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Ren G, Zhong R, Zou G, Du H, Zhang Y. Presence and significance of telocytes in cholelithiasis and biliary dilatation in benign biliary disorders. Sci Rep 2024; 14:14904. [PMID: 38942924 PMCID: PMC11213881 DOI: 10.1038/s41598-024-65776-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 06/24/2024] [Indexed: 06/30/2024] Open
Abstract
Telocytes are closely associated with the regulation of tissue smooth muscle dynamics in digestive system disorders. They are widely distributed in the biliary system and exert their influence on biliary motility through mechanisms such as the regulation of CCK and their electrophysiological effects on smooth muscle cells. To investigate the relationship between telocytes and benign biliary diseases,such as gallbladder stone disease and biliary dilation syndrome, we conducted histopathological analysis on tissues affected by these conditions. Additionally, we performed immunohistochemistry and immunofluorescence double staining experiments for telocytes. The results indicate that the quantity of telocytes in the gallbladder and bile duct is significantly lower in pathological conditions compared to the control group. This reveals a close association between the decrease in telocyte quantity and impaired gallbladder motility and biliary fibrosis. Furthermore, further investigations have shown a correlation between telocytes in cholesterol gallstones and cholecystokinin-A receptor (CCK-AR), suggesting that elevated cholesterol levels may impair telocytes, leading to a reduction in the quantity of CCK-AR and ultimately resulting in impaired gallbladder motility.Therefore, we hypothesize that telocytes may play a crucial role in maintaining biliary homeostasis, and their deficiency may be associated with the development of benign biliary diseases, including gallstone disease and biliary dilation.
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Affiliation(s)
- Gongqing Ren
- The Second Clinical Medical College, Jinan University, Shenzhen, China
| | - Ruizi Zhong
- The Second Clinical Medical College, Jinan University, Shenzhen, China
| | - Gang Zou
- Department of Burns and Plastic Surgery, Shenzhen People's Hospital, Shenzhen, China
| | - Hongling Du
- Department of Thyroid and Breast Surgery, The Second Affiliated Hospital of Guizhou Medical University, Kaili, China
| | - Yue Zhang
- Department of Hepatobiliary Pancreatic Surgery, Shenzhen People's Hospital, No.1017 Dongmen North Road, Shenzhen, 518020, Guangdong Province, China.
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Bian H, Zhang L, Yao Y, Lv F, Wei J. How traditional Chinese medicine can prevent recurrence of common bile duct stones after endoscopic retrograde cholangiopancreatography? Front Pharmacol 2024; 15:1363071. [PMID: 38659575 PMCID: PMC11039848 DOI: 10.3389/fphar.2024.1363071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/20/2024] [Indexed: 04/26/2024] Open
Abstract
Common bile duct stones, as a type of cholelithiasis, are a benign biliary obstruction that easily acute abdominalgia, and Endoscopic Retrograde Cholangiopancreatography (ERCP) is usually the first choice for clinical treatment. However, the increasing recurrence rate of patients after treatment is troubling clinicians and patients. For the prevention of recurrence after ERCP, there is no guideline to provide a clear drug regimen, traditional Chinese medicine however has achieved some result in the treatment of liver-related diseases based on the "gut-liver-bile acid axis". On the basis of this, this article discusses the possibility of traditional Chinese medicine to prevent common bile duct stones (CBDS) after ERCP, and we expect that this article will provide new ideas for the prevention of recurrence of CBDS and for the treatment of cholelithiasis-related diseases with traditional Chinese medicine in future clinical and scientific research.
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Affiliation(s)
- Haoyu Bian
- Department of Gastroenterology, Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Liping Zhang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Yupu Yao
- Department of Gastroenterology, Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Fuqi Lv
- Department of Gastroenterology, Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Jiaoyang Wei
- Department of Gastroenterology, Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, China
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Thomaidou E, Karlafti E, Didagelos M, Megari K, Argiriadou E, Akinosoglou K, Paramythiotis D, Savopoulos C. Acalculous Cholecystitis in COVID-19 Patients: A Narrative Review. Viruses 2024; 16:455. [PMID: 38543820 PMCID: PMC10976146 DOI: 10.3390/v16030455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 05/23/2024] Open
Abstract
Acute acalculous cholecystitis (AAC) represents cholecystitis without gallstones, occurring in approximately 5-10% of all cases of acute cholecystitis in adults. Several risk factors have been recognized, while infectious diseases can be a cause of cholecystitis in otherwise healthy people. Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has spread worldwide, leading to an unprecedented pandemic. The virus enters cells through the binding of the spike protein to angiotensin-converting enzyme 2 (ACE2) receptors expressed in many human tissues, including the epithelial cells of the gastrointestinal (GI) tract, and this explains the symptoms emanating from the digestive system. Acute cholecystitis has been reported in patients with COVID-19. The purpose of this review is to provide a detailed analysis of the current literature on the pathogenesis, diagnosis, management, and outcomes of AAC in patients with COVID-19.
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Affiliation(s)
- Evanthia Thomaidou
- Department of Anesthesiology and Intensive Care Unit, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.T.); (M.D.); (E.A.)
| | - Eleni Karlafti
- Emergency Department, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
- First Propaedeutic Internal Medicine Department, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Matthaios Didagelos
- Department of Anesthesiology and Intensive Care Unit, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.T.); (M.D.); (E.A.)
