Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
J Gastroenterol Hepatol. 2018 Mar;33(3):638-644. doi: 10.1111/jgh.13973.
The enteric nervous system can amplify or modulate intestinal inflammation through secretion of neuropeptides, and enteric glial cells have been implicated in the pathophysiology of Crohn's disease. The goal of the study was to search for an association between the density of neurons, neuropeptides, and enteric glial cells and postoperative recurrence.
The ileal proximal uninflamed section from ileocolonic sample was studied using immunohistochemistry with antibodies directed against vasoactive intestinal polypeptide (VIP), substance P (SP), neuron-specific enolase (NSE), and the glial marker protein S100. The density in the submucosa was calculated, and the relationship of the density of VIP, SP, NSE, and S100 and postoperative disease recurrence was assessed.
There were no significant differences between patients with and without postoperative endoscopic recurrence or clinical recurrence for the density of NSE-positive, VIP-positive, or SP-positive neurons in the proximal margin. Interestingly, the density of S100-positive enteric glial cells was significantly increased in patients with endoscopic and clinical recurrence than in subjects without disease recurrence (P ˂ 0.001). The density of S100-positive enteric glial cells was independently associated with postoperative disease recurrence.
Increased S100-positive enteric glial cells are associated with a high risk of both endoscopic and clinical recurrence after surgery. These findings have implications in individualized postoperative prophylaxis for Crohn's disease.
肠神经系统可以通过神经肽的分泌来放大或调节肠道炎症，而肠胶质细胞被认为与克罗恩病的病理生理学有关。本研究的目的是寻找神经元、神经肽和肠胶质细胞密度与术后复发之间的关联。
使用针对血管活性肠肽（VIP）、P 物质（SP）、神经元特异性烯醇化酶（NSE）和神经胶质标志物 S100 的免疫组织化学方法研究回肠结肠样本的近端非炎症节段。计算粘膜下的密度，并评估 VIP、SP、NSE 和 S100 的密度与术后疾病复发的关系。
在近端边缘，NSE 阳性、VIP 阳性或 SP 阳性神经元的密度在有或无内镜和临床复发的患者之间没有显著差异。有趣的是，与无疾病复发者相比，内镜和临床复发者的 S100 阳性肠胶质细胞密度显著增加（P<0.001）。S100 阳性肠胶质细胞密度与术后疾病复发独立相关。
S100 阳性肠胶质细胞的增加与术后内镜和临床复发的高风险相关。这些发现对克罗恩病的个体化术后预防具有重要意义。
