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Differential changes in intrinsic innervation and interstitial cells of Cajal in small bowel atresia in newborns
Authors:Gfroerer Stefan  Metzger Roman  Fiegel Henning  Ramachandran Priya  Rolle Udo
Institution:Stefan Gfroerer, Henning Fiegel, Udo Rolle, Department of Paediatric Surgery, Johann Wolfgang Goethe-University Frankfurt/M, Theodor-Stern-Kai 7, 60590 Frankfurt/M, Germany;Roman Metzger, Department of Paediatric Surgery, University of Leipzig, 04103 Leipzig, Germany;Priya Ramachandran, Department of Pediatric Surgery, Kanchi Kamakoti Childs Trust Hospital, 12-A Chennai, India
Abstract:AIM: To investigate morphological changes of the enteric nervous system (ENS) and the interstitial cells of Cajal (ICCs) in small bowel atresia.METHODS: Resected small bowel specimens from affected patients (n = 7) were divided into three parts (proximal, atretic, distal). Standard histology and enzyme immunohistochemistry anti-S100, anti-protein gene product (PGP) 9.5, anti-neurofilament (NF), antic-kit-receptor (CD117) was carried out on conventional paraffin sections of the proximal and distal part. RESULTS: The neuronal and glial markers (PGP 9.5, NF, S-100) were expressed in hypertrophied ganglia and nerve fibres within the myenteric and submucosal plexuses. Furthermore, the submucous plexus contained typical giant ganglia. The innervation pattern of the proximal bowel resembled intestinal neuronal dysplasia. The density of myenteric ICCs was clearly reduced in the proximal bowel, whereas a moderate number of muscular ICCs were found. The anti-CD117 immunore- action revealed additional numerous mast cells. The distal bowel demonstrated normal morphology and density of the ENS, the ICCs and the mast cells.CONCLUSION: The proximal and distal bowel in small bowel atresia revealed clear changes in morphology and density of the ENS and ICCs.
Keywords:Small bowel atresia  Enteric nervous system  Gastrointestinal motility  Interstitial cells of Cajal
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