- 1st Cardiology Department, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Kalliopi Megari
- CITY College, University of York Europe Campus, 54626 Thessaloniki, Greece;
| | - Eleni Argiriadou
- Department of Anesthesiology and Intensive Care Unit, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.T.); (M.D.); (E.A.)
| | - Karolina Akinosoglou
- Department of Medicine, University General Hospital of Patras, 26504 Rio, Greece;
| | - Daniel Paramythiotis
- First Propaedeutic Department of Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Christos Savopoulos
- First Propaedeutic Internal Medicine Department, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
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Ding F, Guo R, Chen F, Liu LP, Cui ZY, Wang YX, Zhao G, Hu H. Impact of interstitial cells of Cajal on slow wave and gallbladder contractility in a guinea pig model of acute cholecystitis. World J Gastrointest Surg 2023; 15:1068-1079. [PMID: 37405098 PMCID: PMC10315119 DOI: 10.4240/wjgs.v15.i6.1068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/21/2023] [Accepted: 04/14/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Impaired interstitial cells of Cajal (ICCs) are central to the pathophysiology of acute cholecystitis (AC). Common bile duct ligation is a common model of AC, producing acute inflammatory changes and decrease in gallbladder contractility.
AIM To investigate the origin of slow wave (SW) in the gallbladder and the effect of ICCs on gallbladder contractions during the process of AC.
METHODS Methylene blue (MB) with light was used to establish selective impaired ICCs gallbladder tissue. Gallbladder motility was assessed using the frequency of SW and gallbladder muscle contractility in vitro in normal control (NC), AC12h, AC24h, and AC48h groups of guinea pigs. Hematoxylin and eosin and Masson-stained gallbladder tissues were scored for inflammatory changes. ICCs pathological changes alterations were estimated using immunohistochemistry and transmission electron microscopy. The alterations of c-Kit, α-SMA, cholecystokinin A receptor (CCKAR), and connexin 43 (CX43) were assessed using Western blot.
RESULTS Impaired ICCs muscle strips resulted in the decrease in gallbladder SW frequency and contractility. The frequency of SW and gallbladder contractility were significantly lower in the AC12h group. Compared with the NC group, the density and ultrastructure of ICCs were remarkably impaired in the AC groups, especially in the AC12h group. The protein expression levels of c-Kit were significantly decreased in the AC12h group, while CCKAR and CX43 protein expression levels were significantly decreased in the AC48h group.
CONCLUSION Loss ICCs could lead to a decrease in gallbladder SW frequency and contractility. The density and ultrastructure of ICCs were clearly impaired in the early stage of AC, while CCKAR and CX43 were significantly reduced at end stage.
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Affiliation(s)
- Fan Ding
- Center of Gallbladder Disease, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
- Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai 200331, China
| | - Run Guo
- Department of Ultrasonography, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
| | - Fang Chen
- Department of Ultrasonography, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
| | - Li-Ping Liu
- Department of Ultrasonography, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
| | - Zheng-Yu Cui
- Department of Internal Medicine of Traditional Chinese Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
| | - Yi-Xing Wang
- Department of Internal Medicine of Traditional Chinese Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
| | - Gang Zhao
- Center of Gallbladder Disease, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
- Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai 200331, China
| | - Hai Hu
- Center of Gallbladder Disease, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
- Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai 200331, China
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Huang ZP, Wang K, Qiu H, He JW, Kong LW, Bai M, Cheng YX. Distribution of interstitial cells of Cajal in the Esophagus and change in distribution after thoracic trauma. J Mol Histol 2022; 53:589-598. [PMID: 35661289 DOI: 10.1007/s10735-022-10074-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/14/2022] [Indexed: 11/28/2022]
Abstract
Interstitial cells of Cajal (ICCs) function as pacemaker cells in the gastrointestinal tract. Acute thoracic trauma is a common and lethal cause of death due to physical trauma caused by traffic accidents. This study aimed to explore the distribution of esophageal ICCs and distribution changes observed after acute thoracic trauma. Thirty rabbits were randomly divided into a control group and two study groups. The control group animals underwent an esophagectomy. All animals in the study groups underwent right chest puncture using the Hopkinson bar technique. The study groups were subjected to esophagectomy 24 and 72 h after chest puncture. Distribution, morphology, and density of esophageal ICCs were detected using transmission electron microscopy, toluidine blue staining, and immunohistochemistry. Apoptosis of esophageal ICCs was evaluated using the terminal deoxynucleotidyl transferase (TdT) dUTP Nick-End Labeling assay. Western blotting and reverse transcription polymerase chain reaction were used to detect changes in the SCF/c-kit signaling pathway. Esophageal ICCs distribution and SCF/c-kit signal pathway decreased from the upper part to the lower part in both physiological state and after thoracic trauma. In contrast, death of ICCs increased from the upper part to the lower part, both in physiological and injured state (P < 0.05). After thoracic trauma, increased ICCs and decreased death of ICCs in all parts of the esophagus (P < 0.05) were observed. The observed distribution and changes in esophageal ICCs would have an impact on motility and motility disorders of the esophagus.
