GEB was funded by a KU Leuven university grant (Global Opportunities for Associations GOA 14.011). MMW is supported by a FWO postdoctoral fellowship (1248513 N). MVF is supported by a FWO PhD fellowship (1110019 N). LVO is a research professor funded by the KU Leuven Special Research Fund (Bijzonder Onderzoeksfonds, BOF).

Abstract

Background

The role of persistent immune activation in postinfectious irritable bowel syndrome (PI-IBS) remains controversial. Here, we prospectively studied healthy subjects traveling to destinations with a high-risk to develop infectious gastroenteritis (IGE) in order to identify immune-mediated mechanisms and risk factors of PI-IBS.

Methods

One hundred and one travelers were asked to complete questionnaires on psychological profile and gastrointestinal (GI) symptoms before travel, 2 weeks, 6 months and 1 year after travel. At each visit, blood was collected for PBMC isolation and rectal biopsies were taken. PI-IBS was diagnosed using the Rome III criteria and subjects with persistent postinfectious abdominal complaints (PI-AC) were identified using 3 GSRS symptoms (ie, loose stools, urgency and abdominal pain).

Results

Forty-seven of the 101 subjects reported IGE during travel. After 1 year, two subjects were diagnosed with PI-IBS and eight subjects were presented with PI-AC versus two subjects with IBS and two with abdominal complaints in the non-infected group. PBMC analysis showed no differences in T and B cell populations in subjects with PI-AC vs healthy. Additionally, no differences in gene expression were observed in the early postinfectious phase or after 1 year. Regression analysis identified looser stools, higher anxiety and somatization before infection and several postinfectious GI symptoms as risk factors for PI-AC.

Conclusions

The incidence of PI-IBS is low following travelers’ diarrhea and there is need for larger studies investigating the role of immune activation in PI-IBS. Psychological factors before infection and the severity of symptoms shortly after infection are risk factors for the persistence of PI-AC.

DISCLOSURE

No competing interests declared.

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