title: The enteric nervous system in patients with calculous and acalculous gallbladder.
abstract: BACKGROUND
  It is generally thought that gallbladder motility plays a more or less important role in the pathogenesis of gallstones. Some studies have shown that some abnormalities of its intrinsic innervations, but these studies were usually limited to one cell component.
  
  
  OBJECTIVE
  We investigated the main cell components of gallbladder intrinsic innervation in patients with and without gallstones.
  
  
  METHODS
  Archival gallbladder specimens from 39 patients, 27 with gallstones (age range 45-69 yrs) and 12 patients without gallstones (age range 39-71 yrs) were obtained. Full thickness sections were obtained from the gallbladder neck and immunohistochemistry was carried out for enteric neurons (neuron-specific enolase and calretinin), enteric glia (S100) and interstitial cells of Cajal (CD117 and CD34); tryptase staining was also done to distinguish the latter from mast cells.
  
  
  RESULTS
  Apart from calretinin-positive neurons, patients with gallstones featured a significant decrease of neurons, enteric glial cells (EGC) and mast cells compared to those without gallstones; interstitial cells of Cajal were extremely few and only found in two patients, one for each group.
  
  
  CONCLUSIONS
  The intrinsic innervations of the gallbladder is abnormal in gallstone patients, and this may contribute to gallstone formation in these subjects.
authors.affiliation: Pathology Section, Department of Molecular and Translational Medicine, Spedali Civili and University of Brescia, Perugia, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Villanacci
authors.affiliation: Pathology Section, Department of Experimental Medicine, University of Perugia School of Medicine, Perugia, Italy.
authors.forename: Rachele
authors.initials: R
authors.lastname: Del Sordo
authors.affiliation: Pathology Section, Department of Molecular and Translational Medicine, Spedali Civili and University of Brescia, Perugia, Italy.
authors.forename: Marianna
authors.initials: M
authors.lastname: Salemme
authors.affiliation: Pathology Section, Department of Molecular and Translational Medicine, Spedali Civili and University of Brescia, Perugia, Italy.
authors.forename: Moris
authors.initials: M
authors.lastname: Cadei
authors.affiliation: Pathology Section, Department of Experimental Medicine, University of Perugia School of Medicine, Perugia, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Sidoni
authors.affiliation: Gastroenterology and Hepatology Section, Department of Medicine, University of Perugia School of Medicine, Perugia, Italy. Electronic address: gabassot@tin.it.
authors.forename: Gabrio
authors.initials: G
authors.lastname: Bassotti
mesh_terms: D000328:Adult; D000368:Aged; D017615:Enteric Nervous System / Q000503:physiopathology*; D005260:Female; D005704:Gallbladder / Q000294:innervation* / Q000503:physiopathology; D042882:Gallstones / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D007558:Italy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Enteric nervous system; Gallbladder; Immunohistochemistry; Stones