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Digestive System Diseases pp 165–180Cite as

Paneth Cell Physiology and Pathophysiology in Inflammatory Bowel Disease

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Part of the book series: Stem Cell Biology and Regenerative Medicine ((STEMCELL))

Abstract

Paneth cells, named after Joseph Paneth, are distinctive, mucosal cells responsible for secreting the antimicrobial alpha-defensin peptides as well as enzymes including lysozyme and phospholipase A2 that keep the intestinal crypts sterile. Physiologically, they play a key role in defensive mechanisms against intestinal luminal microbes and in the regulation of host innate immunity. Paneth cells derive from fast-cycling crypt base columnar cells, which are associated in crypt regeneration; they differentiate while migrating toward the crypt base, from which they are eventually cleared by phagocytosis. Paneth cells are mostly located within the ileum; in adults they occur normally in sporadic numbers in the caecum to transverse colon but have been reported more distally only in pathological conditions. Paneth cells found in the descending colon, sigmoid, and rectum are “metaplastic” because they are ectopically in an abnormal location. In pathological states, an increase in Paneth cells – known as Paneth cell hyperplasia – may occur in the proximal colon. Paneth cell metaplasia (PCM) has been most often described in inflammatory bowel disease (IBD), both ulcerative colitis (UC) and Crohn’s disease (CD). In adults, it is thought to be a sign of a long-standing colitis history: it correlates with disease duration, and it has been attributed to the effects of repair and regeneration. Guidelines for reporting gastrointestinal biopsies concurred that PCM was an indicator of chronic mucosal cell damage, though it was not included in the data set for IBD reporting as its diagnostic value was then undefined. Paneth cell metaplasia may as well be present in other pathological states. In neonates, PCs are increased in the regenerating bowel following necrotizing enterocolitis but are not seen in self-limiting infectious colitis. In this e-book chapter, we describe the distribution of Paneth cells in symptomatic patients with or without significant gastrointestinal pathology, compare the findings with newly diagnosed IBD, and evaluate the relation between PCM and histological features of chronic disease.

Author Contributions 

Amosy M’Koma – Invitation recipient for “Special Issue.” Original idea of the paper, formulation of the protocol, and contribution to data abstraction and analysis. Critical drafting, writing and revision of the manuscript, and data analysis. Carried out the literature search, selection, and validity assessment.

Billy R. Ballard – Critical reading of the manuscript and evaluation of the validity of the content.

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Financial Support

This work was supported by Meharry Medical College Schools of Medicine (SOM) and Graduate Studies and Research (SOGRS) and Vanderbilt Institute for Clinical and Translational Research (VICTR).

Potential Competing Interest Statement

Amosy E. M’Koma has received honoraria fees for Educational Presentation from Lipscomb University. Further, he receives institutional grants from Meharry Medical College Schools of Medicine (SOM) and Graduate Studies and Research (SOGRS) and Vanderbilt Institute for Clinical and Translational Research (VICTR).

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Authors and Affiliations

  1. Department of Pathology, Anatomy, and Cell Biology, Meharry Medical College School of Medicine, Nashville, TN, USA

    Billy R. Ballard

  2. Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN, USA

    Billy R. Ballard

  3. Pathology Section, American (National) Medical Association, Silver Spring, MD, USA

    Billy R. Ballard

  4. Department of Biochemistry, Cancer Biology, Neuroscience and Pharmacology, Meharry Medical College School of Medicine, Nashville, TN, USA

    Billy R. Ballard & Amosy E. M’Koma

  5. Department of Surgery, Colon and Rectal Surgery, Vanderbilt University School of Medicine, Nashville, TN, USA

    Amosy E. M’Koma

  6. The American Society of Colon and Rectal Surgeons (ASCRS), Arlington Heights, IL, USA

    Amosy E. M’Koma

  7. The American Gastroenterological Association (AGA), Bethesda, MD, USA

    Amosy E. M’Koma

  8. Vanderbilt-Ingram Cancer Center (VICC), Vanderbilt University Medical Center, Nashville, TN, USA

    Amosy E. M’Koma

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  1. Laboratory of Biology, Medical School National and Kapodistrian University of Athens, Athens, Greece

    Maria Gazouli

  2. First Department of Propaedeutic Surgery, Hippocratio General Hospital, Medical School National and Kapodistrian University of Athens, Athens, Greece

    George E. Theodoropoulos

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Ballard, B.R., M’Koma, A.E. (2019). Paneth Cell Physiology and Pathophysiology in Inflammatory Bowel Disease. In: Gazouli, M., Theodoropoulos, G. (eds) Digestive System Diseases. Stem Cell Biology and Regenerative Medicine. Humana Press, Cham. https://doi.org/10.1007/978-3-030-11965-2_9

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