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Affiliation(s)
- Zhen-Peng Huang
- Faculty of Nursing, Guangxi University of Chinese Medicine, Nanning, Guangxi, China.
| | - Ke Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shannxi, China.,College of Clinical Medicine, Xi'an Medical University, Xi'an, Shannxi, China
| | - Hu Qiu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jia-Wei He
- School of Public Health, Xi'an Medical University, Xi'an, Shannxi, China
| | - Ling-Wang Kong
- School of Public Health, Xi'an Medical University, Xi'an, Shannxi, China
| | - Meng Bai
- College of Clinical Medicine, Xi'an Medical University, Xi'an, Shannxi, China
| | - Yi-Xin Cheng
- College of Clinical Medicine, Xi'an Medical University, Xi'an, Shannxi, China
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Huang ZP, Qiu H, Wang K, He JW, Chen H, Kong LW, Zou Y. Changes in esophagus interstitial cells of Cajal in response to acute stress. Scand J Gastroenterol 2022; 57:392-400. [PMID: 34978503 DOI: 10.1080/00365521.2021.2018490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/08/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Thoracic trauma is common, and traffic accident-related traumatic injury can cause acute stress leading to esophageal motility disorders. Interstitial cells of Cajal (ICCs) are regarded as gastrointestinal pacemaker cells. AIM This study explored the mechanism underlying changes in lower esophagus ICCs under acute stress conditions. METHODS Fifty adult rabbits, randomly divided into one healthy control and four study groups, were subjected to right chest puncture using a Hopkinson bar. Thereafter, one group was immediately subjected to lower esophagectomy, whereas the other three groups were maintained for 24, 48 and 72 h after puncture and subjected to lower esophagectomy. Immunohistochemistry was used to detect ICC distribution, morphology and density, and TUNEL assays were used to determine ICC apoptosis. Enzyme-linked immunosorbent assays (ELISAs) were used to measure cortisol, epinephrine, dopamine, IL-9, cholecystokinin (CCK) and vasoactive intestinal peptide (VIP). Western blotting and RT-PCR were performed to detect changes in SCF/c-kit and nNOS pathways. RESULTS After puncture, lung tissue was hemorrhaged, alveoli in puncture areas were destroyed, esophageal pH was decreased, and serum cortisol, epinephrine and dopamine levels increased. ICC numbers increased and apoptotic ICCs decreased in all stress groups after puncture (all p < .01). IL-9, CCK and VIP levels in lower esophagus tissue were increased after puncture (all p < .01). Moreover, SCF/c-kit and nNOS pathways were upregulated in response to stress (all p < .01). CONCLUSIONS Acute stress promotes increases in lower esophageal ICCs that might affect esophagus ICC functions and esophageal motility.
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Affiliation(s)
- Zhen-Peng Huang
- Guangzhou Institute of Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Hu Qiu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ke Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jia-Wei He
- School of Public Health, Xi'an Medical University, Xi'an, China
| | - Hang Chen
- School of Public Health, Xi'an Medical University, Xi'an, China
| | - Ling-Wang Kong
- School of Public Health, Xi'an Medical University, Xi'an, China
| | - Yue Zou
- Department of Cancer Biology and Life Sciences, College of Medicine, University of Toledo, Toledo, OH, USA
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Fu Y, Pang L, Dai W, Wu S, Kong J. Advances in the Study of Acute Acalculous Cholecystitis: A Comprehensive Review. Dig Dis 2021; 40:468-478. [PMID: 34657038 DOI: 10.1159/000520025] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 10/01/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Acute acalculous cholecystitis (AAC) is characterized by acute necrotizing inflammation with no calculi and is diagnosed based on imaging, intraoperative, and pathological examinations. KEY MESSAGE Although AAC has been studied clinically for a long time, it remains difficult to diagnose and treat. The pathogenesis of AAC is still not fully understood, and it is often regarded as a relatively independent clinical disease that is different from acute calculous cholecystitis (ACC). Pathological studies suggest that AAC is the manifestation of a critical systemic disease, while ACC is a local disease of the gallbladder. SUMMARY Concerning the pathogenesis, diagnosis, and treatment of AAC, we reviewed the research progress of AAC, which will enhance the understanding of the early diagnosis and treatment of AAC.
