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Meng X, Xiao J, Wang J, Sun M, Chen X, Wu L, Chen K, Li Z, Feng C, Zhuansun D, Yang J, Wu X, Yu D, Li W, Niu Y, He Y, Wei M, Chen F, Xiong B, Feng J, Zhu T. Mesenchymal Stem Cells Attenuates Hirschsprung diseases - Associated Enterocolitis by Reducing M1 Macrophages Infiltration via COX-2 Dependent Mechanism. J Pediatr Surg 2024; 59:1498-1514. [PMID: 38508971 DOI: 10.1016/j.jpedsurg.2024.02.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/21/2024] [Accepted: 02/16/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVE AND DESIGN Hirschsprung disease-associated enterocolitis (HAEC) is a common life-threatening complication of Hirschsprung disease (HSCR). We aimed to investigate the effectiveness, long-term safety and the underlying mechanisms of Mesenchymal stem cells (MSCs) based therapy for HAEC. MATERIAL OR SUBJECTS Specimens from HSCR and HAEC patients were used to assess the inflammatory condition. Ednrb knock-out mice was used as HAEC model. MSCs was intraperitoneally transplanted into HAEC mice. The therapy effects, long-term outcome, safety and toxicity and the mechanism of MSCs on the treatment of HAEC were explored in vivo and in vitro. RESULTS Intestinal M1 macrophages infiltration and severe inflammation condition were observed in HAEC. After the injection of MSCs, HAEC mice showed significant amelioration of the inflammatory injury and inhibition of M1 macrophages infiltration. The expression levels of pro-inflammatory cytokines (TNF-α and IFN-γ) were decreased and anti-inflammatory cytokines (IL-10 and TGF-β) were increased. In addition, we found that effective MSCs homing to the inflamed colon tissue occurred without long-term toxicity response. However, COX-2 inhibitor could diminish the therapeutic effects of MSCs. Using MSCs and macrophages co-culture system, we identified that MSCs could alleviate HAEC by inhibiting M1 macrophages activation through COX-2-dependent MAPK/ERK signaling pathway. CONCLUSIONS MSCs ameliorate HAEC by reducing M1 macrophages polarization via COX-2 mediated MAPK/ERK signaling pathway, thus providing novel insights and potentially promising strategy for the treatment or prevention of HAEC.
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Affiliation(s)
- Xinyao Meng
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, China
| | - Jun Xiao
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, China
| | - Jing Wang
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, China
| | - Minxian Sun
- Department of Endocrinology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Xuyong Chen
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, China
| | - Luyao Wu
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, China
| | - Ke Chen
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, China
| | - Zejian Li
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, China
| | - ChenZhao Feng
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Didi Zhuansun
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, China
| | - Jixin Yang
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, China
| | - Xiaojuan Wu
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, China
| | - Donghai Yu
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, China
| | - Wei Li
- Department of Pediatric Surgery, The First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Yonghua Niu
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, China
| | - Ying He
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, China
| | - Mingfa Wei
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, China
| | - Feng Chen
- Department of Pediatric Surgery, Union Hospital, Fujian Medical University, Fuzhou, China.
| | - Bo Xiong
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Jiexiong Feng
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, China.
| | - Tianqi Zhu
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, China.
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Duci M, Santoro L, Dei Tos AP, Loss G, Mescoli C, Gamba P, Fascetti Leon F. Postoperative Hirschsprung's associated enterocolitis (HAEC): transition zone as putative histopathological predictive factor. J Clin Pathol 2023:jcp-2023-209129. [PMID: 38053256 DOI: 10.1136/jcp-2023-209129] [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: 08/10/2023] [Accepted: 11/09/2023] [Indexed: 12/07/2023]
Abstract
AIMS Hirschsprung's-associated enterocolitis (HAEC) is the most severe complication of Hirschsprung disease (HD), and its pathogenesis is still unknown. Length of transition zone (TZ) interposed between aganglionic and normal bowel has been poorly explored as predictor for postoperative HAEC (post-HAEC). This study aimed to identify potential predictive factors for post-HAEC, with a particular focus on histopathological findings. METHODS Data from Hirschsprung patients treated in a single Italian centre between 2010 and 2022 with a follow-up >6 months were collected. Thorough histopathological examination of the resected bowel was conducted, focusing on length of TZ and aganglionic bowel.The degree of inflammatory changes in ganglionic resected bowel was further obtained. Ultra-long HD, total colonic aganglionosis and ultra-short HD were excluded. Bivariate and multivariate regression analysis were performed. RESULTS Thirty-one patients were included; 5 experienced preoperative HAEC (pre-HAEC) and later post-HAEC (16.1%), further 10 patients developed post-HAEC (total post-HAEC 48.38%). Pre-HAEC-history and a TZ<2.25 cm correlated with an early development of post-HAEC. Multivariate analysis identified a TZ<2.25 cm as an independent post-HAEC predictive factor (p=0.0096). Inflammation within the ganglionic zone and a TZ<2.25 cm correlated with higher risk of post-HAEC (p=0.0074, 0.001, respectively). Severe post-HAEC more frequently occurred in patients with pre-HAEC (p=0.011), histological inflammation (p=0.0009) and short TZ (p=0.0015). CONCLUSIONS This study suggests that TZ<2.25 cm predicts the risk of post-HAEC. Preoperative clinical and histopathology inflammation may predispose to worst post-HAEC. Readily available histopathological findings might help identifying patients at higher risk for HAEC and implementing prevention strategies.
