Cellular changes in diabetic and idiopathic gastroparesis.
Cellular changes in diabetic and idiopathic gastroparesis.
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DOI：
10.1053/j.gastro.2011.01.046
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发表时间：
2011-05
期刊：
影响因子：
29.4
通讯作者：
NIDDK Gastroparesis Clinical Research Consortium
中科院分区：
文献类型：
--
作者：
Grover M;Farrugia G;Lurken MS;Bernard CE;Faussone-Pellegrini MS;Smyrk TC;Parkman HP;Abell TL;Snape WJ;Hasler WL;Ünalp-Arida A;Nguyen L;Koch KL;Calles J;Lee L;Tonascia J;Hamilton FA;Pasricha PJ;NIDDK Gastroparesis Clinical Research Consortium
与糖尿病和特发性胃轻瘫相关的细胞变化还没有很好的描述。描述胃轻瘫的组织学异常，并比较特发性胃轻瘫与糖尿病胃轻瘫的结果。从40名胃轻瘫患者（20名糖尿病患者）和匹配的对照组中获得全层胃体活检。切片进行H&E和三色染色，并用针对PGP 9.5、nNOS、VIP、P物质和酪氨酸羟化酶的抗体进行免疫标记以定量神经，S100β用于神经胶质，Kit用于Cajal间质细胞（ICC），CD45和CD68用于免疫细胞，smoothelin用于平滑肌细胞。还通过透射电子显微镜（TEM）检查组织。在83%的患者中发现了组织学异常。最常见的缺陷是ICC丢失，剩余的ICC显示损伤，含有巨噬细胞的异常免疫浸润和神经纤维减少。在光学显微镜下，糖尿病和特发性胃轻瘫之间没有显着差异，除了nNOS表达减少更多的特发性胃轻瘫（40%）相比，糖尿病（20%）患者的视觉分级。在电子显微镜下，显着增加结缔组织间质是目前在这两种疾病。这项研究表明，在全层活检，细胞异常被发现在大多数胃轻瘫患者。最常见的结果是Kit表达的丧失，表明ICC的丧失和CD45和CD68免疫反应性的增加。这些发现表明，组织检查可以导致对这些疾病的病理生理学的有价值的见解，并为发现新的治疗靶点提供了希望。
Cellular changes associated with diabetic and idiopathic gastroparesis are not well described. Describe histologic abnormalities in gastroparesis and compare findings in idiopathic versus diabetic gastroparesis. Full thickness gastric body biopsies were obtained from 40 gastroparetics (20 diabetic) and matched controls. Sections were stained for H&E and trichrome, and immunolabeled with antibodies against PGP 9.5, nNOS, VIP, substance P and tyrosine hydroxylase to quantify nerves, S100β for glia, Kit for interstitial cells of Cajal (ICC), CD45 and CD68, for immune cells and smoothelin for smooth muscle cells. Tissue was also examined by transmission electron microscopy (TEM). Histological abnormalities were found in 83% of patients. Most common defects were loss of ICC with remaining ICC showing injury, an abnormal immune infiltrate containing macrophages, and decreased nerve fibers. On light microscopy, no significant differences were found between diabetic and idiopathic gastroparesis with the exception of nNOS expression which was decreased in more idiopathic gastroparetics (40%) compared to diabetic (20%) patients by visual grading. On electron microscopy, a markedly increased connective tissue stroma was present in both disorders. This study suggests that on full thickness biopsies, cellular abnormalities are found in the majority of patients with gastroparesis. Most common findings were loss of Kit expression suggesting loss of ICC and an increase in CD45 and CD68 immunoreactivity. These findings suggest that examination of tissue can lead to valuable insights into the pathophysiology of these disorders and offers hope that new therapeutic targets can be found.
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