Abnormalities of the intestinal pacemaker cells, enteric neurons, and smooth muscle in intestinal atresia

Radhika krishna OH; Mohammed Abdul Aleem; Geetha Kayla

doi:10.4103/JLP.JLP_94_18

Journal of Laboratory Physicians, Table of Contents

CC BY-NC-ND 4.0 · J Lab Physicians 2019; 11(03): 180-185
DOI: 10.4103/JLP.JLP_94_18

Original Article

Abnormalities of the intestinal pacemaker cells, enteric neurons, and smooth muscle in intestinal atresia

Authors

Radhika krishna OH

Department of Pathology, Niloufer Hospital for Women and Children, Hyderabad, Telangana, India
Mohammed Abdul Aleem

Department of Pathology, Niloufer Hospital for Women and Children, Hyderabad, Telangana, India
Geetha Kayla

Department of Pathology, Niloufer Hospital for Women and Children, Hyderabad, Telangana, India

Abstract

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Abstract

BACKGROUND: Small bowel atresia is a congenital disorder that carves a substantial morbidity. Numerous postoperative gastrointestinal motility problems occur. The underlying cause of this motility disorder is still unclear. Interstitial cells of Cajal (ICC) play a major role in gastrointestinal motility.

AIMS AND OBJECTIVES: To investigate the morphological changes of enteric nervous system and ICC in small bowel atresia.

MATERIAL AND METHODS: Resected small bowel specimen from affected patients (n=15) were divided into three parts (proximal, distal, atretic). Standard histology and immunohistochemistry with anti C-KIT receptor antibody (CD117), calretinin and α-SMA was carried out. The density of myenteric ICCs in the proximal, atretic and distal parts was demonstrated by CD 117 while Calretinin was used for ganglion cells and nerve bundles, α-SMA highlighted muscle hypertrophy.

RESULT AND CONCLUSION: The proximal and distal bowel revealed clear changes in the morphology and density of enteric nervous system and interstitial cells of Cajal..

Key words

C-kit - enteric nervous system - interstitial cells of Cajal - intestinal atresia

