Depopulation of interstitial cells of cajal in chagasic megacolon: towards tailored surgery?

Abstract

-Background -The mechanism of constipation in patients with Chagasic megacolon remains partially explained. In these patients, it was recently demonstrated a reduction in the population of interstitial cells of Cajal. Aim -To evaluate density of Cajal cells in the surgically resected colon of Chagasic patients in comparison to control patients, and to verify possible association between preoperative and postoperative bowel function of Chagasic patients and colonic cell count. Method -Sixteen patients with Chagasic megacolon were operated on. Clinical pre-and postoperative evaluation using the Cleveland Clinic Constipation Score was undertaken.Resected colons were examined. Cajal cells were identified by immunohistochemistry using anti-CD117 antibody. The mean cell number was compared to resected colons from 16 patients with non-obstructive sigmoid cancer. Association between preand post-operative constipation scores and cell count for megacolon patients was evaluated using the Pearson coefficient correlation test (r).

Network properties of interstitial cells of Cajal affect intestinal pacemaker activity and motor patterns, according to a mathematical model of weakly coupled oscillators

“…We need to establish a possible association between disease severity and the extent of reduction of ICC (Yin & Chen, ; Araujo et al . ).…”

Megacolon: variante andina y chagasica, semejanzas y diferencias

“…Las cambios celulares en pacientes con dolicomegacolon chagásico encontrados son: disminución, alteración y destrucción de las células ganglionares en la parte distal de las piezas operatorias con predominio del plexo de Auerbach y menor proporción en el plexo de Meissner de la zona dilatada (Kasamatsu et al, 1995), reporte de reducción de las células intersticiales de Cajal asociadas con contaje de neuronas (Araujo et al, 2012), en conjunto con la disminución de la densidad de PGF 9.5 IR fibras neuronales de la musculatura externa (Jabari et al, 2013) (Hagger et al, 2000) , a nivel del sistema inmune expresión de genes FOXP3 (Fontenot et al, 2003) que controlan la expresión del crecimiento y función de los linfocitos T CD4+ (Da Silveira et al, 2009) relacionado directamente con la exacerbación de la inflamación mayor daño mioenterico y por tanto responsable de las recidivas.…”

Gastrointestinal involvement in Chagas disease

“…Actually, several studies, although not all, have provided evidence that patients with primary achalasia, whose symptoms are fairly similar as compared with those observed in the chagasic form, show functional autonomic nervous system disturbances (vagal impairment) [39][40][41][42] . Besides degeneration and decreased numbers of intrinsic myenteric neurons, reduced numbers of intersticial cells of Cajal 14,43,44 and glial cells 14,22,45 , hypertrophic smooth cells, and increased fibrosis have also been reported, suggesting a complex physiopathology of chagasic esophageal and colonic disorders.…”