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Affiliation(s)
- Yantao Fu
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liwei Pang
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wanlin Dai
- Innovation Institute of China Medical University, Shenyang, China
| | - Shuodong Wu
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jing Kong
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
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Zhu GY, Jia DD, Yang Y, Miao Y, Wang C, Wang CM. The Effect of Shaoyao Gancao Decoction on Sphincter of Oddi Dysfunction in Hypercholesterolemic Rabbits via Protecting the Enteric Nervous System-Interstitial Cells of Cajal-Smooth Muscle Cells Network. J Inflamm Res 2021; 14:4615-4628. [PMID: 34552344 PMCID: PMC8450191 DOI: 10.2147/jir.s326416] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/17/2021] [Indexed: 11/25/2022] Open
Abstract
Objective This study observes the morphological changes in the enteric nervous system (ENS) – interstitial cells of Cajal (ICC) – smooth muscle cells (SMC) network in sphincter of Oddi dysfunction (SOD) in hypercholesterolemic rabbits following treatment with Shaoyao Gancao decoction (SGD), as well as the apoptosis of the ICC. Methods In this study, 48 healthy adult New Zealand rabbits are randomly divided into three groups (n = 16 in each group): the control, the model, and the SGD treatment groups. The hypercholesterolemic rabbit model is established. Hematoxylin and eosin staining, transmission electron microscopy, immunofluorescence, terminal deoxynucleotidyl transferase dUTP nick end labeling staining, immunohistochemistry, Western blot analysis, and reverse transcription-polymerase chain reaction are used to detect the morphological changes in the ENS–ICC–SMC network, the expression of apoptosis-related proteins in the ICC, and to observe the curative effect of SGD after treatment. Results Compared with the control group, the morphology and the ultrastructure of the SO are destroyed in the model group. In addition, the protein gene product 9.5 (PGP9.5), nitric oxide (NO), the SMCs, and the ICC all significantly decreased while substance P (SP) significantly increased. Compared with the model group, the SO morphology and ultrastructure are repaired in the SGD group. In addition, the PGP9.5, NO, the SMCs, and the ICC significantly increased while SP decreased. In addition, SGD may activate the stem cell factor (SCF)/c-Kit signaling pathway to treat SO dysfunction by up-regulating the expression of c-Kit and SCF. Similarly, this pathway restores SO by up-regulating the expression of Bcl2 and inhibiting cleaved caspase-3, Bax, and the tumor necrosis factor. Conclusion Shaoyao Gancao decoction can promote the recovery of sphincter of Oddi dysfunction in hypercholesterolemic rabbits by protecting the ENS–ICC–SMC network.
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Affiliation(s)
- Gui-Ying Zhu
- Department of General Surgery of Integrated Traditional Chinese and Western Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, People's Republic of China
| | - Dan-Dan Jia
- Department of General Surgery of Integrated Traditional Chinese and Western Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, People's Republic of China
| | - Ying Yang
- Department of General Surgery of Integrated Traditional Chinese and Western Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, People's Republic of China
| | - Ye Miao
- Department of General Surgery of Integrated Traditional Chinese and Western Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, People's Republic of China
| | - Chao Wang
- Department of General Surgery of Integrated Traditional Chinese and Western Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, People's Republic of China
| | - Chang-Miao Wang
- Department of General Surgery of Integrated Traditional Chinese and Western Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, People's Republic of China
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Liu Y, Fan Y, Wu S. Developments in research on interstitial Cajal-like cells in the biliary tract. Expert Rev Gastroenterol Hepatol 2021; 15:159-164. [PMID: 32933347 DOI: 10.1080/17474124.2021.1823214] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Interstitial cells of Cajal (ICCs) are a special type of interstitial cells located in the gastrointestinal tract muscles. They are closely related to smooth muscle cells and neurons, participate in gastrointestinal motility and nerve signal transmission, and are pacemaker cells for gastrointestinal electrical activity. Research interest in ICCs has continuously grown since they were first discovered in 1893. Later, researchers discovered that they are also present in other organs, including the biliary tract, urethra, bladder, etc.; these cells were named interstitial Cajal-like cells (ICLCs), and attempts have been made to explain their relationships with certain diseases. AREAS COVERED This review paper summarizes the morphology, identification, classification, function, and distribution of ICLCs in the biliary tract and their relationship to biliary tract diseases. EXPERT OPINION Based on the function and distribution of ICLCs in the biliary tract system, ICLCs will provide a more reliable theoretical basis for the mechanisms of pathogenesis of and treatments for biliary tract diseases.
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Affiliation(s)
- Yingyu Liu
- Department of General Surgery, Shengjing Hospital of China Medical University , Shenyang, China
| | - Ying Fan
- Department of General Surgery, Shengjing Hospital of China Medical University , Shenyang, China
| | - Shuodong Wu
- Department of General Surgery, Shengjing Hospital of China Medical University , Shenyang, China
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10
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Huang ZP, Qiu H, Wang K, Chao WB, Zhu HB, Chen H, Liu Y, Yu BP. The impact of acute stress disorder on gallbladder interstitial cells of Cajal. J Cell Physiol 2020; 235:8424-8431. [PMID: 32329051 DOI: 10.1002/jcp.29686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 12/24/2022]
Abstract
Physical and psychological stress exerts a substantial effect on gastrointestinal motility disorders, where trauma enhances symptoms of digestive dysfunction. Interstitial cells of Cajal (ICCs) act as pacemakers for gastrointestinal motility regulation and are likely important in stress-associated gastrointestinal motility disorders. This study explored the mechanisms underlying gallbladder ICCs function under acute stress conditions using a rabbit chest puncture and cholecystectomy model. The stem cell factor (SCF)/c-kit pathway is essential for the development of ICCs, and gene expression was investigated to identify stress-induced transcriptional alterations. Immunohistochemistry, terminal deoxynucleotidyl transferase dUTP nick end labeling assays were used to determine ICCs apoptosis, whereas western blot analysis and reverse-transcription polymerase chain reaction were used to detect changes in the SCF/c-kit signaling pathway. These methods revealed a reduction in ICCs via apoptosis following stress, and ICCs increased over time after stressor removal. Therefore, this study demonstrates the impact of stress on ICCs development and survival and further confirms the link between stress and gastrointestinal motility.
