Comparative study of collagen deposition in the colon wall of patients operated for sigmoid diverticular disease

Pantaroto, Mário; Filho, Gaspar de Jesus Lopes; Pinto, Clóvis Antônio Lopes; Filho, Armando Antico

doi:10.1590/s0102-865020150100000010

Cited by 9 publications

(5 citation statements)

References 24 publications

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“…These observations might explain the higher prevalence of distal diverticulosis in Western populations. Collagen accounts for mechanical stability of connective tissues, and is altered in patients with a history of recurrent diverticulitis, as a reaction to chronic inflammation 28, 29, 30. In diverticulosis without diverticulitis, there is evidence for higher expression of matrix metalloproteinase-1 (ubiquitously expressed interstitial collagenase) and altered connectives tissues 31, 32, 33, 34, 35.…”

Section: Alternative Hypotheses For Diverticulosis: Altered Tissue Inmentioning

confidence: 99%

Etiopathogenetic Mechanisms in Diverticular Disease of the Colon

Camilleri

Sandler

Peery

2020

Cellular and Molecular Gastroenterology and Hepatology

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This article reviews epidemiological evidence of heritability and putative mechanisms in diverticular disease, with greatest attention to 3 recent studies of genetic associations with diverticular disease based on genome-wide or whole-genome sequencing studies in large patient cohorts. We provide an analysis of the biological plausibility of the significant associations with gene variants reported and highlight the relevance of ANO1, CPI-17 (aka PPP1R14A), COLQ6, COL6A1, CALCB or CALCA, COL6A1, ARHGAP15, and S100A10 to colonic neuromuscular function and tissue properties that may result in altered compliance and predispose to the development of diverticular disease. Such studies also identify candidate genes for future studies.

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Section: Alternative Hypotheses For Diverticulosis: Altered Tissue Inmentioning

confidence: 99%

Etiopathogenetic Mechanisms in Diverticular Disease of the Colon

Camilleri

Sandler

Peery

2020

Cellular and Molecular Gastroenterology and Hepatology

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“…In addition, specific abnormalities in longitudinal muscle relaxation and contents of neural nitric oxide and elastin have been reported 78 , confirming old observations of elastosis confined to the longitudinal muscle layer with subsequent shortening of the teniae coli 79 . A remodeling of the neuromuscular apparatus occurs in complicated DD, consisting of a muscular hypertrophy and architecture disarrangement with reduced content in density of myocytes and contractile myofilaments 80 , an enteric neuropathy with hypoganglionosis, an imbalance in neurotransmitters, a deficiency of glial neurotrophic factors coupled to a nerve fiber remodeling 81 – 83 , and an increase in collagen deposition in the colon wall 84 . An increase in collagen expression has been observed in human colonic circular and longitudinal smooth muscle cells from complicated DD, parallel to a switch from a contractile to a synthetic phenotype 85 .…”

Section: Pathophysiology and Possible Underlying Biological Mechanismmentioning

confidence: 99%

Recent advances in understanding and managing diverticulitis

Severi

Carabotti²,

Cicenia

et al. 2018

F1000Res

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In the past few decades, the increasing socioeconomic burden of acute diverticulitis (AD) has become evident, and with the growth of the population age, this significant economic impact will likely continue to rise. Furthermore, recent evidence showed an increased rate of hospital admissions especially evident among women and younger individuals. The natural history and pathophysiology of this clinical condition is still to be fully defined, and efforts continue to be made in the identification of risk factors and the establishment of relative preventive strategies. The actual therapeutic strategies aimed to modulate gut microbiota, such as rifaximin or probiotics, or to reduce mucosal inflammation, such as mesalazine, present a relatively poor efficacy for both the prevention of the first AD episode (primary prevention) and its recurrence (secondary prevention). In the last few years, the main goal achieved has been in the management of AD in that uncomplicated AD can, to a larger extent, be managed in an outpatient setting with no or little supportive therapy, a strategy that will certainly impact on the health costs of this disease. The problem of AD recurrence remains a topic of debate. The aim of this review is to present updated evidence on AD epidemiology and relative open clinical questions and to analyze in detail predisposing and protective factors with an attempt to integrate their possible modes of action into the several pathogenic mechanisms that have been suggested to contribute to this multifactorial disease. A unifying hypothesis dealing with the colonic luminal and extra-luminal microenvironments separately is provided. Finally, evidence-based changes in therapeutic management will be summarized. Because of an ascertained multifactorial pathogenesis of uncomplicated and complicated AD, it is probable that a single ‘causa prima’ will not be identifiable, and a better stratification of patients could allow one to pursue tailored therapeutic algorithm strategies.

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“…Alterations in colonic muscle properties, collagen metabolism and in the interactions of the extracellular matrix components may play a role in remodelling of the gut wall in diverticular disease [ 33 ]. Collagen deposition in the colon wall of patients operated for sigmoid diverticulitis is higher compared to patients without the disease [ 38 ]. A number of rare hereditable disorders of collagen and elastin are associated with complicated diverticular disease at an early age [ 39 , 40 ].…”

Section: Introductionmentioning

confidence: 99%

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery

et al. 2021

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Aim There is a requirement for an expansive and up to date review of the management of emergency colorectal conditions seen in adults. The primary objective is to provide detailed evidence‐based guidelines for the target audience of general and colorectal surgeons who are responsible for an adult population and who practise in Great Britain and Ireland. Methods Surgeons who are elected members of the Association of Coloproctology of Great Britain and Ireland Emergency Surgery Subcommittee were invited to contribute various sections to the guidelines. They were directed to produce a pathology‐based document using literature searches that were systematic, comprehensible, transparent and reproducible. Levels of evidence were graded. Each author was asked to provide a set of recommendations which were evidence‐based and unambiguous. These recommendations were submitted to the whole guideline group and scored. They were then refined and submitted to a second vote. Only those that achieved >80% consensus at level 5 (strongly agree) or level 4 (agree) after two votes were included in the guidelines. Results All aspects of care (excluding abdominal trauma) for emergency colorectal conditions have been included along with 122 recommendations for management. Conclusion These guidelines provide an up to date and evidence‐based summary of the current surgical knowledge in the management of emergency colorectal conditions and should serve as practical text for clinicians managing colorectal conditions in the emergency setting.

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Comparative study of collagen deposition in the colon wall of patients operated for sigmoid diverticular disease

Cited by 9 publications

References 24 publications

Etiopathogenetic Mechanisms in Diverticular Disease of the Colon

Etiopathogenetic Mechanisms in Diverticular Disease of the Colon

Recent advances in understanding and managing diverticulitis

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery

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