Volume 87 - 2024 - Fasc.1 - Reviews
Efficacy of mast cell directed therapies in irritable bowel syndrome: a systematic review
Background and study aim: Lately, mast cells (MCs) are
increasingly implicated in the pathophysiology of irritable bowel
syndrome (IBS). The aim of this systematic review was to assess
the efficacy of mast cell directed therapies in reducing the main
symptoms of IBS: abdominal pain and changes in stool frequency
or consistency.
Patients and methods: Pubmed, Web of Science and Scopus were
searched until December 19, 2022. Trials evaluating the efficacy
of mast cell directed therapies, compared to placebo or any form
of control group, were included. Trial selection was performed in
two stages: screening titles and abstracts and reviewing full papers
identified as relevant, taking into account the inclusion criteria.
Results: The search strategy identified a total of 1.384 citations.
Eleven trials on 943 IBS patients and 197 controls were included:
ten randomized controlled trials, two of which cross-over trials,
and one cohort study. Of the 11 studies included in the systematic
review, only three studies were found to be at low risk of bias.
This limited evidence suggests a significant overall improvement
in the key symptoms after treatment with disodium cromoglycate,
ebastine, ketotifen or palmitoylethanolamide-polydatin compared
to control groups.
Conclusions: Mast cell modulating therapies could be of
significant value in therapy for IBS patients. Further high-quality
research is needed to establish the therapeutic efficacy of mast
cell targeted therapies in order to draw robust conclusions and
improve the clinical management of irritable bowel syndrome.
