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Role of Esophageal Mast Cell Activation in Noncardiac Chest Pain (NCCP)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00219492
Recruitment Status : Completed
First Posted : September 22, 2005
Last Update Posted : June 20, 2017
Information provided by (Responsible Party):
Milton S. Hershey Medical Center

Brief Summary:
Chest pain is a common clinical complaint. About 30% patients with chest pain will have a normal coronary angiogram and are described as having noncardiac chest pain (NCCP). It is estimated that 25% of the population complain of chest pain at some time in their lifetime. The pathogenesis of NCCP is unknown. Esophageal hypersensitivity as a result of inflammation is considered to be an important mechanism in the development of this pain sensation. Little is currently known about the interaction between inflammatory mediators and peripheral afferent nerve terminals in the esophagus. The mast cell is one of the most enriched pro-inflammatory cells in the gastrointestinal tract. Activation of the mucosal mast cell releases a variety of mediators into adjacent tissues. We hypothesize that mediators released by mast cells sensitize esophageal nociceptors and induce pain sensation.

Condition or disease
Noncardiac Chest Pain (NCCP)

Detailed Description:
  1. Key Objectives: To determine the density and activation of esophageal mast cells in non-cardiac chest pain patients. We expect to find mast cell activation, as measured by mast cell count or degranluation, tryptase staining, and histamine release, will be greater in NCCP patients compared to controls, and the increased mast cell activation will correlate with the severity of NCCP. These results will expand our understanding of the pathogenesis of esophageal originated NCCP, and allow the development of new diagnostic and treatment options.
  2. Study Population: (i) NCCP (ii) Reflux esophagitis (iii) Control subjects.
  3. Summary of Procedures: (i) symptom assessment by chest pain questionnaire; (ii) esophageal reflux evaluation by review of records of 24-hour pH monitoring; (iii) evidence of esophagitis by endoscopy; (iv) esophageal biopsy by endoscopy; (v) mast cell activation study in biopsy specimen by mast cell count, tryptase and Transient receptor potential vanniloid-1 (TRPV1) staining, and histamine release assay.
  4. Major Risks & Discomforts: There are no major risks & discomforts other than involved in standard upper GI endoscopy.

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Study Type : Observational
Actual Enrollment : 86 participants
Time Perspective: Prospective
Official Title: Role of Esophageal Mast Cell Activation in Noncardiac Chest Pain (NCCP)
Study Start Date : September 2005
Actual Primary Completion Date : August 21, 2014
Actual Study Completion Date : August 21, 2014

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Chest Pain

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • NCCP - presence of a history of chest pain with a negative cardiac evaluation, no evidence of gross esophagitis on endoscopy, and lack of any exclusion criteria; Reflux esophagitis - presence of chest pain or heartburn, negative cardiac evaluation, lack of exclusion criteria and presence of esophagitis on endoscopy;
  • Controls - lack of history of chest pain, lack of exclusion criteria and lack of esophagitis on endoscopy. It is anticipated that patients being evaluated for heme positive stool or GI bleeding would be included as controls.

Exclusion Criteria:

- History of ischemic heart disease, history of asthma, significant food allergies, celiac disease, chronic inflammatory conditions (SLE, rheumatoid arthritis), atopic skin disease, varices, coagulopathy, recent drug treatment with steroids.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00219492

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United States, Pennsylvania
Penn State College of Medicine Hershey Medical Center
Hershey, Pennsylvania, United States, 17033
Sponsors and Collaborators
Milton S. Hershey Medical Center
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Principal Investigator: Shaoyong Yu, MD, MPH Department of Medicine, Penn State College of Medicine Hershey Medical Center
Study Director: Ann Ouyang, MD Penn State College of Medicine Hershey Medical Center
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Responsible Party: Milton S. Hershey Medical Center Identifier: NCT00219492    
Other Study ID Numbers: 21370
First Posted: September 22, 2005    Key Record Dates
Last Update Posted: June 20, 2017
Last Verified: June 2017
Keywords provided by Milton S. Hershey Medical Center:
NCCP, mast cell, esophagus
Additional relevant MeSH terms:
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Chest Pain
Neurologic Manifestations
Signs and Symptoms