Interstitial cells of Cajal, enteric nerves, and glial cells in colonic diverticular disease
Authors: C Zambelli
E Battaglia
G Bellone
L Dughera
P Mioli
G Emanuelli
A Morelli
G Bassotti
V Villanacci
S Fisogni
Journal: Journal of clinical pathology (2005)
Discipline: CLINICAL MEDICINE
Keywords: Colonic diverticular disease; Interstitial cells of Cajal; Myenteric plexus neurones; Submucosal plexus neurones; Glial cells
Affiliations: Gastroenterology and Hepatology Section, Department of Clinical and Experimental Medicine, University of Perugia, Via Enrico Dal Pozzo, Padiglione W., 06100 Perugia, Italy. 

Abstract:  Background: Colonic diverticular disease (diverticulosis) is a common disorder in Western countries. Although its pathogenesis is probably multifactorial, motor abnormalities of the large bowel are thought to play an important role. However, little is known about the basic mechanism that may underlie abnormal colon motility in diverticulosis. Aims: To investigate the interstitial cells of Cajal (the gut pacemaker cells), together with myenteric and submucosal ganglion and glial cells, in patients with diverticulosis. Patients: Full thickness colonic samples were obtained from 39 patients undergoing surgery for diverticulosis. Specimens from tumour free areas of the colon in 10 age matched subjects undergoing surgery for colorectal cancer served as controls. Methods: Interstitial cells of Cajal were assessed using anti-Kit antibodies; submucosal and myenteric plexus neurones and glial cells were assessed by means of anti-PGP 9.5 and anti-S-100 monoclonal antibodies, respectively. Results: Patients with diverticulosis had normal numbers of myenteric and submucosal plexus neurones compared with controls (p = 0.103 and p = 0.516, respectively). All subtypes of interstitial cells of Cajal were significantly (p = 0.0003) reduced compared with controls, as were glial cells (p = 0.0041). Conclusions: Interstitial cells of Cajal and glial cells are decreased in colonic diverticular disease, whereas enteric neurones appear to be normally represented. This finding might explain some of the large bowel motor abnormalities reported to occur in this condition. 

Retracted: No

PubPeer comments:
 the study was carried out according to ethical guidelines for retrospective studies using anonymized data , 
 #2 I appreciate the authoru2019s reply to this thread and others. To be sure I understand, the surgical samples described below were obtained from patients *without consent* and then the samples were anonymized and studied by the authors retrospectively following the ethical guidelines you describe in #2? Who obtained the samples? *** ![file] *** ![file] , 
 An additional point is that the study was not authorized by any IRB or ethical board. I understand that those samples whether stored can be used only upon permission of the patient or an ethical board. , 
 #3 If I correctly understand the description of Controls, these were samples of healthy tissue taken from patients for purposes unrelated to their diagnosis or treatment. The corresponding author has declined to state whether they gave prior informed consent. We are assured that this procedure met  ethical guidelines , but not whether this was determined by an independent Review Board or by the authors themselves. Is this a fair summary? , 
 #5 I think that is an accurate and helpful summary. It is disappointing that the author hasnu2019t responded after the initial response. This leaves the readers of this paper, and the many others recently flagged on PubPeer, with the impression that the full answer will not satisfy readersu2019 concerns. , 
 Images duplication in two papers by Bassotti G . ![file] , 
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 Patients Colon specimens were obtained from 39 patients (17 men, 22 women; age range, 49u201378 years) undergoing elective left hemicolectomy for diverticular disease (35 cases) or emergency surgery for acute diverticulitis with pericolic abscess (four cases) in the period January 1999 to January 2004. None of the patients had concomitant tumours, bowel obstruction, or other diseases of the colon. The studies were carried out in accordance with local ethical guidelines, following the recommendations of the Declaration of Helsinki (Edinburgh revision, 2000). Controls We used 10 specimens from age and sex matched subjects undergoing left hemicolectomy for non-obstructing colorectal cancer as controls. The control specimens were taken at least 5 cm from the resection margin in tumour free areas. Methods After removal, the surgical specimens were immediately fixed in 10% neutral buffered formalin for 24 hours, then 12 to 20 full thickness samples were taken from portions bearing diverticula and from those that were macroscopically normal. For conventional histology, 5 u00b5m thick paraffin wax embedded sections were stained with haematoxylin and eosin, periodic acid Schiff, and trichrome stain. , 
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