Rumessen J J
Department of Gastroenterology, Hvidovre Hospital, Copenhagen, Denmark.
Gastroenterology. 1996 Dec;111(6):1447-55. doi: 10.1016/s0016-5085(96)70005-7.
BACKGROUND & AIMS: Submuscular interstitial cells of Cajal (ICC) are putative pacemaker cells of the colonic external muscle. Although motility disturbances and smooth muscle dysfunction are prevalent in patients with ulcerative colitis (UC), ICC have never been studied in this disease. The aim of this study was to examine the ultrastructure of submuscular ICC in UC.
Transmission electron microscopy of the colonic submuscular region was performed using specimens from 4 adult patients who had undergone resection for severe UC. The specimens were compared with similarly processed control samples.
ICC often showed multiple secondary lysosomes, large confluent lipid bodies, and disrupted aggregates of vacuolated glycogen clusters. Intermediate filaments showed margination and clumping. Intramuscular and submucosal nerve terminals were often swollen. Macrophages were frequent, often close to nerves and ICC. Muscle cells of the innermost circular layer, fibroblast-like cells, and glial cells appeared undisturbed. Other inflammatory cells were inconspicuous.
Alterations of ICC ultrastructure are present in the submuscular pacemaker region of the colon in patients with severe UC. The changes in ICC may result from primary damage or changes secondary to defective muscular function, or they may reflect neuroimmune-mediated metabolic responses. It is suggested that ICC are actively involved in the pathogenesis of motility disturbances in UC.
肌间 Cajal 间质细胞（ICC）被认为是结肠外肌的起搏细胞。尽管溃疡性结肠炎（UC）患者普遍存在运动障碍和平滑肌功能障碍，但从未对该疾病中的 ICC 进行过研究。本研究的目的是检查 UC 患者肌间 ICC 的超微结构。
使用 4 例因重症 UC 接受切除术的成年患者的标本，对结肠肌间区域进行透射电子显微镜检查。将标本与经过类似处理的对照样本进行比较。
ICC 常显示多个次级溶酶体、大的融合脂滴以及空泡化糖原簇的聚集破坏。中间丝出现边缘化和聚集。肌内和黏膜下神经末梢常肿胀。巨噬细胞常见，常靠近神经和 ICC。最内层环行肌细胞、成纤维细胞样细胞和神经胶质细胞未见异常。其他炎性细胞不明显。
重症 UC 患者结肠肌间起搏区域存在 ICC 超微结构改变。ICC 的变化可能源于原发性损伤或继发于肌肉功能缺陷的改变，也可能反映神经免疫介导的代谢反应。提示 ICC 积极参与 UC 运动障碍的发病机制。