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Affiliation(s)
- Zhen-Peng Huang
- Guangzhou Institute of Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Hu Qiu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Ke Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shannxi Province, China
| | - Wei-Bo Chao
- College of Clinical Medicine, Xi'an Medical University, Xi'an, Shannxi Province, China
| | - Hao-Bin Zhu
- College of Clinical Medicine, Xi'an Medical University, Xi'an, Shannxi Province, China
| | - Hang Chen
- College of Clinical Medicine, Xi'an Medical University, Xi'an, Shannxi Province, China
| | - Yue Liu
- School of Aeronautics, Northwestern Polytechnical University, Xi'an, Shannxi Province, China
| | - Bao-Ping Yu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
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11
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Wan JF, Chu SF, Zhou X, Li YT, He WB, Tan F, Luo P, Ai QD, Wang Q, Chen NH. Ursodeoxycholic acid protects interstitial Cajal-like cells in the gallbladder from undergoing apoptosis by inhibiting TNF-α expression. Acta Pharmacol Sin 2018; 39:1493-1500. [PMID: 29770794 DOI: 10.1038/aps.2017.206] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 10/31/2017] [Indexed: 02/06/2023] Open
Abstract
Hypomotility is a common symptom of gallstone disease, which is accompanied by a loss of interstitial Cajal-like cells (ICLCs) in the gallbladder. Ursodeoxycholic acid (UDCA) is widely used in treating gallstone disease, and has shown anti-apoptotic and anti-inflammatory effects apart from its ability to dissolve gallstones. In this study, we investigated the anti-apoptotic and anti-inflammatory effects of UDCA on ICLCs in guinea pigs with gallstones. Guinea pigs were fed a high-cholesterol diet for 8 weeks to induce the formation of gallstones. A group of animals was administered UDCA (50 mg·kg-1·d-1, ig) simultaneously. At the end of 8 weeks, the animals were euthanized with anesthesia, cholecystectomy was performed immediately and gallbladder was collected for further analysis. We showed that in the model group the contractility of gallbladder muscle strips in response to both acetylcholine (ACh) and CCK-8 was severely impaired, which was significantly improved by UDCA administration. Furthermore, UDCA administration significantly reduced the apoptotic ratio of ICLCs, based on the observation of co-localization imaging of apoptotic cells and c-kit-positive cells. Western blotting analysis and real-time PCR results revealed that the TNF-α/Caspase8/Caspase3 pathway was suppressed in the UDCA-treated animals, confirming the anti-apoptotic effect of UDCA in the gallbladder. The H&E staining showed that UDCA administration significantly attenuated inflammatory cell infiltration in the gallbladder wall. In conclusion, UDCA can protect ICLCs in the gallbladder from undergoing apoptosis by inhibiting the TNF-α/Caspase8/caspase3 pathway.
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12
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Chen L, Yu B. Telocytes and interstitial cells of Cajal in the biliary system. J Cell Mol Med 2018; 22:3323-3329. [PMID: 29700981 PMCID: PMC6010895 DOI: 10.1111/jcmm.13643] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 03/08/2018] [Indexed: 12/17/2022] Open
Abstract
A novel type of interstitial tissue cells in the biliary tree termed telocytes (TCs), formerly known as interstitial Cajal‐like cells (ICLCs), exhibits very particular features which unequivocally distinguish these cells from interstitial cells of Cajal (ICCs) and other interstitial cell types. Current research substantiates the existence of TCs and ICCs in the biliary system (gallbladder, extrahepatic bile duct, cystic duct, common bile duct and sphincter of Oddi). Here, we review the distribution, morphology and ultrastructure of TCs and ICCs in the biliary tree, with emphasis on their presumptive roles in physiological and pathophysiological processes.
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Affiliation(s)
- Lei Chen
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Digestive System Disease, Wuhan, China
| | - Baoping Yu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Digestive System Disease, Wuhan, China
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Primary Extragastrointestinal Stromal Tumours in the Hepatobiliary Tree and Telocytes. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 913:207-228. [PMID: 27796890 DOI: 10.1007/978-981-10-1061-3_14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The first decade of the twenty-first century witnessed the presence and light microscopic, immunophenotypic, and ultrastructural characterization of interstitial Cajal-like cells (coined as 'telocytes') in virtually every extragastrointestinal site of the human body by Laurentiu M. Popescu and his co-workers. Not surprisingly, stromal tumours, immunophenotypically similar to that of telocytes [CD117 (c-KIT) +/CD34 +], have also been sporadically reported outside the tubular gut (so-called extragastrointestinal stromal tumours, EGISTs), including the gall bladder, liver, and pancreas. A meticulous literature search from January 2000 to November 2015 have found 9 such case reports of EGISTs in the gall bladder, 16 in the liver, and 31 occurring in the pancreas. The site wise mean age at presentation for these tumours were reported to be 62.2 ± 16.6, 50.9 ± 20.1, and 55.3 ± 14.3 years, respectively. Six of nine EGISTs in the gall bladder were associated with gallstones. On pathological evaluation, these tumours exhibited prominent spindled cell morphology and consistent expression of CD117/c-KIT and CD34 on immunohistochemistry and variable expression of vimentin and α-smooth muscle actin. The biological behaviour of hepatic and pancreatic lesions was favourable compared to that in the gall bladder, following definitive surgery with or without imatinib therapy. While the exact pathophysiologic role played by telocytes in various organs is yet to be fully elucidated, there seems to be a direct link between these enigmatic stromal cells and pathogenesis of gallstones and origin of EGISTs, and a hope for targeted therapies. Furthermore, the possible role of telocytes in hepatic regeneration and liver fibrosis opens a new dimension for futuristic research.
