Haemorrhoids are related to changes of cell function in mucosa and submucosa.
OBJECTIVE
Epidemiology and risk factors of haemorrhoidal disease are not well defined. This study tried to evaluate if the appearance of haemorrhoids is related to a disturbed remodelling of the soft tissue of rectal mucosa and submucosa. Therefore, immunohistochemical expression profiles of five parameters as potential mediators in neoangiogenesis (EGFR), in inflammatory cell activity (COX-2), and in cell migration, differentiation, and wound healing (notch-3, c-myc, and beta-Catenin) were analysed (Saed et al., Fertil Steril 83(Suppl 1):1216-1219, 1; Saed et al., Fertil Steril 79:1404-1408, 2; Stojadinovic et al., Am J Pathol 167:59-69, 3).


METHODS
Haemorrhoidal tissue specimens were collected from 44 patients. Healthy rectal mucosa was obtained from 16 non-fixed fresh cadavers and served as control. Histological and immunohistochemical markers like EGFR, COX-2, notch-3, c-myc, and beta-Catenin were analysed semi-quantitatively, separately for mucosal and submucosal layer.


RESULTS
Significantly increased expressions were found for EGFR, COX-2, and notch-3 in the mucosal and submucosal layer of haemorrhoidal tissue in comparison to normal rectal tissue.


CONCLUSIONS
This finding confirms that haemorrhoidal disease may be regarded as a manifestation of a soft tissue disease.
Klink
Christian
C
Department of Surgery, RWTH Aachen University Hospital, Aachen, Germany. cklink@ukaachen.de
Binnebösel
Marcel
M
Kämmer
Daniel
D
Willis
Stefan
S
Prescher
Andreas
A
Klinge
Uwe
U
Schumpelick
Volker
V
D000368:Aged; D051546:Cyclooxygenase 2 / Q000378:metabolism; D066246:ErbB Receptors / Q000378:metabolism; D006484:Hemorrhoids / Q000201:enzymology / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology*; D051880:Receptors, Notch / Q000378:metabolism; D051176:beta Catenin / Q000378:metabolism
D051880:Receptors, Notch; D051176:beta Catenin; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D066246:ErbB Receptors