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Affiliation(s)
- Miriam Duci
- Pediatric Surgery Unit, Department of Women's and Children's Health, Università degli Studi di Padova, Padova, Italy
| | - Luisa Santoro
- Surgical Pathology and Cytopathology Unit, Department of Medicine - DIMED, University of Padova School of Medicine, Padova, Italy
| | - Angelo Paolo Dei Tos
- Surgical Pathology and Cytopathology Unit, Department of Medicine - DIMED, University of Padova School of Medicine, Padova, Italy
| | - Greta Loss
- Pediatric Surgery Unit, Department of Women's and Children's Health, Università degli Studi di Padova, Padova, Italy
| | - Claudia Mescoli
- Surgical Pathology and Cytopathology Unit, Department of Medicine - DIMED, University of Padova School of Medicine, Padova, Italy
| | - Piergiorgio Gamba
- Pediatric Surgery Unit, Department of Women's and Children's Health, Università degli Studi di Padova, Padova, Italy
| | - Francesco Fascetti Leon
- Pediatric Surgery Unit, Department of Women's and Children's Health, Università degli Studi di Padova, Padova, Italy
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Matsukuma K, Gui D, Saadai P. Hirschsprung Disease for the Practicing Surgical Pathologist. Am J Clin Pathol 2023; 159:228-241. [PMID: 36565211 DOI: 10.1093/ajcp/aqac141] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/16/2022] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Hirschsprung disease (HD) is a congenital condition defined by the absence of ganglion cells in the distal-most portion of the gastrointestinal tract. Biopsies and resections for HD can be adrenaline inducing for the general surgical pathologist because specimens are infrequent; HD is 1 of only a few neuroanatomic diseases that general surgical pathologists diagnose; numerous preanalytic factors (eg, biopsy adequacy, surgeon sampling protocol, processing artifacts) can affect histologic interpretation; and most importantly, the diagnosis has high stakes. METHODS We provide a comprehensive overview of the background, relevant clinical procedures, and pathologic assessment of HD. Grossing and frozen section protocols, an algorithmic approach to diagnosis, and histologic pearls and pitfalls are also discussed. RESULTS Evaluation and recognition of the features of HD have evolved significantly in the past 2 decades with the discovery of the value of calretinin immunohistochemistry in the late 2000s and the recent development of straightforward and reproducible histologic criteria for identification of the HD transition zone. CONCLUSIONS These advancements have substantially improved the pathologist's ability to reliably evaluate for HD. Nonetheless, as with any high-stakes surgical pathology specimen, clear communication with the clinical team is essential.
