Slow transit colon constipation is not related to the number of interstitial cells of Cajal.
OBJECTIVE
Recent studies have demonstrated decreased numbers of interstitial cells of Cajal in patients suffering from severe chronic constipation as measured by c-Kit (CD117) and CD34 immunohistology. In this study, we wished to determine whether there were abnormalities in the number of neurons of the Auerbach's plexus, their CD117 and CD34 immunoreactivity, or the thickness of colon wall sections in patients with refractory slow transit colonic constipation as compared with control subjects.


METHODS
Specimens from 13 patients who had undergone subtotal colectomy for severe chronic constipation refractory to medical treatment were compared with normal controls. Enteric neurons of Auerbach's plexus were counted, and thickness of the circular and longitudinal layer of the muscularis externa as well as total muscularis externa was measured. Quantitative assessment of anti-CD117 and anti-CD34 immunoreactivity was performed using an Automated Cellular Imaging System and expressed as fractional scores.


RESULTS
Except for a decreased circular muscle layer thickness in the constipated patients, no statistically significant differences were observed between the two groups. In particular, there was no relationship between CD117/CD34 fractional staining score and the duration or severity of disease, despite the selection of highly symptomatic individuals requiring colonic resection.


CONCLUSIONS
Using quantitative immunohistochemistry for CD117/CD34, we could not detect a relationship between fractional CD117/CD34 staining score and chronic constipation as compared to controls.
Toman
Jeffrey
J
Section of Colon and Rectal Surgery, Department of Surgery, University of Louisville School of Medicine, Louisville, KY 40292, USA.
Turina
Matthias
M
Ray
Mukunda
M
Petras
Robert E
RE
Stromberg
Arnold J
AJ
Galandiuk
Susan
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count; D020541:Coiled Bodies / Q000473:pathology*; D003082:Colectomy; D003106:Colon / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D003248:Constipation / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D003937:Diagnosis, Differential; D005772:Gastrointestinal Transit / Q000502:physiology*; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index