title: Quantitative Histomorphometry of the Healthy Peritoneum.
abstract: The peritoneum plays an essential role in preventing abdominal frictions and adhesions and can be utilized as a dialysis membrane. Its physiological ultrastructure, however, has not yet been studied systematically. 106 standardized peritoneal and 69 omental specimens were obtained from 107 patients (0.1-60 years) undergoing surgery for disease not affecting the peritoneum for automated quantitative histomorphometry and immunohistochemistry. The mesothelial cell layer morphology and protein expression pattern is similar across all age groups. Infants below one year have a thinner submesothelium; inflammation, profibrotic activity and mesothelial cell translocation is largely absent in all age groups. Peritoneal blood capillaries, lymphatics and nerve fibers locate in three distinct submesothelial layers. Blood vessel density and endothelial surface area follow a U-shaped curve with highest values in infants below one year and lowest values in children aged 7-12 years. Lymphatic vessel density is much lower, and again highest in infants. Omental blood capillary density correlates with parietal peritoneal findings, whereas only few lymphatic vessels are present. The healthy peritoneum exhibits major thus far unknown particularities, pertaining to functionally relevant structures, and subject to substantial changes with age. The reference ranges established here provide a framework for future histomorphometric analyses and peritoneal transport modeling approaches.
authors.affiliation: Center for Pediatric and Adolescent Medicine, University of Heidelberg, Germany.
authors.forename: Betti
authors.initials: B
authors.lastname: Schaefer
authors.affiliation: Center for Pediatric and Adolescent Medicine, University of Heidelberg, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Bartosova
authors.affiliation: Institute of Pathology, University of Heidelberg, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Macher-Goeppinger
authors.affiliation: Institute of Pathophysiology, Semmelweis University, Budapest, Hungary.
authors.forename: Akos
authors.initials: A
authors.lastname: Ujszaszi
authors.affiliation: Department of Obstetrics and Gynecology, University of Heidelberg, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Wallwiener
authors.affiliation: Department of Urology, University of Heidelberg, Germany.
authors.forename: Joanne
authors.initials: J
authors.lastname: Nyarangi-Dix
authors.affiliation: First Department of Pediatrics, Semmelweis University, Budapest, Hungary.
authors.forename: Peter
authors.initials: P
authors.lastname: Sallay
authors.affiliation: Department of Pediatric Nephrology, University of Charité, Berlin, Germany.
authors.forename: Dorothea
authors.initials: D
authors.lastname: Burkhardt
authors.affiliation: Department of Pediatric Nephrology, University of Charité, Berlin, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Querfeld
authors.affiliation: Division of Pediatric Surgery, University of Heidelberg, Germany.|Department of Pediatric Surgery, University Children´s Hospital Basel, Switzerland.
authors.forename: Viktoria
authors.initials: V
authors.lastname: Pfeifle
authors.affiliation: Bioquant, Hamamatsu Tissue Imaging and Analysis (TIGA) Center, Heidelberg, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Lahrmann
authors.affiliation: Division of Nephrology, University of Heidelberg, Germany.
authors.forename: Vedat
authors.initials: V
authors.lastname: Schwenger
authors.affiliation: Center for Pediatric and Adolescent Medicine, University of Heidelberg, Germany.
authors.forename: Elke
authors.initials: E
authors.lastname: Wühl
authors.affiliation: Division of Pediatric Surgery, University of Heidelberg, Germany.|Department of Pediatric Surgery, University Children´s Hospital Basel, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Holland-Cunz
authors.affiliation: Center for Pediatric and Adolescent Medicine, University of Heidelberg, Germany.
authors.forename: Franz
authors.initials: F
authors.lastname: Schaefer
authors.affiliation: Center for Pediatric and Adolescent Medicine, University of Heidelberg, Germany.
authors.forename: Claus P
authors.initials: CP
authors.lastname: Schmitt
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004848:Epithelium / Q000098:blood supply; D005260:Female; D006801:Humans; D007223:Infant; D042601:Lymphatic Vessels / Q000166:cytology; D008297:Male; D008562:Membrane Glycoproteins / Q000378:metabolism; D008875:Middle Aged; D010537:Peritoneum / Q000098:blood supply / Q000166:cytology* / Q000378:metabolism; D055815:Young Adult; D000098853:Podoplanin
chemical_list: D008562:Membrane Glycoproteins; C117468:PDPN protein, human; D000098853:Podoplanin