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Affiliation(s)
- Karen Matsukuma
- Department of Pathology and Laboratory Medicine, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Dorina Gui
- Department of Pathology and Laboratory Medicine, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Payam Saadai
- Department of Surgery, Division of Pediatric Surgery, University of California Davis School of Medicine, Sacramento, CA, USA.,Pediatric Colorectal Center, Shriners Hospitals for Children, Sacramento, CA, USA
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Xie C, Yan J, Zhang Z, Kai W, Wang Z, Chen Y. Risk factors for Hirschsprung-associated enterocolitis following Soave: a retrospective study over a decade. BMC Pediatr 2022; 22:654. [PMID: 36357849 PMCID: PMC9647981 DOI: 10.1186/s12887-022-03692-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/20/2022] [Indexed: 11/11/2022] Open
Abstract
Background Hirschsprung-associated enterocolitis (HAEC), one of the most significant causes of morbidity and mortality for patients with Hirschsprung disease (HSCR), can occur before and after radical surgery. This study aims to identify the risk factors for HAEC before and after Soave. Methods A retrospective study of 145 patients with HSCR treated by transanal or combination with laparoscopic or laparotomy Soave procedure between January 2011 and June 2021 was performed. Data were retrieved from the medical records. HAEC was defined as the presence of clinical signs of bowel inflammation and requiring treatment with intravenous antibiotics and rectal irrigation for at least two days in the outpatient or inpatient department. Univariate analysis and multivariate regression models were used to identify risk factors for developing pre-and postoperative HAEC. Results The incidence of pre-and postoperative HAEC was 24.1% and 20.7%, respectively. More than 90% of the patients with the first episode of postoperative HAEC occurred within the first year after Soave. Long-segment aganglionosis was the independent risk factor for developing preoperative HAEC ([OR] 5.8, Cl 2.4–14.2, p < 0.001), while the history of preoperative HAEC was significantly associated with developing postoperative HAEC ([OR] 4.2, Cl 1.6–10.8, p = 0.003). Conclusions Long-segment aganglionosis was the independent risk factor for the development of preoperative HAEC, and the history of preoperative HAEC was strongly associated with developing HAEC after Soave. Level of Evidence Level III
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Zheng Z, Gao M, Tang C, Huang L, Gong Y, Liu Y, Wang J. E. coli JM83 damages the mucosal barrier in Ednrb knockout mice to promote the development of Hirschsprung‑associated enterocolitis via activation of TLR4/p‑p38/NF‑κB signaling. Mol Med Rep 2022; 25:168. [PMID: 35302172 PMCID: PMC8971921 DOI: 10.3892/mmr.2022.12684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/24/2022] [Indexed: 11/29/2022] Open
Abstract
Hirschsprung-associated enterocolitis (HAEC) is characterized by intestinal mucosal damage and an imbalance in the intestinal microbiota. Recent studies have indicated that the TLR4/p-p38/NF-κB signaling pathway in the intestine is of great importance to intestinal mucosal integrity. The present study aimed to investigate the role of TLR4/phosphorylated (p-)38/NF-κB signaling in the pathogenesis of HAEC in E. coli JM83-infected endothelin receptor B (Ednrb)−/− mice. Ednrb−/− mice were infected with E. coli JM83 by oral gavage to establish the HAEC model. Wild-type and Ednrb−/− mice were randomly divided into uninfected and E. coli groups. The role of TLR4/p-p38/NF-κB signaling was further evaluated by in vivo and in vitro analyses. The activation of the TLR4/p-p38/NF-κB signaling pathway induced by E. coli JM83 resulted in HAEC in Ednrb−/− mice, which was evidenced by a significant increase in the expression of TNF-α, TGF-β and IL-10, and a decreased density of F-actin protein expression. TLR4 knockdown reduced the severity of enterocolitis and attenuated the expression of IL-10, TNF-α and TGF-β, whilst increasing the density of F-actin protein in Ednrb−/− mice after E. coli infection. These results indicated that E. coli JM83 activates TLR4/p-p38/NF-κB signaling in Ednrb−/− to promote the development of HAEC. Thus, inhibition of this signaling pathway may benefit the treatment and prevention of HAEC.
