vasoactive-intestinal-peptide and Cecal-Diseases

Epithelial endocrine cells containing 5-hydroxytryptamine, substance P, somatostatin, enteroglucagon and vasoactive intestinal polypeptide-immunoreactivity were localized by immunocytochemistry in the mucosa of normal appendices, ileum and proximal colon, and in neurogenic appendicopathy. In neurogenic appendicopathy a large number of proliferating nerves were visualized independently of neurotransmitters by immunostaining for neuron-specific enolase. A large number of nerve fibers were shown to contain substance P-immunoreactivity and to be of intrinsic origin. Stromal endocrine cells containing 5-hydroxytryptamine, somatostatin- and possibly substance P-immunoreactivity, were observed in substantial numbers in neurogenic appendicopathy. Substance P may be involved as a neurotransmitter and/or as a paracrine/endocrine peptide in the pathogenesis of spastic contractions and abnormal peristalsis of the appendix, which are characteristic of neurogenic appendicopathy. Stromal endocrine cells may be considered to be the origin of certain carcinoids in the appendix.

Topics: Appendix; Cecal Diseases; Colon; Endocrine Glands; Glucagon-Like Peptides; Humans; Ileum; Intestinal Mucosa; Phosphopyruvate Hydratase; Serotonin; Somatostatin; Substance P; Vasoactive Intestinal Peptide

Neurogenic appendicopathy is a frequent (17.8%), non-purulent form of appendicitis. Light microscopy enabled differentiation between an intramucosal variant, a type with central neuroma and neuromuscular proliferations in the submucosa. All nerves within the gut wall were visualized independently of neurotransmitters by immunostaining for neuron-specific enolase. Proliferation of nerve fibres with substance P- and VIP-immunoreactivity was observed in the intramucosal variant and in central neuroma. Moreover, an increase was found in stromal endocrine cells with 5-hydroxy-tryptamine-, somatostatin- and substance P-immunoreactivity. These endocrine stroma cells are considered to be the site of origin of appendix carcinoids. We, therefore, suggest that appendix carcinoids originate in-frequently multicentric-foci of small endocrine cell groups localized within proliferating nerve fibres in the subepithelial stroma, independent of the epithelial layer.

Topics: Antibody Specificity; Appendix; Cecal Diseases; Glucagon; Histocytochemistry; Humans; Immune Sera; Immunochemistry; Motilin; Nerve Fibers; Neuroma; Neurotensin; Pancreatic Polypeptide; Phosphopyruvate Hydratase; Serotonin; Somatostatin; Substance P; Vasoactive Intestinal Peptide