The role of glial cells and apoptosis of enteric neurones in the neuropathology of intractable slow transit constipation
The role of glial cells and apoptosis of enteric neurones in the neuropathology of intractable slow transit constipation
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DOI：
10.1136/gut.2005.073197
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发表时间：
2006-01-01
期刊：
影响因子：
24.5
通讯作者：
Salemi, B
中科院分区：
文献类型：
--
作者：
Bassotti, G;Villanacci, V;Salemi, B
背景：特发性慢传输型便秘是最严重且通常最难治的便秘形式之一。由于运动异常被认为发挥着重要的发病作用，因此对结肠神经肠系统进行了研究，该系统控制内脏的运动方面。目的：我们假设存在大肠的重要神经病理学异常，这些异常并不局限于卡哈尔间质细胞和神经节细胞，并且先前描述的肠神经元减少（如果得到证实）可能与此相关。 患者和方法：通过常规方法和免疫组织化学方法对 26 名严重便秘患者的手术标本进行了评估。使用对肠神经元、神经胶质细胞、卡哈尔间质细胞以及与后者相关的成纤维细胞样细胞的特异性染色。此外，通过间接和直接技术评估神经节细胞凋亡。将患者的数据与 10 名对照者的数据进行比较。结果：严重便秘患者的肠神经节细胞、神经胶质细胞和 Cajal 间质细胞显着减少。与后者相关的成纤维细胞样细胞在患者和对照组之间没有显着差异。患者的肠神经细胞凋亡明显多于对照组。结论：严重便秘患者存在重要的神经肠异常，不仅限于神经节细胞和卡哈尔间质细胞。肠神经元的减少可能部分是由于细胞凋亡现象的增加。
Background: Idiopathic slow transit constipation is one of the most severe and often intractable forms of constipation. As motor abnormalities are thought to play an important pathogenetic role, studies have been performed on the colonic neuroenteric system, which rules the motor aspects of the viscus.Aims: We hypothesised that important neuropathological abnormalities of the large bowel are present, that these are not confined to the interstitial cells of Cajal and ganglion cells, and that the previously described reduction of enteric neurones, if confirmed, might be related to an increase in programmed cell death ( apoptosis).Patients and methods: Surgical specimens from 26 severely constipated patients were assessed by conventional and immunohistochemical methods. Specific staining for enteric neurones, glial cells, interstitial cells of Cajal, and fibroblast-like cells associated with the latter were used. In addition, gangliar cell apoptosis was evaluated by means of indirect and direct techniques. Data from patients were compared with those obtained in 10 controls.Results: Severely constipated patients displayed a significant decrease in enteric gangliar cells, glial cells, and interstitial cells of Cajal. Fibroblast-like cells associated with the latter did not differ significantly between patients and controls. Patients had significantly more apoptotic enteric neurones than controls.Conclusion: Severely constipated patients have important neuroenteric abnormalities, not confined to gangliar cells and interstitial cells of Cajal. The reduction of enteric neurones may in part be due to increased apoptotic phenomena.