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Karakuş OZ, Ulusoy O, Aktürk G, Ateş O, Olgun EG, Dalgıç M, Hakgüder G, Özer E, Olguner M, Akgür FM. The Density of Interstitial Cells of Cajal Is Diminished in Choledochal Cysts. Dig Dis Sci 2016; 61:900-4. [PMID: 26547756 DOI: 10.1007/s10620-015-3936-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 10/22/2015] [Indexed: 12/09/2022]
Abstract
BACKGROUND AND AIMS Interstitial cells of Cajal (ICC) have been shown to be present in the extrahepatic biliary tract of animals and humans. However, ICC distribution in choledochal cysts (CC) has not been investigated. A study was conducted to investigate the distribution of ICC in the extrahepatic biliary tract, including CC, in pediatric human specimens. METHOD The specimens were divided into two main groups as gallbladders and common bile ducts. Gallbladders were obtained from the cholelithiasis, CC operations and autopsies. Common bile ducts were obtained from autopsies. Tissues were stained using c-kit immunohistochemical staining. ICC were assessed semi-quantitatively by applying morphological criteria and were counted as the number of cells/0.24 mm(2) in each area under light microscopy. RESULTS A total of 35 gallbladders and 14 CC were obtained from operations. Ten gallbladders plus common bile ducts were obtained from autopsies. The mean numbers of ICC in the gallbladders of cholelithiasis and the gallbladders of CC were 12.2 ± 4.9 and 5.3 ± 1.2, respectively (p = 0.003). The mean numbers of ICC in the common bile ducts and CC were 9.8 ± 2.9 and 3.4 ± 1.4, respectively (p = 0.001). CONCLUSION The scarcity of ICC in the extrahepatic biliary tract may be responsible for the etiopathogenesis of the CC.
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Affiliation(s)
- Osman Z Karakuş
- Department of Pediatric Surgery, Dokuz Eylül University, Medical School, Izmir, Turkey. .,Çocuk Cerrahisi Anabilim Dalı, Tıp Fakültesi, Dokuz Eylül Üniversitesi, 35340, Balçova, Izmir, Turkey.
| | - Oktay Ulusoy
- Department of Pediatric Surgery, Dokuz Eylül University, Medical School, Izmir, Turkey
| | - Güray Aktürk
- Department of Pathology, Dokuz Eylül University, Medical School, Izmir, Turkey
| | - Oğuz Ateş
- Department of Pediatric Surgery, Dokuz Eylül University, Medical School, Izmir, Turkey
| | - Esra G Olgun
- Department of Morgue, Regional Center, Forensic Medicine Institutions, Izmir, Turkey
| | - Mustafa Dalgıç
- Department of Morgue, Regional Center, Forensic Medicine Institutions, Izmir, Turkey
| | - Gülce Hakgüder
- Department of Pediatric Surgery, Dokuz Eylül University, Medical School, Izmir, Turkey
| | - Erdener Özer
- Department of Pathology, Dokuz Eylül University, Medical School, Izmir, Turkey
| | - Mustafa Olguner
- Department of Pediatric Surgery, Dokuz Eylül University, Medical School, Izmir, Turkey
| | - Feza M Akgür
- Department of Pediatric Surgery, Dokuz Eylül University, Medical School, Izmir, Turkey
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Chen Y, Kong J, Wu S. Cholesterol gallstone disease: focusing on the role of gallbladder. J Transl Med 2015; 95:124-31. [PMID: 25502177 DOI: 10.1038/labinvest.2014.140] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 10/11/2014] [Accepted: 10/15/2014] [Indexed: 02/06/2023] Open
Abstract
Gallstone disease (GSD) is one of the most common biliary tract diseases worldwide in which both genetic and environmental factors have roles in its pathogenesis. Biliary cholesterol supersaturation from metabolic defects in the liver is traditionally seen as the main pathogenic factor. Recently, there have been renewed investigative interests in the downstream events that occur in gallbladder lithogenesis. This article focuses on the role of the gallbladder in the pathogenesis of cholesterol GSD (CGD). Various conditions affecting the crystallization process are discussed, such as gallbladder motility, concentrating function, lipid transport, and an imbalance between pro-nucleating and nucleation inhibiting proteins.
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Affiliation(s)
- Yongsheng Chen
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jing Kong
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shuodong Wu
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
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Huang ZP, Yang Y, Yang B, Yu BP. Interstitial cells of Cajal and biliary system diseases. Shijie Huaren Xiaohua Zazhi 2015; 23:404-408. [DOI: 10.11569/wcjd.v23.i3.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Interstitial cells of Cajal (ICCs) were first identified using histological staining techniques and best described in the gastrointestinal tract by Santiago Rarnon Cajal, who was a Spanish neuroanatomist, in 1893. Over the past about 100 years, studies have demonstrated that ICCs mainly exist in the esophagus, stomach, proximal duodenum wall, small and large bowel, ileum, appendix, colon and so on. They generate electrical pacemaker activity in gastrointestinal smooth muscles, propagating digestive tract slow wave, mediating and regulating gastrointestinal tract neurotransmitters. In recent years, ICCs have also been found and confirmed to be present in the biliary system, including the gallbladder and extrahepatic biliary duct, the cystic duct and the common bile duct, both in the guinea pigs and humans. Recent studies have confirmed that ICCs in the biliary system are closely related with producing and spreading the gallbladder spontaneous rhythm, adjusting the gallbladder contraction and gallbladder movement. Besides, ICCs play an important role in a variety of diseases of the biliary system, such as cholelithiasis and biliary system malignant tumors. This paper reviews ICCs in the biliary system in terms of their distribution, morphology, ultrastructure, and role in pathophysiology of biliary system diseases.
