Differential changes in intrinsic innervation and interstitial cells of Cajal in small bowel atresia in newborns.
OBJECTIVE
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.


CONCLUSIONS
The proximal and distal bowel in small bowel atresia revealed clear changes in morphology and density of the ENS and ICCs.
Department of Paediatric Surgery, Johann Wolfgang Goethe-University Frankfurt/M, Theodor-Stern-Kai 7, 60590 Frankfurt/M, Germany.
Stefan
S
Gfroerer
Roman
R
Metzger
Henning
H
Fiegel
Priya
P
Ramachandran
Udo
U
Rolle
D015415:Biomarkers / Q000032:analysis; D048430:Cell Shape; D017615:Enteric Nervous System / Q000737:chemistry / Q000473:pathology*; D005865:Gestational Age; D006801:Humans; D007082:Ileum / Q000294:innervation* / Q000473:pathology* / Q000601:surgery; D007150:Immunohistochemistry; D007231:Infant, Newborn; D056885:Interstitial Cells of Cajal / Q000737:chemistry / Q000473:pathology*; D016900:Neurofilament Proteins / Q000032:analysis; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis; D009418:S100 Proteins / Q000032:analysis; D043222:Ubiquitin Thiolesterase / Q000032:analysis
D015415:Biomarkers; D016900:Neurofilament Proteins; D009418:S100 Proteins; C482860:UCHL1 protein, human; D019009:Proto-Oncogene Proteins c-kit; D043222:Ubiquitin Thiolesterase