Interstitial cells of Cajal in the vermiform appendix in childhood.
OBJECTIVE
The interstitial cells of Cajal (ICC) have not yet been investigated in the vermiform appendix. They are important for the peristalsis of the gastrointestinal tract and have been found to be altered in various motility disorders. Motor disturbance has been suggested as a possible contributor in the unclear etiology of appendicitis. We wanted to examine the distribution of the ICC in the vermiform appendix. Furthermore we investigated whether ICC are altered in persons with appendicitis.


METHODS
We investigated the ICC distribution in 28 appendices of children using immunohistochemistry and anti-c-kit antibodies. Cells and processes were quantified in normal, acute and chronic inflamed appendices.


RESULTS
IC(C)-CM and IC(C)-LM were found in the circular and longitudinal muscle layers, respectively. IC(C)-LM, however, were scarce and inhomogeneous in contrast to the IC(C)-CM. The functionally important subgroups of the colon, the IC(C)-SM and IC(C)-MP, however, could not be detected in the appendix with the used antibody. There was no difference in the distribution of detected ICC between normal and inflamed appendices.


CONCLUSIONS
IC(C)-LM are altered and IC(C)-SM and IC(C)-MP are lost in the vermiform appendix with no differences between healthy and inflamed tissue and without a correlation to appendicitis. Thus, other factors must be considered in the etiology of appendicitis.
Richter
A
A
Clinic for Pediatric Surgery, University Hospital Charité Berlin, Berlin, Germany. dr.andre-richter@web.de
Wit
C
C
Vanderwinden
J-M
JM
Wit
J
J
Barthlen
W
W
D000208:Acute Disease; D000293:Adolescent; D000911:Antibodies, Monoclonal; D001064:Appendicitis / Q000473:pathology* / Q000601:surgery; D001065:Appendix / Q000033:anatomy & histology / Q000473:pathology* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007155:Immunologic Factors; D007223:Infant; D008297:Male; D008499:Medical Records; D008854:Microscopy, Electron; D009197:Myenteric Plexus / Q000473:pathology*; D032389:Myocytes, Smooth Muscle; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis* / Q000276:immunology; D012189:Retrospective Studies
D000911:Antibodies, Monoclonal; D007155:Immunologic Factors; D019009:Proto-Oncogene Proteins c-kit