Derbeneva Darja, Pilmane Mara, Petersons Aigars
Institute of Anatomy and Anthropology, Riga Stradins University, Kronvalda Boulevard 9, Riga, LV-1010, Latvia.
Department of Paediatric Surgery, Riga Stradins University, Dzirciema street 16, Riga, LV-1007, Latvia.
BMC Pediatr. 2025 Apr 12;25(1):288. doi: 10.1186/s12887-025-05650-4.
Chronic calculous cholecystitis is the main cause of cholecystectomies in children, and 50.5% of patients with gallstones are asymptomatic at the time of diagnosis. However, the morphopathogenesis of chronic cholecystitis with cholelithiasis is unclear and may involve various genes, gene proteins, and growth factors.
Tissues were obtained from four males (aged 6-18 years) and two females (aged 15 and 14 years) during planned cholecystectomies. Five healthy gallbladder tissues were obtained from the archival postmortem tissue of children. SHH, IHH, HGF, IGF1, IGF1R, and HOXB3 were detected by immunohistochemistry and evaluated semiquantitatively. Statistical analysis was used to identify statistically significant differences and correlations between the factors.
Decreased numbers of SHH-, IHH-, and IGF1R-positive cells, along with an increased number of HOXB3-positive cells, were observed in patients. SHH-positive epitheliocytes and connective tissue cells; IHH-positive cells in all locations; IGF1R-positive epitheliocytes, endotheliocytes, and smooth muscle cells; and HOXB3-positive smooth muscle cells were significantly different among the groups. However, the strongest negative correlation was found between HOXB3-positive smooth myocytes and SHH- and IHH-positive connective tissues, and the strongest positive correlation was detected among epithelial IHH, SHH, and IGF1R, as well as between IGF1R in the epithelium and endothelium of the blood vessels.
The reduced number of cells positive for the primary endodermal proteins SHH/IHH and the decreased number of IGFR1-positive cells suggest their potential roles in the development of chronic calculous cholecystitis. Additionally, the increased number of HOXB3-positive cells under these conditions likely implies stimulated growth properties, whereas HGF and IGF1 appear to have a reduced contribution to the pathogenesis of chronic calculous cholecystitis.
慢性结石性胆囊炎是儿童胆囊切除术的主要原因,50.5%的胆结石患者在诊断时无症状。然而,慢性胆囊炎合并胆石症的形态发病机制尚不清楚,可能涉及多种基因、基因蛋白和生长因子。
在计划性胆囊切除术中从4名男性(年龄6 - 18岁)和2名女性(年龄分别为15岁和14岁)获取组织。从儿童存档的尸检组织中获取5个健康胆囊组织。通过免疫组织化学检测SHH、IHH、HGF、IGF1、IGF1R和HOXB3,并进行半定量评估。采用统计分析来确定各因素之间的统计学显著差异和相关性。
在患者中观察到SHH、IHH和IGF1R阳性细胞数量减少,同时HOXB3阳性细胞数量增加。SHH阳性上皮细胞和结缔组织细胞;所有部位的IHH阳性细胞;IGF1R阳性上皮细胞、内皮细胞和平滑肌细胞;以及HOXB3阳性平滑肌细胞在各组之间存在显著差异。然而,HOXB3阳性平滑肌细胞与SHH和IHH阳性结缔组织之间的负相关性最强,而上皮IHH、SHH和IGF1R之间以及血管上皮和内皮中的IGF1R之间的正相关性最强。
原肠胚内胚层蛋白SHH/IHH阳性细胞数量减少以及IGFR1阳性细胞数量减少表明它们在慢性结石性胆囊炎的发生发展中可能发挥作用。此外,在这些条件下HOXB3阳性细胞数量增加可能意味着生长特性受到刺激,而HGF和IGF1似乎对慢性结石性胆囊炎的发病机制贡献较小。