| Neuroimmune appendicitis. | |
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MedLine Citation:
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PMID: 10465170 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: 15-25% of appendices removed from patients with suspected appendicitis appear normal on histological examination. The cause of pain in such patients is unknown. Since the content of neuropeptides seems to be altered in chronic inflammation, we investigated possible changes in peptidergic innervation for substance P (SP), vasoactive intestinal peptide (VIP), and growth-associated protein-43 (GAP-43). METHODS: Appendices classified as showing acute appendicitis, non-acute appendicitis (clinical signs of acute appendicitis, but histologically not inflamed), or normal were processed for SP, VIP, and GAP-43 immunocytochemistry. The density of SP immunostaining was assessed by digitised morphometry. FINDINGS: 31 appendix specimens were studied (16 acute, 15 non-acute). 16 specimens were used as controls. Expression of GAP-43 was increased in the non-acute appendices. We observed larger amounts of SP-immunoreactive and VIP-immunoreactive nerves in the mucosal layer of the appendix in patients with non-acute appendicitis than in controls and patients with acute appendicitis (mean % area SP-immunoreactive 0.0496 [SD 0.0113] non-acute, 0.0221 [0.0049] acute, 0.0229 [0.0068] controls). In addition, a close spatial relation between SP-immunoreactive and VIP-immunoreactive nerve fibres and lymphoid cells was detected in the outer zone of lymph follicles. INTERPRETATION: Neuroproliferation in the appendix, in association with an increase in neurotransmitters SP and VIP, may be involved in the pathophysiology of acute right abdominal pain in the absence of an acute inflammation of the appendix. Our data, together with increasing knowledge about the way in which the nervous system and immune cells interact, suggest that neuroimmune appendicitis is a distinct pathological entity. |
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Authors:
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P Di Sebastiano; T Fink; F F di Mola; E Weihe; P Innocenti; H Friess; M W Büchler |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Lancet Volume: 354 ISSN: 0140-6736 ISO Abbreviation: Lancet Publication Date: 1999 Aug |
Date Detail:
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Created Date: 1999-09-02 Completed Date: 1999-09-02 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 2985213R Medline TA: Lancet Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 461-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Visceral and Transplantation Surgery, University of Berne, Inselspital, Switzerland. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abdominal Pain
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etiology* Acute Disease Adolescent Adult Aged Appendectomy Appendicitis / immunology*, pathology Appendix / immunology, innervation*, pathology Diagnosis, Differential Enteric Nervous System / immunology, pathology Female GAP-43 Protein / metabolism* Humans Immunoenzyme Techniques Lymphoid Tissue / immunology, pathology Male Middle Aged Neuronal Plasticity / physiology* Prospective Studies Substance P / metabolism* Vasoactive Intestinal Peptide / metabolism* |
| Chemical | |
Reg. No./Substance:
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0/GAP-43 Protein; 33507-63-0/Substance P; 37221-79-7/Vasoactive Intestinal Peptide |
| Comments/Corrections | |
Comment In:
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Lancet. 1999 Nov 6;354(9190):1648
[PMID:
10560704
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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