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Affiliation(s)
- Zebing Zheng
- Department of Pediatric Surgery, Children's Hospital of Soochow University, Pediatric Research Institute of Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Mingjuan Gao
- Department of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Chengyan Tang
- Department of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Lu Huang
- Department of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Yuan Gong
- Department of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Yuanmei Liu
- Department of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Jian Wang
- Department of Pediatric Surgery, Children's Hospital of Soochow University, Pediatric Research Institute of Soochow University, Suzhou, Jiangsu 215123, P.R. China
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Namjoshi SS, Galloway D, Herdes RE, Talathi S, Ding VY, Mezoff EA. Bacterial overgrowth assessment and treatment among pediatric intestinal rehabilitation & nutrition support providers: an international survey of clinical practice patterns. JPEN J Parenter Enteral Nutr 2022; 46:1914-1922. [PMID: 35274342 DOI: 10.1002/jpen.2369] [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: 10/28/2021] [Revised: 02/15/2022] [Accepted: 03/06/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Small bowel bacterial overgrowth (SBBO) is a common, but difficult to diagnose and treat problem in pediatric short bowel syndrome (SBS). Lack of clinical consensus criteria and unknown sensitivity and specificity of bedside diagnosis makes research on this potential SBS disease modifier challenging. The objective of this research was to describe clinical care of SBBO among international intestinal rehabilitation and nutrition support (IR&NS) providers treating patients with SBS. METHODS & MATERIALS A secure, confidential, international, electronic survey of IR&NS practitioners was conducted between March 2021 and May 2021. All analyses were conducted in the R statistical computing framework ™, version 4.0 RESULTS: 60% of respondents agreed and 0% strongly disagreed that abdominal pain, distension, emesis, diarrhea, and malodorous stool, were attributable to SBBO. No more than 20% of respondents strongly agreed and no more than 40% agreed that any sign or symptom was specific for SBBO. For a first-time diagnosis, 31 practitioners agreed with use of a 7-day course of a single antibiotic, with a majority citing Grade 5 evidence to inform their decisions (case series, uncontrolled studies, or expert opinion). The most common first antibiotic used to treat a new onset SBBO was metronidazole, and rifaximin was the 2nd most commonly used. 100% of respondents reported they would consider a consensus algorithm for SBBO, even if the algorithm may be divergent from their current practice. CONCLUSION SBBO practice varies widely among experienced IR&NS providers. Development of a clinical consensus algorithm may help standardize care to improve research and care of this complex problem and to identify risks and benefits of chronic antibiotic use in SBS. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Shweta S Namjoshi
- Stanford University School of Medicine & the Lucile Packard Children's Hospital, Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition
| | - David Galloway
- University of Alabama at Birmingham, Center for Advanced Intestinal Rehabilitation, Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition
| | - Rachel E Herdes
- Stanford University School of Medicine & the Lucile Packard Children's Hospital, Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition
| | - Saurabh Talathi
- University of Oklahoma College of Medicine, Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition
| | - Victoria Y Ding
- Stanford University School of Medicine, Department of Medicine, Department of Biomedical Informatics Research
| | - Ethan A Mezoff
- The Ohio State University College of Medicine, Center for Intestinal Rehabilitation and Nutrition Support, Division of Gastroenterology, Hepatology & Nutrition at Nationwide Children's Hospital
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Taylor MA, Bucher BT, Reeder RW, Avansino JR, Durham M, Calkins CM, Wood RJ, Levitt MA, Drake K, Rollins MD. Comparison of Hirschsprung Disease Characteristics between Those with a History of Postoperative Enterocolitis and Those without: Results from the Pediatric Colorectal and Pelvic Learning Consortium. Eur J Pediatr Surg 2021; 31:207-213. [PMID: 32947626 DOI: 10.1055/s-0040-1716876] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The current understanding of Hirschsprung-associated enterocolitis (HAEC) is based mainly on single-center, retrospective studies. The aims of this study are to determine risk factors for postoperative HAEC using the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) database. MATERIALS AND METHODS We performed a multicenter, retrospective, case-control study of children with Hirschsprung disease (HD) who had undergone a pull-through procedure and were evaluated at a PCPLC member site between February 2017 and March 2020. The cohort with a history of postoperative HAEC was compared with that without postoperative episodes of HAEC to determine relevant associations with postoperative HAEC. RESULTS One-hundred forty of 299 (46.8%) patients enrolled had a history of postoperative HAEC. Patients with a rectosigmoid transition zone had a lower association with postoperative HAEC as compared with those with a more proximal transition zone (odds ratio [OR]: 0.46, 95% confidence interval [CI]: 0.26, 0.84, p < 0.01). Private insurance was protective against postoperative HAEC on univariate analysis (OR: 0.62, 95% CI: 0.38, 0.99, p = 0.047), but not on multivariate analysis (OR: 0.62, 95% CI: 0.37, 1.04, p = 0.07). Preoperative HAEC was not associated with the development of postoperative HAEC. CONCLUSION Patients with a rectosigmoid transition zone have less postoperative HAEC compared with patients with a more proximal transition zone. Multi-institutional collection of clinical information in patients with HD may allow for the identification of additional risk factors for HAEC and afford the opportunity to improve care.
