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- Anan, Intissar, et al.
(författare)
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Comparison of amyloid deposits and infiltration of enteric nervous system in the upper with those in the lower gastrointestinal tract in patients with familial amyloidotic polyneuropathy.
- 2001
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Ingår i: Acta Neuropathologica. - 0001-6322 .- 1432-0533. ; 102:3, s. 227-32
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Tidskriftsartikel (refereegranskat)abstract
- Gastrointestinal (GI) complications in familial amyloidotic polyneuropathy (FAP) are invariably present during the course of the disease. The aim of this study was to investigate amyloid deposits in the myenteric plexus of the stomach and small intestine in FAP patients and compare the results with those of the colon. Six FAP patients were included in the study. The myenteric plexus and the number of macrophages (CD68) and blood vessels were immunostained and quantified by computerised image analysis. Double staining for amyloid and nerve elements was used to detect amyloid infiltration in the myenteric plexus. Amyloid was found predominantly in the walls of blood vessels, and was detected in the nerves of five FAP patients and in 18% of the examined ganglia of the myenteric plexus of the stomach. In the small intestine, 6% of examined ganglia showed amyloid deposits. In contrast, no deposits were found in the myenteric plexus of the colon. CD68-positive cells showed no difference in three parts of the GI tract. Most amyloid deposits were noted in the stomach, followed by the small intestine. There are significantly more blood vessels in the stomach and small intestine compared with the colon, and the amount of amyloid correlated with the number of blood vessels, and not with the amount of nerves and ganglia. The enteric nerve system is not a targeted organ for amyloid deposition in FAP.
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| 2. |
- Björk, Jan, et al.
(författare)
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Periampullary adenomas and adenocarcinomas in familial adenomatous polyposis : Cumulative risks and APC gene Mutations
- 2001
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Ingår i: Gastroenterology. - : Elsevier. - 0016-5085 .- 1528-0012. ; 121:5, s. 1127-1135
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Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: Patients with familial adenomatous polyposis (FAP) have a high prevalence of duodenal adenomas, and the region of the ampulla of rater is the predilection site for duodenal adenocarcinomas. This study assessed the risk of stage IV periampullary adenomas according to the Spigelman classification and periampullary adenocarcinomas in Swedish FAP patients screened by esophagogastroduodenoscopy (EGD). The genotype of patients with stage IV periampullary adenomas and periampullary adenocarcinomas was also investigated. Methods: A retrospective study of 180 patients screened by EGD in 1982-1999 was undertaken. Kaplan-Meier analysis was performed to evaluate cumulative risk. Mutation analysis was carried out in patients with periampullary adenocarcinomas diagnosed outside the screening program, in addition to patients in the screening group with stage IV periampullary adenomas and adenocarcinomas. Results: Periampullary adenoma stage IV was diagnosed in 14 patients (7.8%), with a cumulative risk of 20% at age 60 years. Periampullary adenocarcinoma was diagnosed in 5 patients (2.8%), with a cumulative risk of 10% at age 60. Three of the adenocarcinomas occurred in patients with stage IV periampullary adenomas compared with 2 in patients with less severe periampullary adenomatosis at screening (odds ratio, 31; 95% confidence interval, 4.6-215). Fifteen (88%) of the APC gene mutations were detected; 12 of these were located downstream from codon 1051 in exon 15. Conclusions: The life time risk of severe periampullary lesions in FAP patients is high, and an association between stage IV periampullary adenomas and a malignant course of the periampullary adenomatosis is strongly suggestive. Mutations downstream from codon 1051 seem to be associated with severe periampullary lesions.
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| 6. |
- Ekelund, M, et al.
(författare)
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Intestinal adaptation in atrophic rat ileum is accompanied by supersensitivity to vasoactive intestinal peptide, pituitary adenylate cyclase-activating peptide and nitric oxide
- 2001
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 1502-7708 .- 0036-5521. ; 36:3, s. 251-257
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Intestinal inactivity leads to atrophic changes and concomitant alterations in the expression of neurotransmitters in the enteric nervous system. In atrophic rat ileum neurones expressing vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase-activating peptide (PACAP) decrease in number while nitric oxide synthase (NOS) expressing neurones increase. Since little is known about functional changes accompanying intestinal atrophy the aim of the present study was to investigate relaxatory responses to VIP, PACAP-27 and nitric oxide (NO) in longitudinal smooth muscle from atrophic rat ileum. METHODS: To create a dysfunctional (atrophic) intestine, the distal 10 cm of rat ileum was surgically bypassed. In vitro experiments were carried out on longitudinal muscle strips from rat ileum having been sham-operated, one week or four weeks bypassed. RESULTS: The amplitudes of the relaxatory responses to PACAP-27, VIP and the NO-donor S-nitroso-N-acetylpenicillamine (SNAP), but not forskolin, were significantly increased in the one-week bypassed ileum. In the four-weeks bypassed ileum the VIP, PACAP-27, SNAP and forskolin evoked relaxations were of the same magnitude as those of the sham-operated. The augmented responses to both VIP and PACAP-27 could be blocked by pre-treatment with apamin while N(G)-nitro-L-arginine methyl ester (L-NAME) and tetrodotoxin were ineffective. In contrast to sham-operated and four-weeks bypassed ileum, cross-desensitization between VIP and PACAP-27 was noted after one week of bypass. CONCLUSION: Intestinal adaptation after bypassing the distal ileum of the rat includes a transient supersensitivity of the longitudinal muscle to the NO donor SNAP, VIP and PACAP-27. These augmented relaxatory responses may contribute to the hypomotility noted in inactive intestine.
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| 9. |
- Järnerot, G, et al.
(författare)
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Familial occurrence of microscopic colitis: a report on five families
- 2001
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 1502-7708 .- 0036-5521. ; 36:9, s. 959-962
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The etiology and pathogenesis of microscopic colitis is unknown. Whether genetic predisposition is of importance, as in many other gastrointestinal diseases, is unknown. Familial occurrence of collagenous colitis has earlier been reported only in two families. METHODS: Familial occurrence of microscopic colitis was searched for in a Swedish national microscopic colitis register. RESULTS: Familial occurrence of microscopic colitis was identified in five families. In all families a sister-sister relationship was found. Two sisters with collagenous colitis had been living apart in different Nordic countries for many years before developing the disease. In one pair, the smoking sister had collagenous colitis and the never smoking sister had lymphocytic colitis. CONCLUSIONS: Considering the relative rarity of microscopic colitis, these findings indicate that a genetic predisposition may be of importance.
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