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Lazebnik LB, Lychkova AE, Shcherbakov PL. Pacemakers in extrahepatic biliary ducts. Bull Exp Biol Med 2014; 156:374-6. [PMID: 24771379 DOI: 10.1007/s10517-014-2352-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Indexed: 11/25/2022]
Abstract
Pacemaker cells in the biliary system were studied by using electromyographic and histological methods. The pacemaker cells of the duodenal-biliary complex are located in the bile duct (predominantly, in its proximal part). They are characterized with enhanced spontaneous spike and slow-wave electrical activity. The pacemaker cells organize the sequential motor activity of the proximal and distal portions of ductus choledochus, with subsequent involvement of the duodenum into this activity.
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Affiliation(s)
- L B Lazebnik
- Central Research Institute of Gastroenterology, Moscow Department of Health Care, Moscow, Russia
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Rusu MC, Poalelungi CV, Vrapciu AD, Păduraru L, Didilescu AC, Stan CI. Anoctamin 1 Positive Esophageal Interstitial Cajal Cells in Late Stage Human Embryos. Anat Rec (Hoboken) 2013; 297:301-7. [DOI: 10.1002/ar.22837] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 09/21/2013] [Accepted: 10/18/2013] [Indexed: 12/14/2022]
Affiliation(s)
- Mugurel Constantin Rusu
- Division of Anatomy; Faculty of Dental Medicine; “Carol Davila” University of Medicine and Pharmacy; Bucharest Romania
- MEDCENTER - Center of Excellence in Laboratory Medicine and Pathology
| | - Cristian Viorel Poalelungi
- Department of Obstetrics and Gynaecology; "Dr.I.Cantacuzino" Hospital, "Carol Davila" University of Medicine and Pharmacy; Bucharest Romania
| | - Alexandra Diana Vrapciu
- Division of Anatomy; Faculty of Dental Medicine; “Carol Davila” University of Medicine and Pharmacy; Bucharest Romania
| | - Luminiţa Păduraru
- Division of Neonatology; “Mother and Child” Department; “Gr.T.Popa” University of Medicine and Pharmacy; Iasi Romania
| | - Andreea Cristiana Didilescu
- Division of Embryology; Faculty of Dental Medicine; “Carol Davila” University of Medicine and Pharmacy; Bucharest Romania
| | - Cristinel Ionel Stan
- Division of Anatomy; Faculty of Medicine; Gr.T.Popa” University of Medicine and Pharmacy; Iasi Romania
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Matyja A, Gil K, Pasternak A, Sztefko K, Gajda M, Tomaszewski KA, Matyja M, Walocha JA, Kulig J, Thor P. Telocytes: new insight into the pathogenesis of gallstone disease. J Cell Mol Med 2013; 17:734-42. [PMID: 23551596 PMCID: PMC3823177 DOI: 10.1111/jcmm.12057] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 03/01/2013] [Indexed: 12/11/2022] Open
Abstract
The major mechanisms of gallstone formation include biliary cholesterol hypersecretion, supersaturation and crystallization, mucus hypersecretion, gel formation and bile stasis. Gallbladder hypomotility seems to be a key event that triggers the precipitation of cholesterol microcrystals from supersaturated lithogenic bile. Telocytes, a new type of interstitial cells, have been recently identified in many organs, including gallbladder. Considering telocyte functions, it is presumed that these cells might be involved in the signalling processes. The purpose of this study was to correlate the quantity of telocytes in the gallbladder with the lithogenicity of bile. Gallbladder specimens were collected from 24 patients who underwent elective laparoscopic cholecystectomy for symptomatic gallstone disease. The control group consisted of 25 consecutive patients who received elective treatment for pancreatic head tumours. Telocytes were visualized in paraffin sections of gallbladders with double immunofluorescence using primary antibodies against c-Kit (anti-CD117) and anti-mast cell tryptase. Cholesterol, phospholipid and bile acid levels were measured in gallbladder bile. The number of telocytes in the gallbladder wall was significantly lower in the study group than that in the control group (3.03 ± 1.43 versus 6.34 ± 1.66 cell/field of view in the muscularis propria, P < 0.001) and correlated with a significant increase in the cholesterol saturation index. The glycocholic and taurocholic acid levels were significantly elevated in the control subjects compared with the study group. The results suggest that bile composition may play an important role in the reduction in telocytes density in the gallbladder.
