Hennig R, Zanli J, Osman T, Esposito I, Berhane T, Vetrhus M, Søndenaa K, Büchler MW, Friess H. Association between gallstone-evoked pain, inflammation and proliferation of nerves in the gallbladder: a possible explanation for clinical differences.
Scand J Gastroenterol 2007;
42:878-84. [PMID:
17558913 DOI:
10.1080/00365520701207074]
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Abstract
OBJECTIVE
To investigate whether enhanced neuroproliferation could be involved in the pathogenesis of gallstone pain.
MATERIAL AND METHODS
Gallbladders from 117 patients with gallstones and 43 controls were examined. The gallbladder samples were immunostained against the pan-neuronal marker PGP 9.5 and the number of nerves and nerve area per tissue area estimated.
RESULTS
More nerves and an increased nerve area per tissue area were found in uncomplicated symptomatic gallstone disease. In comparison, acute cholecystitis displayed a significantly (p=0.01) decreased number of nerves and nerve area per tissue area. In both categories, the gallbladder neck contained more nerves (p=0.06 and 0.04, respectively) and an increased nerve area per tissue area (p=0.034 and 0.008, respectively) than the body.
CONCLUSIONS
Uncomplicated disease showed enhanced neuroproliferation, significantly more in the gallbladder neck, whereas significantly fewer nerves were observed in acute cholecystitis. Nerve growth alteration may play a role in uncomplicated gallstone pain but the pathology may be different in inflammation.
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