A Study On The Interstitial Cells Of Cajal And Synaptophysin In The Patients With Congenital Intestinal Atresia

Objective The current study examined the distribution of interstitial cells of Cajal(ICCs) and expression of synaptophysin(SY) immunoreactivity ,and investigated the pathogenesis of congenital intestinal atresia (IA).Methods Full-thickness bowel specimens were obtained from the affected segments of 16 patients with IA and 5 normal controls.By using immunohistochemistry for light microscopy,we compared the distribution of ICCs and SY in bowel of IA with that from normal controls.The number of ICCs in myenteric layer and circular muscle layer from different samples were accounted and compared.By using image analysis system,we analysised the mean optical density(MOD) of SY in different layers of the three groups.Resultsâ‘ In bowels from normal controls and distal bowl of IA moderate to large amount of ICCs were observed around the myenteric plexus and at the circular muscle layer.ICCs in both the muscle layer and around the myenteric plexus appeared as a network structure.On the contrary,the mumber of c-kit+ ICCs was remarkably reduced or even disappeared in proximate bowel segment of IA.In these segment,ICCs were sparse and only a few ICCs localized around the myenteric plexus region.Statistics showed the significant difference of ICCs between this group and normal controls(P<0.01).â‘¡In normal controls and distal bowl of IA,SY immunoreactivity was abundant in the myenteric plexuses, moderately in circular and longitudinal muscle layer,and sparse in submucosae. The expression of SY immunoreactivity was remarkly reduced in proximate bowel segment of IA (P<0.01 or P<0.05). Conclusion Results of our study show the abnormal distribution of ICCs and SY immunoreactivity in bowl affected by IA.The reduction or absence of ICCs is one of the pathological change in IA.In addition to this,there is abnormal distribution of SY in bowel affected by IA.As is well known,SY is the marker of synapse in myenteric nerve plexus and neuromuscular junctions in muscular layer.We conclude the functional element composed of motor nerve ending,ICCs and smooth muscle cell is destructed in IA.And there is abnormal in neuromuscular junctions in the bowel affected by IA.These pathological changes may lead to the abnormal spontaneous electrical activity and conduction in segments of IA.Abnormal distribution of ICCs and SY in the bowel affected by IA may explain the postoperative intestinal dysmotility in these patients.