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Structure of the myenteric plexus in normal and diseased human ileum analyzed by X-ray virtual histology slices

Veress, Bela LU ; Peruzzi, Niccolò LU ; Eckermann, Marina ; Frohn, Jasper ; Salditt, Tim ; Bech, Martin LU orcid and Ohlsson, Bodil LU (2022) In World Journal of Gastroenterology 28(29). p.3994-4006
Abstract

BACKGROUND The enteric nervous system (ENS) is situated along the entire gastrointestinal tract and is divided into myenteric and submucosal plexuses in the small and large intestines. The ENS consists of neurons, glial cells, and nerves assembled into ganglia, surrounded by telocytes, interstitial cells of Cajal, and connective tissue. Owing to the complex spatial organization of several interconnections with nerve fascicles, the ENS is difficult to examine in conventional histological sections of 3-5 μm. AIM To examine human ileum full-thickness biopsies using X-ray phase-contrast nanotomography without prior staining to visualize the ENS. METHODS Six patients were diagnosed with gastrointestinal dysmotility and neuropathy based on... (More)

BACKGROUND The enteric nervous system (ENS) is situated along the entire gastrointestinal tract and is divided into myenteric and submucosal plexuses in the small and large intestines. The ENS consists of neurons, glial cells, and nerves assembled into ganglia, surrounded by telocytes, interstitial cells of Cajal, and connective tissue. Owing to the complex spatial organization of several interconnections with nerve fascicles, the ENS is difficult to examine in conventional histological sections of 3-5 μm. AIM To examine human ileum full-thickness biopsies using X-ray phase-contrast nanotomography without prior staining to visualize the ENS. METHODS Six patients were diagnosed with gastrointestinal dysmotility and neuropathy based on routine clinical and histopathological examinations. As controls, full-thickness biopsies were collected from healthy resection ileal regions after hemicolectomy for right colon malignancy. From the paraffin blocks, 4-µm thick sections were prepared and stained with hematoxylin and eosin for localization of the myenteric ganglia under a light microscope. A 1-mm punch biopsy (up to 1 cm in length) centered on the myenteric plexus was taken and placed into a Kapton® tube for mounting in the subsequent investigation. X-ray phase-contrast tomography was performed using two custom-designed laboratory setups with micrometer resolution for overview scanning. Subsequently, selected regions of interest were scanned at a synchrotron-based end-station, and high-resolution slices were reported. In total, more than 6000 virtual slices were analyzed from nine samples. RESULTS In the overview scans, the general architecture and quality of the samples were studied, and the myenteric plexus was localized. High-resolution scans revealed details, including the ganglia, interganglional nerve fascicles, and surrounding tissue. The ganglia were irregular in shape and contained neurons and glial cells. Spindle-shaped cells with very thin cellular projections could be observed on the surface of the ganglia, which appeared to build a network. In the patients, there were no alterations in the general architecture of the myenteric ganglia. Nevertheless, several pathological changes were observed, including vacuolar degeneration, autophagic activity, the appearance of sequestosomes, chromatolysis, and apoptosis. Furthermore, possible expulsion of pyknotic neurons and defects in the covering cellular network could be observed in serial slices. These changes partly corresponded to previous light microscopy findings. CONCLUSION The analysis of serial virtual slices could provide new information that cannot be obtained by classical light microscopy. The advantages, disadvantages, and future possibilities of this method are also discussed.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Enteric nervous system, Immunohistochemistry, Neuropathy, Synchrotron, Virtual histology, X-ray phase-contrast nanotomography
in
World Journal of Gastroenterology
volume
28
issue
29
pages
13 pages
publisher
WJG Press
external identifiers
  • pmid:36157532
  • scopus:85135723428
ISSN
1007-9327
DOI
10.3748/wjg.v28.i29.3994
language
English
LU publication?
yes
id
cb1cbd1b-0e7f-4953-98c0-56c39732d4bb
date added to LUP
2022-10-18 15:36:52
date last changed
2024-04-18 09:17:30
@article{cb1cbd1b-0e7f-4953-98c0-56c39732d4bb,
  abstract     = {{<p>BACKGROUND The enteric nervous system (ENS) is situated along the entire gastrointestinal tract and is divided into myenteric and submucosal plexuses in the small and large intestines. The ENS consists of neurons, glial cells, and nerves assembled into ganglia, surrounded by telocytes, interstitial cells of Cajal, and connective tissue. Owing to the complex spatial organization of several interconnections with nerve fascicles, the ENS is difficult to examine in conventional histological sections of 3-5 μm. AIM To examine human ileum full-thickness biopsies using X-ray phase-contrast nanotomography without prior staining to visualize the ENS. METHODS Six patients were diagnosed with gastrointestinal dysmotility and neuropathy based on routine clinical and histopathological examinations. As controls, full-thickness biopsies were collected from healthy resection ileal regions after hemicolectomy for right colon malignancy. From the paraffin blocks, 4-µm thick sections were prepared and stained with hematoxylin and eosin for localization of the myenteric ganglia under a light microscope. A 1-mm punch biopsy (up to 1 cm in length) centered on the myenteric plexus was taken and placed into a Kapton<sup>®</sup> tube for mounting in the subsequent investigation. X-ray phase-contrast tomography was performed using two custom-designed laboratory setups with micrometer resolution for overview scanning. Subsequently, selected regions of interest were scanned at a synchrotron-based end-station, and high-resolution slices were reported. In total, more than 6000 virtual slices were analyzed from nine samples. RESULTS In the overview scans, the general architecture and quality of the samples were studied, and the myenteric plexus was localized. High-resolution scans revealed details, including the ganglia, interganglional nerve fascicles, and surrounding tissue. The ganglia were irregular in shape and contained neurons and glial cells. Spindle-shaped cells with very thin cellular projections could be observed on the surface of the ganglia, which appeared to build a network. In the patients, there were no alterations in the general architecture of the myenteric ganglia. Nevertheless, several pathological changes were observed, including vacuolar degeneration, autophagic activity, the appearance of sequestosomes, chromatolysis, and apoptosis. Furthermore, possible expulsion of pyknotic neurons and defects in the covering cellular network could be observed in serial slices. These changes partly corresponded to previous light microscopy findings. CONCLUSION The analysis of serial virtual slices could provide new information that cannot be obtained by classical light microscopy. The advantages, disadvantages, and future possibilities of this method are also discussed.</p>}},
  author       = {{Veress, Bela and Peruzzi, Niccolò and Eckermann, Marina and Frohn, Jasper and Salditt, Tim and Bech, Martin and Ohlsson, Bodil}},
  issn         = {{1007-9327}},
  keywords     = {{Enteric nervous system; Immunohistochemistry; Neuropathy; Synchrotron; Virtual histology; X-ray phase-contrast nanotomography}},
  language     = {{eng}},
  number       = {{29}},
  pages        = {{3994--4006}},
  publisher    = {{WJG Press}},
  series       = {{World Journal of Gastroenterology}},
  title        = {{Structure of the myenteric plexus in normal and diseased human ileum analyzed by X-ray virtual histology slices}},
  url          = {{http://dx.doi.org/10.3748/wjg.v28.i29.3994}},
  doi          = {{10.3748/wjg.v28.i29.3994}},
  volume       = {{28}},
  year         = {{2022}},
}