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Post inflammatory damage to the enteric nervous system in diverticular disease and its relationship to symptoms

Simpson, J.; Sundler, Frank LU ; Humes, D. J.; Jenkins, D.; Scholefield, J. H. and Spiller, R. C. (2009) In Neurogastroenterology and Motility 21(8). p.847-847
Abstract
Some patients with colonic diverticula suffer recurrent abdominal pain and exhibit visceral hypersensitivity, though the mechanism is unclear. Prior diverticulitis increases the risk of being symptomatic while experimental colitis in animals increases expression of neuropeptides within the enteric nervous system (ENS) which may mediate visceral hypersensitivity. Our aim was to determine the expression of neuropeptides within the ENS in diverticulitis (study 1) and in patients with symptomatic disease (study 2). Study 1 - Nerves in colonic resection specimens with either acute diverticulitis (AD, n = 16) or chronic diverticulitis (CD, n = 16) were assessed for neuropeptide expression recording % area staining with protein gene product... (More)
Some patients with colonic diverticula suffer recurrent abdominal pain and exhibit visceral hypersensitivity, though the mechanism is unclear. Prior diverticulitis increases the risk of being symptomatic while experimental colitis in animals increases expression of neuropeptides within the enteric nervous system (ENS) which may mediate visceral hypersensitivity. Our aim was to determine the expression of neuropeptides within the ENS in diverticulitis (study 1) and in patients with symptomatic disease (study 2). Study 1 - Nerves in colonic resection specimens with either acute diverticulitis (AD, n = 16) or chronic diverticulitis (CD, n = 16) were assessed for neuropeptide expression recording % area staining with protein gene product (PGP9.5), substance P (SP), neuropeptide K (NPK), pituitary adenylate cyclase activating polypeptide (PACAP), vasoactive intestinal polypeptide (VIP) and galanin. Study 2 - Seventeen symptomatic and 15 asymptomatic patients with colonic diverticula underwent flexible sigmoidoscopy and multiple peridiverticular mucosal biopsies. Study 1- Neural tissue, as assessed by PGP staining was increased to a similar degree in circular muscle in both AD and CD. The CD specimens showed significant increases in the immunoreactivity of SP, NPK and galanin in both mucosal and circular muscle layer compared with controls. Study 2 - Mucosal histology was normal and PGP9.5 staining was similar between groups however patients with symptomatic diverticular disease demonstrated significantly higher levels of SP, NPK, VIP, PACAP and galanin within the mucosal plexus. Patients with symptomatic diverticular disease exhibit increased neuropeptides in mucosal biopsies which may reflect resolved prior inflammation, as it parallels the changes seen in acute and chronic diverticulitis. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
substance P, symptoms, galanin, diverticula, enteric nerves
in
Neurogastroenterology and Motility
volume
21
issue
8
pages
847 - 847
publisher
Wiley-Blackwell
external identifiers
  • wos:000267884500010
  • scopus:65449125951
ISSN
1350-1925
DOI
10.1111/j.1365-2982.2009.01308.x
language
English
LU publication?
yes
id
6d593853-e19f-4797-938c-40421a419869 (old id 1462429)
date added to LUP
2009-08-31 11:04:02
date last changed
2017-08-13 03:41:23
@article{6d593853-e19f-4797-938c-40421a419869,
  abstract     = {Some patients with colonic diverticula suffer recurrent abdominal pain and exhibit visceral hypersensitivity, though the mechanism is unclear. Prior diverticulitis increases the risk of being symptomatic while experimental colitis in animals increases expression of neuropeptides within the enteric nervous system (ENS) which may mediate visceral hypersensitivity. Our aim was to determine the expression of neuropeptides within the ENS in diverticulitis (study 1) and in patients with symptomatic disease (study 2). Study 1 - Nerves in colonic resection specimens with either acute diverticulitis (AD, n = 16) or chronic diverticulitis (CD, n = 16) were assessed for neuropeptide expression recording % area staining with protein gene product (PGP9.5), substance P (SP), neuropeptide K (NPK), pituitary adenylate cyclase activating polypeptide (PACAP), vasoactive intestinal polypeptide (VIP) and galanin. Study 2 - Seventeen symptomatic and 15 asymptomatic patients with colonic diverticula underwent flexible sigmoidoscopy and multiple peridiverticular mucosal biopsies. Study 1- Neural tissue, as assessed by PGP staining was increased to a similar degree in circular muscle in both AD and CD. The CD specimens showed significant increases in the immunoreactivity of SP, NPK and galanin in both mucosal and circular muscle layer compared with controls. Study 2 - Mucosal histology was normal and PGP9.5 staining was similar between groups however patients with symptomatic diverticular disease demonstrated significantly higher levels of SP, NPK, VIP, PACAP and galanin within the mucosal plexus. Patients with symptomatic diverticular disease exhibit increased neuropeptides in mucosal biopsies which may reflect resolved prior inflammation, as it parallels the changes seen in acute and chronic diverticulitis.},
  author       = {Simpson, J. and Sundler, Frank and Humes, D. J. and Jenkins, D. and Scholefield, J. H. and Spiller, R. C.},
  issn         = {1350-1925},
  keyword      = {substance P,symptoms,galanin,diverticula,enteric nerves},
  language     = {eng},
  number       = {8},
  pages        = {847--847},
  publisher    = {Wiley-Blackwell},
  series       = {Neurogastroenterology and Motility},
  title        = {Post inflammatory damage to the enteric nervous system in diverticular disease and its relationship to symptoms},
  url          = {http://dx.doi.org/10.1111/j.1365-2982.2009.01308.x},
  volume       = {21},
  year         = {2009},
}