Ultrastructure of the Ileum in Crohn's Disease

Ranløv, Poul; Nielsen, Michael Havbro Faber; Wanstrup, John

doi:10.3109/00365527209180772

Cited by 36 publications

(16 citation statements)

References 9 publications

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“…A similar increase in mast cells has been observed in five cases of diverticulitis. 9 On the other hand, almost total absence of stainable mast cells in affected areas of the bowel in Crohn's disease together with marked decrease in IgE-containing immunocytes has been reported. 6 The absence of mast cells in this instance may have been due to degranulation and consumption of IgE during immediate hypersensitivity reaction in the bowel wall, explaining the local edema which might result from release of vasoactive substances.…”

Section: Discussionmentioning

confidence: 99%

Mast Cells and Headache in Crohn's Disease

Atkinson

Appenzeller

1978

Headache

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SYNOPSIS Four patients with vascular headaches of remarkable severity and chronicity not responding to usual therapies brought attention to their families in which at least two members each also have Crohn's disease. Hitherto an association of Crohn's disease with vascular headache of the migrainous type has not been recognized.One patient suffered bouts of extreme constipation at age four years. When eight years old he developed “screaming, pounding headaches”. During headaches, intermittent crampy periumbilical pain and diarrhea appeared. Subsequent radiologic and surgical evidence resulted in a diagnosis of Crohn's disease. His 11‐year‐old brother was seen for headaches which were intractable over a period of at least six months, but bowel symptoms has not appeared as yet. Their father has Crohn's disease.A 19‐year‐old woman with Crohn's disease presented with headaches of the migrainous type of eight months duration, resistent to all therapies. Her mother has Crohn's disease and migraine and a sister has peptic ulcers, “gaseous colon” and migraine.Resected bowel of three of these patients showed large numbers of mast cells. We suggest that vasoactive substances, including histamine released from mast cells, could cause headache. Moreover, impaired sulfate conjugation of monamines, or decreased monoamine oxidase in diseased bowel could facilitate the absorption and increase the circulation of vasoactive substances causing headache.

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Section: Discussionmentioning

confidence: 99%

Mast Cells and Headache in Crohn's Disease

Atkinson

Appenzeller

1978

Headache

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“…Crohn's Ulcerative colitis (1966) suggested that the four sigmoidoscopic stages recognized by Buie (1926) (Ranlov et al, 1972;Cook and Turnbull, 1975). The presence of this abundance of degranulated mast cells would indicate that they play a role in the inflammatory process and, indeed, some of the histological features characteristic of Crohn's disease are most readily explained on this basis; thus, the marked oedema could well be due to release of vasoactive amines from mast cells, while focal mucosal ulceration could result from the release of proteolytic enzymes.…”

Section: Discussionmentioning

confidence: 99%

Mast cells and immunoglobulin E in inflammatory bowel disease.

Lloyd¹,

Green²,

Fox³

et al. 1975

Gut

108

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It is currently thought that both ulcerative colitis and Crohn's disease may be immunologically mediated, though the exact mechanisms responsible for both initiating and maintaining these two inflammatory bowel conditions are still far from clear. In recent years, the limited role of humoral antibodies in these diseases has become increasingly apparent and interest has tended to centre upon the possibility that they are the result of a cell mediated delayed hypersensitivity type of reaction in the bowel wall. In both these diseases, however, the inflammatory lesions are of a mixed type and features of an acute and a chronic inflammatory reaction are often both present. McGovern and Archer (1957) were the first to suggest that the acute inflammatory component of ulcerative colitis was mediated by mast cells, and subsequent workers have claimed that a marked increase in intestinal mast cells is a prominent feature of inflammatory bowel disease, some noting this increase only in ulcerative colitis (McAuley and Sommers, 1961;Bercovitz and Sommers, 1966;Sommers, 1966) and others finding it to be also a feature of Crohn's disease (Hiatt and Katz, 1962 These studies were made at a time when it was not yet fully established that mast cells could react with antigen and IgE to produce an immediate hypersensitivity reaction (Stanworth, 1971). Thus the possibility exists that one of the immunological mechanisms involved in inflammatory bowel disease is an immediate hypersensitivity reaction and it was with this in mind that the mast cell and IgE-containing immunocyte populations of the normal and inflamed bowel were studied. Methods MAST CELLSA preliminary study showed that bowel obtained at necropsy was unsuitable for the demonstration of mast cells and their distribution was therefore studied in surgically resected or biopsy specimens, all of which were obtained fresh. Thirty specimens of ileum were studied of which 12 were from patients with proven Crohn's disease; the remaining 18 were considered as normal controls and were attached to right hemicolectomy specimens resected for colonic carcinoma. Mast cell distribution was also studied in 44 surgically resected colons and in 60 specimens of rectum, some surgically resected and others obtained at biopsy. Of the colonic specimens, 15 were from patients with Crohn's disease, and 14 from cases of ulcerative colitis; multiple sections were taken from 861 on 11 May 2018 by guest. Protected by copyright.

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“…Altered intestinal motility has been described for both CD and UC. The inflammation in CD is transmural and involves a large number of mast cells [112]. KIT immunoreactivity in the small intestine was decreased in ICC-IM and at AP [10, 113].…”

Section: Inflammationmentioning

confidence: 99%

Interstitial cells of Cajal, macrophages and mast cells in the gut musculature: morphology, distribution, spatial and possible functional interactions

Mikkelsen

2010

J Cellular Molecular Medi

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Interstitial cells of Cajal (ICC) are recognized as pacemaker cells for gastrointestinal movement and are suggested to be mediators of neuromuscular transmission. Intestinal motility disturbances are often associated with a reduced number of ICC and/or ultrastructural damage, sometimes associated with immune cells. Macrophages and mast cells in the intestinal muscularis externa of rodents can be found in close spatial contact with ICC. Macrophages are a constant and regularly distributed cell population in the serosa and at the level of Auerbach’s plexus (AP). In human colon, ICC are in close contact with macrophages at the level of AP, suggesting functional interaction. It has therefore been proposed that ICC and macrophages interact. Macrophages and mast cells are considered to play important roles in the innate immune defence by producing pro-inflammatory mediators during classical activation, which may in itself result in damage to the tissue. They also take part in alternative activation which is associated with anti-inflammatory mediators, tissue remodelling and homeostasis, cancer, helminth infections and immunophenotype switch. ICC become damaged under various circumstances – surgical resection, possibly post-operative ileus in rodents – where innate activation takes place, and in helminth infections – where alternative activation takes place. During alternative activation the muscularis macrophage can switch phenotype resulting in up-regulation of F4/80 and the mannose receptor. In more chronic conditions such as Crohn’s disease and achalasia, ICC and mast cells develop close spatial contacts and piecemeal degranulation is possibly triggered.

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Ultrastructure of the Ileum in Crohn's Disease

Cited by 36 publications

References 9 publications

Mast Cells and Headache in Crohn's Disease

Mast Cells and Headache in Crohn's Disease

Mast cells and immunoglobulin E in inflammatory bowel disease.

Interstitial cells of Cajal, macrophages and mast cells in the gut musculature: morphology, distribution, spatial and possible functional interactions

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