Brief Article
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World J Gastroenterol. Dec 7, 2010; 16(45): 5716-5721
Published online Dec 7, 2010. doi: 10.3748/wjg.v16.i45.5716
Differential changes in intrinsic innervation and interstitial cells of Cajal in small bowel atresia in newborns
Stefan Gfroerer, Roman Metzger, Henning Fiegel, Priya Ramachandran, Udo Rolle
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
Author contributions: Gfroerer S and Metzger R performed the majority of the investigations; Ramachandran P provided the collection of specimens; Fiegel H was involved in the evaluation of the staining results and editing of the manuscript; Rolle U designed the study and wrote the manuscript.
Correspondence to: Udo Rolle, MD, Professor, Department of Paediatric Surgery, Johann Wolfgang Goethe-University Frankfurt/M, Theodor-Stern-Kai 7, 60590 Frankfurt/M, Germany. udo.rolle@kgu.de
Telephone: +49-69-63016659 Fax: +49-69-63017936
Received: March 13, 2010
Revised: April 19, 2010
Accepted: April 26, 2010
Published online: December 7, 2010
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), anti-c-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 immunoreaction 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