Expression Of FGF10 And BMP4 In Intestinal Atresia Proximal Segment

Congenital intestinal atresia (CIA), a common neonatal gastrointestinal tract malformation, is the main cause of neonatal intestinal obstruction. At present, the surgery is the only effective method to restore intestinal smooth, but a considerable amount of CIA postoperatives are suffering from a longer period of gastrointestinal motile disorders. Histopathological changes in proximal intestines of CIA are considered to be related to the occurrence of the disease.The trend has been reported at home and abroad that nerve pathological changes of CIA proximal segments are reducing gradually as moving away from the caecum of CIA segment, but the observed scope of intestinal nerve pathological changes is not consistent with the range of intestinal proximal resection. In recent years, a large number of animal studies abroad have shown that FGF10 is closely related to the development of the gastrointestinal tract of the mice. The mice with FGF10 gene defects have gastrointestinal malformations such as duodenal atresia, colon atresia and so on. Meanwhile, it has been proved that BMP4 is related to the development and maturation of intestinal nerve system. ObjectBy studying the distribution of FGF10 and BMP4 of the proximal intestinal wall in different parts of CIA, this research is to explore the relationship of CIA, FGF10 and BMP4 respectively and to discuss problems of children with intestinal dysfunction after the operations and guide the clinical treatment. Materials and Methods 20 cases of CIA have been studied who have been confirmed by pathological examination and surgical treatment from July 2008 to May 2009 at the Third Affiliated Hospital of Zhengzhou University, of which 3 cases are typeⅠ,10 cases typeⅡ,7 cases typeⅢ. The CIA segments, the proximal 5cm, and 10cm were retained and detected with the method of immunohistochemistry and RT-PCRJ. Children in this group include 12 males and 8 females, aged 1 to 6d, who were full-term children not found other intestinal malformation.20 cases were distributed. 10 cases in control group were dead full-term children with no gastrointestinal tract abnormalities of which six are males and four are females. In RT-PCR control group, 10 cases of normal intestinal tissue from children who took intussusception, intestinal resection and anastomosis, and enterostomy were chosen as control.Those children were aged 5 days to 4 months, who were not found other inestinal malformations and had negative family history.1 20 cases of CIA segments, proximal 5cm and proximal 10cm were resected, and then FGF10 and BMP4 expressions were observed and compared with 10 cases of normal intestines by immunohistochemical technique.2 20 cases of CIA segments, proximal 5cm and proximal 10cm were resected, and then FGF10 mRNA and BMP4 mRNA expressions were observed and compared with 16 cases of normal intestines by RT-PCR technique.3 Statistical analysis:SPSS 16.0 for data analysis. Measurement data are indicated with the mean±and standard deviation (x±s). The mean of samples in each group was compared using single factor analysis of variance, pair comparisons using LSD-t test, the correlation between the factors using pearson correlation analysis, with a=0.05 as standard level and P<0.05 for significant difference. Results1 Immunohistochemical results:the comparison of FGF10 between normal control group (148.32±1.90), CIA segments (123.41±2.59), and CIA proximal 5cm (137.51±2.13) respectively was statistically significant (P< 0.05) while the comparison of FGF10 between normal controls group (148.32±1.90) and CIA proximal 10cm (147.51±2.76) was not statistically significant (P> 0.05). the comparison of BMP4 between normal control group (206.40±3.22), CIA segments (138.57±2.81),and proximal 5cm (171.01±2.84) respectively was statistically significant (P<0.05), while the comparison of BMP4 between normal controls group (206.40±3.22) and CIA proximal 10cm (204.48±2.18) was not statistically significant (P>0.05).2 Immunohistochemical results:the comparison of FGF10 mRNA between normal control group (0.95±0.12), CIA segments(0.56±0.08), and CIA proximal 5cm (0.59±0.09) respectively was statistically significant (P<0.05) while the comparison of FGF10 mRNA between normal controls group (0.95±0.12) and CIA proximal 10cm (0.89±0.10) was not statistically significant (P> 0.05). the comparison of BMP4 mRNA between normal control group (1.12±0.10), CIA segments (0.67±0.09), and proximal 5cm(0.78±0.11) respectively was statistically significant (P<0.05), while the comparison of BMP4 between normal controls group (1.12±0.10) and CIA proximal 10cm (1.10±0.11) was not statistically significant (P>0.05). Conclusions1 The expressions of FGF 10 and BMP4 in CIA segments and proximal 5cm are significantly reduced compared with the normal intestine. This abnormal distribution is related to the abnormal development of nerve system.2 FGF 10 and BMP4 in CIA proximal intestinal segments are significantly reduced. With its stable nature, both of them can be used as a new indicator of diagnosis of CIA.3 The expression of FGF 10 and BMP4 in CIA proximal 10cm is close to the normal intestine. Therefore, in order to ensure a smooth postoperative recovery of intestinal function, the scope of intestinal resection should be more than 10cm..