Clinical and Morphological Features Associated with Emboli during Carotid Angioplasty

Abstract

Backmound: Galanin is a neuropeptide distributed widely throughout the central and peripheral nervous system. In particular, its presence has been demonstrated in dorsal root ganglia, spinal dorsal horn neurones and enteric nerves. It is known to have a modulatory function on nociception and peripheral nerve injury has been shown to upregulate its synthesis. We have previously shown that resection sections for complicated diverticular disease shown evidence of neural damage and regeneration within the enteric nervous system (ENS).& To quantify the level of galanin expressed by mucosal nerves in patients with symptomatic and asymptomatic diverticular disease.Method: Ten symptomatic and ten asymptomatic patients underwent flexible sigmoidoscopy and multiple perimverticula biopsies were obtained. Standard fluorescent immune histochemical methods were used. Mucosal nerves were identified using PGF9.5 and peripherin. Using digitised image analysis, the level of galanin immunoreactivity within mucosal nerves was expressed as % area of lamina propia.Results: Median age was 68.5 years (range 49-70) with no difference between groups. Symptomatic patients experienced recurrent abdominal pain on a median of 6(range 3 -12) daydmonth. Duration of the pain was 4 (0.75-12) hours. No pain was experienced by the asymptomatic group. The % area of galanin immunoreactivity within the lamina propia was 0.155% in symptomatic patients compared with 0.004% in controls (p<0.0001 Mann Whitney).