title: Alpha-synuclein immunohistochemistry of gastrointestinal and biliary surgical specimens for diagnosis of Lewy body disease.
abstract: In Lewy body disease, Lewy pathology (LP: the accumulation of α-synuclein in neuronal perikarya and processes as Lewy bodies and Lewy neurites and dots, respectively) is observed in the central and peripheral nervous systems. Previous autopsy or biopsy studies of individuals with Lewy body diseases (LBDs) indicated that LP could be observed in the peripheral nerves of the gastrointestinal (GI) systems. The aim of this study is to clarify whether examination of GI and biliary surgical specimens would be useful for diagnosing LBD. We analyzed eight patients diagnosed clinically with LBD and with medical histories of GI or biliary surgery at our hospital. LP was identified by using α-synuclein immunohistochemistry in GI and biliary surgical specimens obtained before, at or after the clinical onset of LBD. LP was frequently observed in Auerbach's plexus, Meissner's plexus and the subserosal nerve fascicles within the GI and biliary surgical specimens. LP was observed in the specimens obtained 7 years before the onset of LBD. Our approach does not require any invasive procedures for patients. The immunohistochemical analysis of anti- α-synuclein antibody to archival GI or biliary surgical specimens from patients with clinically suspected LBD may contribute to clinical diagnosis of LBD.
authors.affiliation: Department of Neuropathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology Tokyo, Japan ; Department of Pathology, Graduate School of Medicine, The University of Tokyo Tokyo, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Ito
authors.affiliation: Department of Neuropathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology Tokyo, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Takao
authors.affiliation: Department of Neuropathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology Tokyo, Japan ; Department of Pathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hatsuta
authors.affiliation: Department of Neurology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology Tokyo, Japan.
authors.forename: Kazutomi
authors.initials: K
authors.lastname: Kanemaru
authors.affiliation: Department of Pathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology Tokyo, Japan.
authors.forename: Tomio
authors.initials: T
authors.lastname: Arai
authors.affiliation: Department of Laboratory Medicine, National Center for Neurology and Psychiatry Tokyo, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Saito
authors.affiliation: Department of Pathology, Graduate School of Medicine, The University of Tokyo Tokyo, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Fukayama
authors.affiliation: Department of Neuropathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology Tokyo, Japan ; Department of Neurology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology Tokyo, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Murayama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001659:Biliary Tract / Q000294:innervation* / Q000378:metabolism* / Q000473:pathology; D015415:Biomarkers / Q000378:metabolism; D001706:Biopsy; D005260:Female; D041981:Gastrointestinal Tract / Q000294:innervation* / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D016631:Lewy Bodies / Q000378:metabolism / Q000473:pathology; D020961:Lewy Body Disease / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D008297:Male; D009197:Myenteric Plexus / Q000378:metabolism / Q000473:pathology; D016501:Neurites / Q000378:metabolism / Q000473:pathology; D012189:Retrospective Studies; D013368:Submucous Plexus / Q000378:metabolism / Q000473:pathology; D051844:alpha-Synuclein / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D051844:alpha-Synuclein
keywords: Lewy body disease; Lewy pathology; gastrointestinal and biliary tract; surgical specimen; α-synuclein