Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Appendicitis remains the most common acute surgical emergency worldwide. Although neutrophilic infiltration is the hallmark histopathological feature, the contribution of other immune cells, such as mast cells and eosinophils, as well as alterations in the enteric nervous system (ENS), are less understood. Eosinophils are typically linked to parasitic infections, gastrointestinal inflammation, and allergic responses, whereas mast cells function as inflammatory effector cells with key neuro‐immune interactions. Disruption of the ENS in appendicitis may exacerbate ischemia and motility disturbances. The present study aimed to evaluate eosinophil and mast cell infiltration, alongside changes in ENS components including ganglion cells and nerve fibers, in surgically resected appendices. A prospective observational study was conducted on 120 appendectomy specimens, including approximately 20 ± 10 controls and 80 ± 20 cases of acute appendicitis. Mast cells were identified using toluidine blue staining, eosinophils with hematoxylin–eosin, nerve fibers and ganglion cells with immunohistochemistry markers (S‐100, neurofilament, and calretinin). For each specimen, cell counts per high‐power field (HPF) were obtained by averaging five randomly selected fields, independently evaluated by two observers who were unaware of the specimen grouping. Statistical analyses were performed using Student’s t‐test, Pearson correlation, ANOVA, and multivariate regression. Patients with appendicitis had much higher mast cell counts compared to controls (22 ± 6 vs. 5 ± 3/HPF; p < 0.001). Eosinophil counts increased slightly (8 ± 4 vs. 2 ± 2/HPF; p < 0.01). Conversely, nerve fiber density and ganglion cell numbers reduced significantly (3.2 ± 1.0 vs. 5.6 ± 1.2/HPF, p < 0.001; 1.1 ± 0.5 vs. 2.0 ± 0.6/HPF, p < 0.01). A negative relationship was observed between mast cell density and ganglion cell number (r = –0.45; p < 0.01). Loss of ganglion cells was predicted independently by mast cell density, as revealed by regression (ß = –0.42, p < 0.001). Acute appendicitis is associated with reduced ENS elements along with increased mast cell and eosinophil infiltration. These findings suggest that mast cells may contribute to ganglion cell loss, highlighting a potential neuro‐immune interaction in the pathophysiology of appendicitis.
How to cite this article:
S. Eniya, N. Madhumidha and V.B. Santhakumari. Study of Mast Cells, Eosinophils, Nerves and Ganglion Cells in Surgically Resected Specimens of Appendices.
DOI: https://doi.org/10.36478/makrjms.2024.6.615.621
URL: https://www.makhillpublications.co/view-article/1815-9346/makrjms.2024.6.615.621