目的:分析 c-kit和缝隙连接蛋白43(Cx43)在新生儿自发性胃穿孔(spontaneous neonatal gastric perforation, SNGP)中的表达情况,探讨Cajal间质细胞(interstitial cell of Cajal, ICC)在新生儿SNGP中的意义。方法:收集2001~2010年手术治疗的19例SNGP胃组织标本,以8例无消化道畸形新生儿尸检胃组织作为对照,采用免疫组织化学SP法进行c-kit和Cx43检测。结果:SNGP患儿胃壁穿孔处肌层缺失,穿孔周围肌束明显变薄。与对照组比较,SNGP患儿胃组织中c-kit阳性细胞以及Cx43阳性细胞表达明显减少(P<0.01)。结论:新生儿SNGP与胃壁ICC数量减少、缝隙连接结构破坏有关。
Abstract
OBJECTIVE: To study the clinical significance of interstitial cell of Cajal (ICC) in spontaneous neonatal gastric perforation by examining the expression of c-kit and Cx43 in neonates with this disorder. METHODS: The gastric specimens of 19 cases of neonatal gastric perforation from 2001 to 2010 and 8 cases of accidental death without digestive tract malformations (control) were collected. Immunohistochemical staining was employed to examine the expression of c-kit and Cx43 (immunomarkers of ICCs) in gastric tissues. RESULTS: The muscular layer of the stomach wall became thinner or deficient in the gastric perforation group. C-kit and Cx43 positive cells in gastric tissues decreased significantly in the gastric perforation group compared with those in the control group (P<0.01). CONCLUSIONS: The development of spontaneous neonatal gastric perforation is associated with the decreased quantity of ICCs and damaged gap junction structure of the stomach wall.
关键词
自发性胃穿孔 /
Cajal间质细胞 /
C-kit /
缝隙连接蛋白43 /
新生儿
Key words
Spontaneous gastric perforation /
Interstitial cell of Cajal /
C-kit /
Cx43 /
Neonate
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1]Jawad AJ, Al-Rabie A, Hadi A, Al-Sowailem A, AI-Rawaf A, Abu-Touk B, et al. Spontaneous neonatal gastric perforation[J]. Pediatr Surg Int, 2002, 18(5-6): 396-399.
[2]Rolle U, PiasecznaPiotrowska A, Puri P. Interstitial cells of Cajal in the normal gut and in interstinal motility disorders of childhood[J]. Pediatr Surg Int, 2007,23(12): 1139-1152.
[3]Wallace AS, Burns AJ. Development of the enteric nervous system, smooth muscle and interstitial cells of Cajal in the human gastrointestinal tract[J]. Cell Tissue Res, 2005, 319(3):367-382.
[4]Leone R, Krasna IH.Spontaneous neonatal gastric perforation: is it really-spontaneous?[J]. Pediatr Surg, 2000, 35(7): 1066-1069.
[5]Sanders KM, Koh SD, Ward SM. Interstitial cells of cajal as pacemakers in the gastrointestinal tract[J]. Annu Rev Physiol, 2006, 68: 307-343.
[6]Tong W, Jia H, Zhang L, Li C, Ridolfi TJ, Liu B. Exogenous stem cell factor improves interstitial cells of Cajal restoration after blockade of c-kit signaling pathway[J]. Scand J Gastroenterol, 2010, 45(7-8): 844-851.
[7]Ohshiro K, Yamataka A, Kobayashi H, Hirai S, Miyahara K, Sueyoshi N, et al. Idiopathic gastric perforation in neonates and abnormal distribution of intestinal pacemaker cells[J]. J Pediatr Surg, 2000, 35(5): 673-676.
[8]Nemeth L, Maddur S, Puri P. Immunolocalization of the gap junction protein connexin43 in the interstitial cells of cajal in the normal and Hirschsprung′s disease bowel[J]. J Pediatr Surg, 2000, 35(6): 823-828.
[9]杨烨,侯豫,赵新,张薇,王宝新.先天性巨结肠壁CX43蛋白和Cajal间质细胞的分布[J].中国当代儿科杂志,2009,11(3):213216.
[10]Timmermans JP. Interstitial cells of Cajal: is their role in gastrointestinal function in view of therapeutic perspectives underestimated or exaggerated?[J]. Folia Morphol, 2001, 60(1): 1-9.
[11]Burns AJ. Disorders of interstitial cells of Cajal[J]. J Pediatr Gastroenterol Nutr, 2007, 45 (Suppl 2): S103-S106.
[12]Daniel EE. Physiology and pathophysiology of the interstitial cell of Cajal: from bench to bedside. Ⅲ. Interaction of interstitial cells of Cajal with neuromediators: an interim assessment[J]. Am J Physiol Gastrointest Liver Physiol, 2001, 281(6): G1329-G1332.