Maturity of the Myenteric Plexus Is Decreased in the Gastroschisis Rat Model

França, Willy Marcus; Langone, Francesco; Hoz, Cristiane Lucia R. de la; Gonçalves, Anderson; Bittencourt, Daniel Guimarães; Pereira, Luis Violin; Sbragia, Lourenço

doi:10.1159/000109228

Cited by 17 publications

(17 citation statements)

References 59 publications

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“…The immaturity picture of the cells responsible for intestinal motor activities presently observed at birth in the baby with GS is very similar to that reported for animal models of GS [8, 11–13, 18]. Moreover, the absence of degenerative processes in all the specimens, together with the presence of a progressive maturative course, supports the hypothesis of a delayed differentiation, rather than an arrest.…”

Section: Discussionsupporting

confidence: 83%

“…During the last 10 years a series of articles regarding the possible role of the ICC in the gastrointestinal malformations, including GS, has been published [8, 15–18]. In the rat model of GS, a morphological immaturity of various cell types, including ICC, smooth muscle cells and enteric neurons, has been reported [8, 11–13] thus suggesting a possible explanation for the paralytic ileus characteristic of this malformation. In the present study, the immature features reported for the experimental GS were confirmed by examining samples of small intestine of a baby born with GS.…”

Section: Discussionmentioning

confidence: 99%

“…Several articles regarding the pathogenesis of the intestinal damage in GS have been published [6–8] and the prolonged contact with the amniotic fluid, rich of gastrointestinal enzymes and waste products, seems to be the main cause of the damage [9]; however, the aetiology of the paralytic ileus is not completely understood. Experimental studies in different animal models have addressed this aspect [8, 10–13] and, recently, the possible role of ICC has been raised in a rat model of GS [8]. In this latter study, an immaturity of the ICC was observed with immunohistochemistry and transmission electron microscope (TEM) in the herniated loops of the rat at term foetuses with GS [8].…”

Section: Introductionmentioning

confidence: 99%

“…In this latter study, an immaturity of the ICC was observed with immunohistochemistry and transmission electron microscope (TEM) in the herniated loops of the rat at term foetuses with GS [8]. In the same rat model, immature neurons and smooth muscle cells were also seen [11–13]. Unfortunately, due to mortality of the animals, the possible maturation of these cells in parallel with a normal peristaltic activity could never be investigated after birth.…”

Section: Introductionmentioning

confidence: 99%

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Delayed development of interstitial cells of Cajal in the ileum of a human case of gastroschisis

Midrio¹,

Vannucchi²,

Pieri³

et al. 2008

J Cellular Molecular Medi

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The Interstitial Cells of Cajal (ICC) are responsible for rhythmic electrical activity. A paralytic ileus is present in gastroschisis (GS), a malformation due to a defective closure of the abdominal wall through which part of the intestine herniates during pregnancy. In experimental GS, ICC morphological immaturity was shown in the rat foetus at-term but it could not be demonstrated whether differentiation is accomplished post-natally. For this purpose we morphologically investigated ICC, as well as enteric neurons and smooth muscle cells, in a case of human GS at birth and 1 month later when peristaltic activity had initiated. A 36 weeks gestation female was born by c/section with prenatal diagnosis of GS and possible volvulus of the herniated intestine. At birth, the necrotic intestine was resected and both ileostomy and colostomy were performed. The intestine continuity was restored after 4 weeks. Intestinal specimens, taken during both operations at the level of the proximal stoma, were immunostained with c-kit, neuron-specific-enolase and α-smooth-muscle-actin antibodies and some processed for electron microscopy. ICC were present at the myenteric plexus only. At birth, these cells were rare and ultrastructurally immature; 1 month later, when partial enteral feeding was tolerated, they formed rows or groups and many of them were ultrastructurally differentiated. Neurons and smooth muscle cells, immature at birth, had developed after 1 month. Therefore, ICC differentiation, as well as that of neurons and smooth muscle cells, is delayed at birth and this might explain the paralytic ileus in GS. One month later, differentiation quickly proceeded at all cellular levels paralleling the increasing tolerance of enteral nutrition.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Delayed development of interstitial cells of Cajal in the ileum of a human case of gastroschisis

Midrio¹,

Vannucchi²,

Pieri³

et al. 2008

J Cellular Molecular Medi

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“…Bowel motility is impaired in these patients [Rubin et al, 1978; Simmons and Georgeson, 1996]. Gastroschisis is thought to affect development of intestinal pacemaker cells [Midrio et al, 2004] as well as enteric neurons [Vannucchi et al, 2003; Franca et al, 2007] and can result in either hyper‐ or hypo‐motility. Hypermotility can be controlled with medications, but fewer options are available for the infant with hypomotility.…”

Section: Postnatal and Surgical Managementmentioning

confidence: 99%

Clinical considerations in gastroschisis: Incremental advances against a congenital anomaly with severe secondary effects

Nichol

Byrne

Dodgion

et al. 2008

American J of Med Genetics Pt C

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Gastroschisis is one of the most challenging congenital anomalies that physicians treat in the first 2 months of life. Over the last 40 years, tremendous progress has been made in the management of this defect. Survival has increased significantly during this period as well. However, gastroschisis still presents the clinician with a unique set of challenges as a result of secondary effects on intestinal development. These challenges or clinical considerations are discussed in this review including a history of the management of the defect, prenatal counseling, prenatal intervention, postnatal and surgical management, complications and long-term outcomes.

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Gastroschisis: sonographic diagnosis, associations, management and outcome

2008

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Gastroschisis is a defect in the abdominal wall, typically on the right side of a normally inserted umbilical cord through which bowel and other abdominal contents herniate. Classically, no membrane covers the herniated abdominal contents, which distinguishes the defect from exomphalos, an important differential diagnosis. Gastroschisis is usually diagnosed prenatally using ultrasound examination. The prevalence is increasing worldwide from approximately 0.1 per 10,000 total births in the 1970s to over 5 in the early 2000s. The reasons for this are unknown, but factors such as maternal smoking, recreational drugs and young maternal age are strongly associated with the defect. The increasing prevalence is causing concern because the cost of treating gastroschisis is high. Neonatal morbidity depends on significant complicating factors such as bowel atresia or necrosis and prolonged post-operative ileus. Foetuses with gastroschisis are more likely to be born premature and with intra-uterine growth restriction, both of which contribute to the morbidity. Gastroschisis requires early surgery after birth, often followed by prolonged neonatal care. However, advances in surgical and post-operative care in the last decade have meant that currently 90% of affected neonates survive, with few long-term problems.

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Maturity of the Myenteric Plexus Is Decreased in the Gastroschisis Rat Model

Cited by 17 publications

References 59 publications

Delayed development of interstitial cells of Cajal in the ileum of a human case of gastroschisis

Delayed development of interstitial cells of Cajal in the ileum of a human case of gastroschisis

Clinical considerations in gastroschisis: Incremental advances against a congenital anomaly with severe secondary effects

Gastroschisis: sonographic diagnosis, associations, management and outcome

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