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Affiliation(s)
- Mark A Taylor
- Department of Surgery, University of Utah School of Medicine and Primary Children's Hospital, Salt Lake City, Utah, United States
| | - Brian T Bucher
- Department of Surgery, University of Utah School of Medicine and Primary Children's Hospital, Salt Lake City, Utah, United States
| | - Ron W Reeder
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Jeffrey R Avansino
- Department of Pediatric Surgery, Seattle Children's, Seattle, Washington, United States
| | - Megan Durham
- Division of Pediatric Surgery, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia, United States
| | - Casey M Calkins
- Department of Pediatric Surgery, Children's Wisconsin, Milwaukee, Wisconsin, United States
| | - Richard J Wood
- Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, Columbus, Ohio, United States
| | - Marc A Levitt
- Department Colorectal and Pelvic Reconstructive Surgery, Children's National Hospital, District of Columbia, Washington, United States
| | - Kaylea Drake
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Michael D Rollins
- Department of Surgery, University of Utah School of Medicine and Primary Children's Hospital, Salt Lake City, Utah, United States
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Apfeld JC, Wood RJ, Halleran DR, Deans KJ, Minneci PC, Cooper JN. Relationships Between Hospital and Surgeon Operative Volumes and Surgical Outcomes in Hirschsprung's Disease. J Surg Res 2021; 257:379-388. [DOI: 10.1016/j.jss.2020.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/14/2020] [Accepted: 08/02/2020] [Indexed: 12/20/2022]
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Mariana N, Asadul Isl A, Hatta M, Fransiscus H. IL23 mRNA Expression in Hirschsprung-Associated Enterocolitis. JOURNAL OF MEDICAL SCIENCES 2020. [DOI: 10.3923/jms.2020.39.43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Li HB, Jin XQ, Jin X, Guo ZH, Ding XH, Wang Q, Liu RZ. BMP4 knockdown of NCSCs leads to aganglionosis in the middle embryonic stage. Mol Med Rep 2018; 17:5423-5427. [PMID: 29393463 DOI: 10.3892/mmr.2018.8519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 12/14/2017] [Indexed: 11/06/2022] Open
Abstract
Transplacental bone morphogenetic protein (BMP)4 RNA interference (RNAi) is a technique used to knockdown genes in embryos. BMP4 are essential for the development of nervous system in the differentiation of neural crest stem cells (NCSCs). The failure of differentiation and migration of NCSCs may lead to aganglionosis. In the present study, pregnant mice were divided into three groups: Ringer's group, pSES group and RNAi‑BMP4 group. In order to silence the BMP4 gene in the first generation (F1), 11.5 day pregnant mice were injected with the small interfering RNA BMP4 plasmid, pSES or Ringer's solution via the tail vein. Semi‑quantitative reverse transcriptase‑polymerase chain reaction (RT‑PCR)and western blotting were employed to ensure the downregulation of BMP4. Finally, X‑rays were performed following a barium enema. Aganglionosis was diagnosed by general anatomy and immunohistochemistry. Compared with the control group, transplacental RNAi was able to downregulate the BMP4‑Smad4 of 11.5 day embryos, as determined by semi‑quantitative RT‑PCR and western blotting. The megacolons of the mice were demonstrated by X‑ray and confirmed by general anatomy. Aganglionosis of colonic mucosa and submucosa were diagnosed by pathology, and immunohistochemistry. Knockdown of BMP4 in pregnant mice at the middle embryonic stage led to aganglionosis. It was therefore demonstrated that BMP‑Smad was essential to the NCSCs of middle stage embryos. BMP‑Smad served important roles in the generation of aganglionosis. This technique of knockdown BMP4 gene may be used to establish an aganglionosis mouse model.
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Affiliation(s)
- Hong-Bo Li
- Department of Pediatric Surgery, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, P.R. China
| | - Xian-Qing Jin
- Department of Pediatric Surgery, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, P.R. China
| | - Xin Jin
- Department of Pediatric Surgery, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, P.R. China
| | - Zheng-Hua Guo
- Department of Pediatric Surgery, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, P.R. China
| | - Xiong-Hui Ding
- Department of Pediatric Surgery, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, P.R. China
| | - Quan Wang
- Department of Pediatric Surgery, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, P.R. China
| | - Rui-Zhuo Liu
- Department of Pediatric Surgery, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, P.R. China
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