Colonic wall changes in patients with diverticular disease - is there a predisposition for a complicated course?
| Autor: | H. P. Alizai, Ulf P. Neumann, Marcel Binnebösel, Anne Mossdorf, Raphael Rosch, Tom Florian Ulmer |
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| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Colon Apoptosis Gastroenterology Diverticulitis Colonic Pathogenesis Internal medicine Matrix Metalloproteinase 13 medicine Humans Diverticular disease Diverticulitis Aged Plexus business.industry Enteric neuropathy Rectum General Medicine Extracellular matrix Middle Aged medicine.disease Diverticulosis Matrix metalloproteinase medicine.anatomical_structure Ki-67 Antigen Case-Control Studies Immunohistochemistry Sphincter Surgery Collagen Matrix Metalloproteinase 1 business Neuroglia |
| Zdroj: | International journal of surgery (London, England). 12(5) |
| ISSN: | 1743-9159 |
| Popis: | Background The aim of this study was to evaluate colonic wall changes and enteric neuropathy in patients with either uncomplicated (UDD) or complicated diverticular disease (CDD). Furthermore, we evaluated the presence of an anatomic sphincter at the rectosigmoid junction (RSJ). Methods Samples of colonic tissue from fifteen patients with UDD, fifteen patients with CDD and fifteen patients as control were collected. Collagen quotient I/III was measured with the Sirius-red test, expression of MMP-1, MMP-13, innervation (S100), proliferation (Ki67) and apoptosis (TUNEL) in the colonic wall were investigated by immunohistochemical studies. Furthermore, measurements of the different layers were performed to investigate the RSJ. Results Patients with either UDD or CDD had lower collagen I/III quotients compared to the control group, significant for CDD ( p = 0.007). For MMP-1 and MMP-13 only a slight increase for patients with CDD was found. The percentage of proliferating (Ki67) and apoptotic (TUNEL) cells was significantly higher for patients with CDD than in the control group ( p = 0.016; p = 0.037). Upon investigating the S100-expression a significant reduce in glial cells density was found in the myenteric and mucosal plexus for both groups (UDD and CDD) compared to the control group. Measurements of the different colon layers oral, aboral and at the RSJ revealed equal values. Conclusions This study has shown that colonic wall changes and enteric neuropathy seem to play a role in the pathogenesis of colonic diverticulosis. None of our results suggest a predisposition for a complicated diverticular disease. Furthermore, the presence of an anatomic sphincter at the rectosigmoid junction could not be detected. |
| Databáze: | OpenAIRE |
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