College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia.
NHMRC Centre for Research Excellence in Digestive Health, New Lambton Heights, Australia.
J Gastroenterol Hepatol. 2023 Aug;38(8):1355-1364. doi: 10.1111/jgh.16278. Epub 2023 Jul 6.
AIMS: Eosinophils contribute to tissue homeostasis, damage, and repair. The mucosa of colonic diverticula has not been evaluated for eosinophils by quantitative histology. We aimed to investigate whether mucosal eosinophils and other immune cells are increased in colonic diverticula. METHODS: Hematoxylin and eosin stained sections from colonic surgical resections (n = 82) containing diverticula were examined. Eosinophils, neutrophils, and lymphocytes, in five high power fields in the lamina propria were counted at the base, neck, and ostia of the diverticulum and counts compared to non-diverticula mucosa. The cohort was further subgrouped by elective and emergency surgical indications. RESULTS: Following an initial review of 10 surgical resections from patients with diverticulosis, a total of 82 patients with colonic resections containing diverticula from the descending colon were evaluated (median age 71.5, 42 M/40F). Eosinophil counts for the entire cohort were increased in the base and neck (median 99 and 42, both P = <0.001) compared with the control location (median 16). Eosinophil counts remained significantly increased in the diverticula base (both P = <0.001) and neck (P = 0.01 and <0.001, respectively) in both elective and emergency cases. Lymphocytes were also significantly increased at the diverticula base compared to controls in both elective and emergency subgroups. CONCLUSION: Eosinophils are significantly and most strikingly increased within the diverticulum in resected colonic diverticula. While these observations are novel, the role of eosinophil and chronic inflammation is as yet unclear in the pathophysiology of colonic diverticulosis and diverticular disease.
目的:嗜酸性粒细胞有助于组织的动态平衡、损伤和修复。尚未通过定量组织学评估结肠憩室的黏膜中是否存在嗜酸性粒细胞。我们旨在研究结肠憩室中黏膜嗜酸性粒细胞和其他免疫细胞是否增加。
方法:检查包含憩室的结肠手术切除标本的苏木精和伊红染色切片(n=82)。在憩室的基底、颈部和口部的固有层的五个高倍视野中计数嗜酸性粒细胞、中性粒细胞和淋巴细胞,并与非憩室黏膜的计数进行比较。该队列还根据选择性和紧急手术指征进一步分为亚组。
结果:在对 10 例憩室病患者的手术切除标本进行初步审查后,共评估了 82 例来自降结肠的含有憩室的结肠切除术患者(中位年龄 71.5 岁,42 例男性/40 例女性)。整个队列的基底和颈部的嗜酸性粒细胞计数均增加(中位数分别为 99 和 42,均 P<0.001),与对照部位(中位数 16)相比。在选择性和紧急情况下,憩室基底的嗜酸性粒细胞计数仍然明显增加(两者均 P<0.001),颈部的嗜酸性粒细胞计数也明显增加(分别为 P=0.01 和<0.001)。在选择性和紧急亚组中,淋巴细胞在憩室基底与对照相比也显著增加。
结论:在切除的结肠憩室中,憩室中嗜酸性粒细胞明显且最为显著增加。虽然这些观察结果是新颖的,但嗜酸性粒细胞和慢性炎症在结肠憩室病和憩室疾病的病理生理学中的作用尚不清楚。
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