MORPHOMETRIC ANALYSIS OF SUBMUCOSAL AND MYENTERIC NERVE PLEXUSES IN CHRONIC INFLAMMATORY BOWEL DISEASE IN CHILDREN
Abstract
ABSTRACT
Introduction: Chronic inflammatory bowel diseases (IBD) include ulcerative colitis (UC) and Crohn's disease (CD), characterized by relapses and an insufficiently clarified etiology. The enteric nervous system (ENS) consists of neuronal cells distributed along the gastrointestinal tract, organized into the submucosal Meissner's and myenteric Auerbach's plexuses. The glial cell index (GCI) represents the ratio of the number of glial cells to ganglion cells within the ganglia of the ENS.
Aim: The aim of this study is a morphometric analysis of the ENS in intestinal samples from surgically treated pediatric patients with CD and UC.
Material and methods: Histological slides from the archives of the Institute of Pathology, Faculty of Medicine, University of Belgrade, were analyzed. The study included an analysis of intestinal wall sections from pediatric patients with IBD (experimental group) and those with uncomplicated familial adenomatous polyposis syndrome (control group). Using the ImageJ software, five microphotographs of submucosal and myenteric nerve plexuses stained with Masson trichrome and captured with an Olympus DP70 digital camera at x400 magnification were analyzed.
Results: A significant difference in the GCI value in the myenteric plexus of the colon was observed between the experimental and control groups. No significant difference in the GCI value in the submucosal plexus of the colon was found between the two groups. A minimal difference in the GCI value within the experimental group was observed in the submucosal plexus sections.
Conclusion: This study presents a unique analysis of glial cells in CD, UC, and the control group in the submucosal and myenteric plexuses. The results indicate a disruption of GCI in the ENS in IBD, which likely represents the morphological substrate for intestinal motility disorders in these conditions.
References
1. Kummar V, Abbas KA, Fausto N, Mitchell NR, editors. Robbins basic pathology: Oral cavity and gastrointestinal tract. 8th ed. Belgrade: Data Status; 2010.
2. Rosen MJ, Dhawan A, Saeed SA. Inflammatory Bowel Disease in Children and Adolescents. JAMA Pediatr. 2015;169(11):1053-1060. doi:10.1001/jamapediatrics.2015.1982
3. Abraham BP, Ahmed T, Ali T. Inflammatory Bowel Disease: Pathophysiology and Current Therapeutic Approaches. Handb Exp Pharmacol. 2017;239:115-146.doi:10.1007/164_2016_122
4. Xavier RJ, Podolsky DK. Unravelling the pathogenesis of inflammatory bowel disease. Nature. 2007;448(7152):427-434. doi:10.1038/nature06005
5. Younis N, Zarif R, Mahfouz R. Inflammatory bowel disease: between genetics and microbiota. Mol Biol Rep. 2020;47(4):3053-3063. doi:10.1007/s11033-020-05318-5
6. Altajar S, Moss A. Inflammatory Bowel Disease Environmental Risk Factors: Diet and Gut Microbiota. Curr Gastroenterol Rep. 2020;22(12):57. doi:10.1007/s11894-020-00794-y
7. Paredes Méndez JE, Junes Pérez SI, Vargas Marcacuzco HT, et al. Manejo médico quirúrgico de la enfermedad inflamatoria intestinal moderada-severa [Medical and surgical management of moderate-to-severe inflamatory bowel disease]. Rev Gastroenterol Peru. 2021;41(2):79-85.
8. Villanacci V, Bassotti G, Nascimbeni R, et al. Enteric nervous system abnormalities in inflammatory bowel diseases. Neurogastroenterol Motil. 2008;20(9):1009-1016.doi:10.1111/j.1365-2982.2008.01146.x
9. Niesler B, Kuerten S, Demir IE, Schäfer KH. Disorders of the enteric nervous system - a holistic view. Nat Rev Gastroenterol Hepatol. 2021;18(6):393-410. doi:10.1038/s41575-020-00385-2
10. Jankovic R. Analysis of glial cell index and interstitial cells of cajal in colorectal biopsies of children with hirschsprung disease and related disorders [Dissertation]. Belgrade: Faculty of Medicine, University of Belgrade; 2016.
11. Lake JI, Heuckeroth RO. Enteric nervous system development: migration, differentiation, and disease. Am J Physiol Gastrointest Liver Physiol. 2013;305(1):G1-G24. doi:10.1152/ajpgi.00452.2012
12. Cabarrocas J, Savidge TC, Liblau RS. Role of enteric glial cells in inflammatory bowel disease. Glia. 2003;41(1):81-93. doi:10.1002/glia.10169
13. Biskou O, Meira de-Faria F, Walter SM, et al. Increased Numbers of Enteric Glial Cells in the Peyer's Patches and Enhanced Intestinal Permeability by Glial Cell Mediators in Patients with Ileal Crohn's Disease. Cells. 2022;11(3):335. doi:10.3390/cells11030335
14. Pochard C, Coquenlorge S, Freyssinet M, et al. The multiple faces of inflammatory enteric glial cells: is Crohn's disease a gliopathy?. Am J Physiol Gastrointest Liver Physiol. 2018;315(1):G1-G11.doi:10.1152/ajpgi.00016.2018