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Affiliation(s)
- Andrzej Matyja
- First Department of General, Oncological and Gastrointestinal Surgery, Jagiellonian University Medical College, Krakow, Poland
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Pasternak A, Gil K, Matyja A, Gajda M, Sztefko K, Walocha JA, Kulig J, Thor P. Loss of gallbladder interstitial Cajal-like cells in patients with cholelithiasis. Neurogastroenterol Motil 2013; 25:e17-24. [PMID: 23121223 DOI: 10.1111/nmo.12037] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Interstitial cells of Cajal (ICCs) play an important role in the regulation of gut motility. There is growing evidence that interstitial Cajal-like cells (ICLCs) are present in the gallbladder wall. We hypothesize that changes in the density of ICLCs in the gallbladder wall may lead to the development of cholelithiasis due to the impairment of the gallbladder motility. The purpose of this study was to identify ICLCs in the gallbladders of patients with gallstones and to assess their densities. METHODS Data from 30 patients with gallstones and 25 individuals without gallstones were compared. Tissue samples were obtained during surgery, embedded in paraffin, and cut into sections. Following staining for CD117 and mast cell tryptase, the number of ICLCs and mast cells was determined using image analysis. KEY RESULTS Cells positive for the c-Kit receptor (CD117) were detected in the gallbladder wall in all cases examined. Interstitial Cajal-like cells were most frequently observed in the muscularis propria. The density of ICLCs in the muscularis propria was significantly lower in the patients with gallstones than the density observed in the controls (26.24 ± 10.89 vs 56.29 ± 13.35 cells/mm(2)). In contrast, the number of mast cells in the gallbladder was increased in the patients with gallstones when compared with the controls (143 ± 24 vs 112 ± 19 cells/mm(2)). CONCLUSIONS & INFERENCES The histopathological differences observed in this study may help elucidate the pathophysiology of gallstones. Gallbladder motility may be affected by the decreased number of ICLCs in patients with cholelithiasis.
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Affiliation(s)
- Artur Pasternak
- First Department of General, Oncological and Gastrointestinal Surgery, Jagiellonian University Medical College, Krakow, Poland
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Abstract
Interstitial cells of Cajal (ICCs) are a kind of cells mainly found in the gastrointestinal tract as pacemaker and signal transduction cells. They have a close connection with muscular cells and terminal neurons and can stimulate and promote gastrointestinal motility. With the help of electron microscopes, we can clearly recognize their distribution and inner structure. C-kit protein is expressed by ICCs. Besides, many disorders of gastrointestinal motility are related to ICCs. In recent years, many scholars have found the trace of ICCs in different organs such as the gastrointestinal tract, biliary tract, bladder, and uterus, and they have tried to state the relationship between abnormal ICCs and some diseases. This article will review the progress in research of ICCs in terms of their origin, morphology, receptors, function, and related diseases.
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A series of six cases of sphincter of Oddi pathology in the cat (2008–2009). J Feline Med Surg 2010; 12:794-801. [DOI: 10.1016/j.jfms.2010.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2010] [Indexed: 12/14/2022]
Abstract
The sphincter of Oddi (SO) is located within the wall of the duodenum as the terminal part of the common bile duct. Six cats are reported with obstructive processes within their SO. Three of them may have had some form of sphincter dysfunction associated with the pre-existing complex known as ‘inflammatory bowel disease’ (IBD), two may have had the equivalent of the infant human condition known as ‘bile plug syndrome’ and the sixth had sphincter dysfunction associated with a tumour at the confluence of the common and right hepatic duct. In all six cases, the sphincter obstructions were surgically managed. The outcomes for 4/6 were favourable but 1/6 was euthanased intraoperatively, and 1/6 had a metastatic neoplasia and was euthanased 2 months postoperatively.
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Ahmadi O, Nicholson MDL, Gould ML, Mitchell A, Stringer MD. Interstitial cells of Cajal are present in human extrahepatic bile ducts. J Gastroenterol Hepatol 2010; 25:277-85. [PMID: 19793166 DOI: 10.1111/j.1440-1746.2009.05980.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Interstitial cells of Cajal (ICC) are distributed with smooth muscle throughout the gastrointestinal tract and are involved in regulating motility. ICC were recently discovered in the wall of the human gallbladder. This study sought to determine whether ICC are present in human bile ducts. METHODS Biliary tract samples were obtained from several sources: surgical specimens (n = 16, 11 women, mean age 61 years); archival post-mortem specimen (n = 1, 86 years, man); and cadavers (n = 2, 68 and 80 years, men). Paraffin-embedded sections (3 microm) from the gallbladder (fundus, body and neck) and both extrahepatic and intrahepatic bile ducts were investigated. A double immunofluorescence protocol using polyclonal and monoclonal c-kit antibodies and mast cell tryptase was used to distinguish c-kit-positive cells with typical ICC morphology from c-kit-positive mast cells. Small bowel samples were used as positive controls. ICC in the gallbladder were confirmed by ultrastructural study. RESULTS c-kit-positive cells with characteristic ICC morphology were identified in the subepithelial and muscular layers of the gallbladder and extrahepatic bile ducts. They were most prominent within the muscle layer of the extrahepatic bile ducts where they were organized into loosely arranged laminae running parallel to circular smooth muscle fibers. ICC were not found in intrahepatic bile ducts. CONCLUSION This study demonstrates for the first time that ICC are present in human extrahepatic bile ducts where they are more densely aggregated than in the gallbladder. This cellular network is likely to be involved in biliary tract motility and its related disorders.
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Affiliation(s)
- Omid Ahmadi
- Department of Anatomy and Structural Biology, Otago School of Medical Sciences, University of Otago, New Zealand
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