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References

References
1 Stollman TH, de Blaauw I, Wijnen MH, van der Staak FH, Rieu PN, Draaisma JM, et al. Decreased mortality but increased morbidity in neonates with jejunoileal atresia; a study of 114 cases over a 34-year period. J Pediatr Surg 2009;44:217-21.
2 Dalla Vecchia LK, Grosfeld JL, West KW, Rescorla FJ, Scherer LR, Engum SA. Intestinal atresia and stenosis: A 25-year experience with 277 cases. Arch Surg 1998;133:490-6.
3 Gfroerer S, Metzger R, Fiegel H, Ramachandran P, Rolle U. Differential changes in intrinsic innervation and interstitial cells of Cajal in small bowel atresia in newborns. World J Gastroenterol 2010;16:5716-21.
4 Ozguner IF, Savas C, Ozguner M, Candir O. Intestinal atresia with segmental musculature and neural defect. J Pediatr Surg 2005;40:1232-7.
5 Tandler J. Developmental history of the human duodenum in early embryonic stages. Morphol Jahrb. 1900;29:187-216.
6 Grosfeld JL, Ballantine TV, Shoemaker R. Operative mangement of intestinal atresia and stenosis based on pathologic findings. J Pediatr Surg 1979;14:368-75.
7 Millar AJ, Rode H. Jejuno ileal atresia. In: Puri P, Hollwarth ME, editors. Pediatric Surgery. Berlin, Germany: Springer Science and Business Media; 2006. p. 213-28.
8 Wang X, Yuan C, Xiang L, Li X, Zhao Z, Jin X. The clinical significance of pathological studies of congenital intestinal atresia. J Pediatr Surg 2013;48:2084-91.
9 Doolin EJ, Ormsbee HS, Hill JL. Motility abnormality in intestinal atresia. J Pediatr Surg 1987;22:320-4.
10 Cezard JP, Cargill G, Faure C, Boige N, Mashako LM, Munck A, et al. Duodenal manometry in postobstructive enteropathy in infants with a transient enterostomy. J Pediatr Surg 1993;28:1481-5.
11 Tepas JJ, Wyllie RG, Shermeta DW, Inon AE, Pickard LR, Haller JA Jr., et al. Comparison of histochemical studies of intestinal atresia in the human newborn and fetal lamb. J Pediatr Surg 1979;14:376-80.
12 Masumoto K, Suita S, Nada O, Taguchi T, Guo R. Abnormalities of enteric neurons, intestinal pacemaker cells, and smooth muscle in human intestinal atresia. J Pediatr Surg 1999;34:1463-8.
13 Grosfeld JL. Jejunoileal atresia and stenosis. In: O'neill JA Jr., Rowe ML, Grosfeld JL, Fonkalsrud EW, Coran AG, editors. Pediatric Surgery. 5th ed. St. Louis (Mo): Mosby; 1998. p. 1145-58.
14 Tibboel D, van Nie CJ, Molenaar JC. The effects of temporary general hypoxia and local ischemia on the development of the intestines: An experimental study. J Pediatr Surg 1980;15:57-62.
15 Hamdy MH, Man DW, Bain D, Kirkland IS. Histochemical changes in intestinal atresia and its implications on surgical management: A preliminary report. J Pediatr Surg 1986;21:17-21.
16 Di Nardo G, Stanghellini V, Cucchiara S, Barbara G, Pasquinelli G, Santini D, et al. Enteric neuropathology of congenital intestinal obstruction: A case report. World J Gastroenterol 2006;12:5229-33.
17 Watanabe Y, Ando H, Seo T, Katsuno S, Marui Y, Horisawa M. Two-dimensional alterations of myenteric plexus in jejunoileal atresia. J Pediatr Surg 2001;36:474-8.
18 Kapur RP. Neuropathology of paediatric chronic intestinal pseudo-obstruction and related animal models. J Pathol 2001;194:277-88.
19 Barbosa AJ, Tafuri WL. Ganglion cell number in hypertrophic colon above experimental stenosis. Braz J Med Biol Res 1983;16:165-9.
20 Brehmer A, Göbel D, Frieser M, Graf M, Radespiel-Tröger M, Neuhuber W. Experimental hypertrophy of myenteric neurones in the pig: A morphometric study. Neurogastroenterol Motil 2000;12:155-62.
21 Chang IY, Glasgow NJ, Takayama I, Horiguchi K, Sanders KM, Ward SM. Loss of interstitial cells of Cajal and development of electrical dysfunction in murine small bowel obstruction. J Physiol 2001;536:555-68.
22 Ekblad E, Sjuve R, Arner A, Sundler F. Enteric neuronal plasticity and a reduced number of interstitial cells of Cajal in hypertrophic rat ileum. Gut 1998;42:836-44.
23 Gabella G. Size of neurons and glial cells in the intramural ganglia of the hypertrophic intestine of the guinea-pig. J Neurocytol 1984;13:73-84.
24 Gálvez Y, Skába R, Vajtrová R, Frantlová A, Herget J. Evidence of secondary neuronal intestinal dysplasia in a rat model of chronic intestinal obstruction. J Invest Surg 2004;17:31-9.
25 Jew JY, Williams TH, Gabella G, Zhang MQ. The intestine as a model for neuronal plasticity. Arch Histol Cytol 1989;52 Suppl:167-80.
26 Khen N, Jaubert F, Sauvat F, Fourcade L, Jan D, Martinovic J, et al. Fetal intestinal obstruction induces alteration of enteric nervous system development in human intestinal atresia. Pediatr Res 2004;56:975-80.
27 Ramachandran P, Vincent P, Ganesh S, Sridharan S. Morphological abnormalities in the innervation of the atretic segment of bowel in neonates with intestinal atresia. Pediatr Surg Int 2007;23:1183-6.
28 Rømert P, Mikkelsen HB. C-kit immunoreactive interstitial cells of Cajal in the human small and large intestine. Histochem Cell Biol 1998;109:195-202.
29 Streutker CJ, Huizinga JD, Driman DK, Riddell RH. Interstitial cells of Cajal in health and disease. Part I: Normal ICC structure and function with associated motility disorders. Histopathology 2007;50:176-89.
30 Kenny SE, Connell G, Woodward MN, Lloyd DA, Gosden CM, Edgar DH, et al. Ontogeny of interstitial cells of Cajal in the human intestine. J Pediatr Surg 1999;34:1241-7.