Enterochromaffin Cells and Mast Cells in Acute AppendicitisFunding None.
Background and Objective Serotonin levels are increased in acute appendicitis. We investigated the possible source of this increase. The aim of this study was to compare the distribution and density of epithelial and nonepithelial enterochromaffin (EC) cells as well as numbers of degranulated and nondegranulated mast cells in different layers of normal appendices and acute appendicitis.
Methods Sections from 15 cases of acute appendicitis and 10 cases where the appendix was morphologically normal were stained with Hematoxylin & Eosin, Toluidine blue, and immunohistochemically for chromogranin and CD-117. EC cells stained by chromogranin were counted per crypt and extraepithelial EC cells counted and expressed as cells per unit area (mm2). Mast cells stained by Toluidine blue and CD-117 were counted in lamina propria, submucosa, and muscle layers. The difference between Toluidine blue and CD117 stained mast cells was taken to be an estimate of degranulated cells. The cell counts were expressed per unit area (mm2) as well as per cross-sectional area of the appendix.
Results There was no statistically significant difference in epithelial and extraepithelial EC cells between acute appendicitis and normal appendix. Estimated mast cell degranulation as indicated by mast cell counts per cross-sectional area is greatly increased in acute appendicitis when compared with normal.
Conclusion Degranulated mast cells rather than EC cells may be the main source of raised serotonin in acute appendicitis.
01 September 2020 (online)
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- 1 Bosak Versic A, Glavan N, Bukvic N, Tomasic Z, Nikolic H. Does elevated urinary 5-hydroxyindole acetic acid level predict acute appendicitis in children?. Emerg Med J 2016; 33 (12) 848-852
- 2 Rørdam P, Mortensen P, Hindberg I, Christiansen J. Acute appendicitis and plasma concentration of serotonin. Acta Chir Scand 1987; 153 (7-8) 437-439
- 3 Aravindan KP. Eosinophils in acute appendicitis: possible significance. Indian J Pathol Microbiol 1997; 40 (04) 491-498
- 4 Santosh G, Aravindan KP. Evidence for eosinophil degranulation in acute appendicitis. Indian J Pathol Microbiol 2008; 51 (02) 172-174
- 5 Mentes O, Eryilmaz M, Harlak A. et al. The importance of urine 5-hydroxyindoleacetic acid levels in the early diagnosis of acute appendicitis. Am J Emerg Med 2009; 27 (04) 409-412
- 6 Bolandparvaz S, Vasei M, Owji AA. et al. Urinary 5-hydroxy indole acetic acid as a test for early diagnosis of acute appendicitis. Clin Biochem 2004; 37 (11) 985-989
- 7 Kalra U, Chitkara N, Dadoo RC, Singh GP, Gulati P, Narula S. Evaluation of plasma serotonin concentration in acute appendicitis. Indian J Gastroenterol 1997; 16 (01) 18-19
- 8 Oruc MT, Kulah B, Ozozan O. et al. The value of 5-hydroxy indole acetic acid measurement in spot urine in diagnosis of acute appendicitis. East Afr Med J 2004; 81 (01) 40-41
- 9 Vasei M, Zakeri Z, Azarpira N, Hosseini SV, Solaymani-Dodaran M. Serotonin content of normal and inflamed appendix: a possible role of serotonin in acute appendicitis. APMIS 2008; 116 (11) 947-952
- 10 Kushnir-Sukhov NM, Brown JM, Wu Y, Kirshenbaum A, Metcalfe DD. Human mast cells are capable of serotonin synthesis and release. J Allergy Clin Immunol 2007; 119 (02) 498-499
- 11 Singh UR, Malhotra A, Bhatia A. Eosinophils, mast cells, nerves and ganglion cells in appendicitis. Indian J Surg 2008; 70 (05) 231-234
- 12 Mysorekar VV, Chanda S, Dandeka CP. Mast cells in surgically resected appendices. Indian J Pathol Microbiol 2006; 49 (02) 229-233
- 13 Boehme SA, Lio FM, Sikora L. et al. Cutting edge: serotonin is a chemotactic factor for eosinophils and functions additively with eotaxin. J Immunol 2004; 173 (06) 3599-3603
- 14 Naik R, Gowda RJ, Pai MR. Mast cell count in surgically resected appendices. J Indian Med Assoc 1997; 95 (11) 571-572
- 15 Coşkun N, Indel SM, Elpek GO. Mast cell density and neuronal hypertrophy in patients with acute appendicitis. Turk J Gastroenterol 2003; 14 (01) 54-58