title: Intramuscular interstitial cells of Cajal associated with mast cells survive nitrergic nerves in achalasia.
abstract: Achalasia is dominated by injury to inhibitory nerves. As intramuscular interstitial cells of Cajal (ICC-IM) are proposed to form functional units with nitrergic nerves, their fate in achalasia may be critically important. We studied the relationship between loss of nitrergic nerves and injury to ICC-IM in patients with achalasia and determined associations between ICC-IM and mast cells (MC), using quantitative immunohistochemistry and electron microscopy. Loss of neuronal nitric oxide synthase (nNOS) immunoreactivity was completed within 3 years of acquiring achalasia. Thereafter, progressive ultrastructural injury to remaining nerve structures was evident. Within the first 2 years, the number of ICC-IM did not decline although ultrastructural injury was already present. Thereafter, loss of ICC-IM occurred unrelated to duration of disease. Damage to ICC-IM appeared unrelated to nerve injury. A significant MC infiltration was observed in the musculature; the number of MC was positively related to the persistent number of ICC-IM. Mast cell formed close contacts with ICC-IM and piecemeal-degranulation occurred towards ICC-IM. In conclusion, injury to ICC-IM in achalasia is variable, but not related to duration of disease and injury to nitrergic nerves. MC are prominent and form close functional contact with ICC-IM which may be responsible for their relatively long survival.
authors.affiliation: IDRP, McMaster University, ON, Canada. zaratenatalia1@yahoo.es
authors.forename: N
authors.initials: N
authors.lastname: Zarate
authors.forename: X Y
authors.initials: XY
authors.lastname: Wang
authors.forename: G
authors.initials: G
authors.lastname: Tougas
authors.forename: M
authors.initials: M
authors.lastname: Anvari
authors.forename: D
authors.initials: D
authors.lastname: Birch
authors.forename: F
authors.initials: F
authors.lastname: Mearin
authors.forename: J-R
authors.initials: JR
authors.lastname: Malagelada
authors.forename: J D
authors.initials: JD
authors.lastname: Huizinga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002450:Cell Communication / Q000502:physiology; D004931:Esophageal Achalasia / Q000276:immunology* / Q000473:pathology; D004947:Esophagus / Q000166:cytology* / Q000276:immunology* / Q000294:innervation; D006801:Humans; D007150:Immunohistochemistry; D008407:Mast Cells / Q000166:cytology* / Q000276:immunology / Q000378:metabolism; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D009130:Muscle, Smooth / Q000166:cytology / Q000276:immunology / Q000378:metabolism; D009197:Myenteric Plexus / Q000378:metabolism / Q000473:pathology; D009410:Nerve Degeneration; D026602:Nitrergic Neurons / Q000378:metabolism / Q000473:pathology*; D052248:Nitric Oxide Synthase Type I / Q000378:metabolism; D019009:Proto-Oncogene Proteins c-kit / Q000378:metabolism
chemical_list: D052248:Nitric Oxide Synthase Type I; D019009:Proto-Oncogene Proteins c-kit