• Nutrition · Feb 2020

    Interstitial cells of Cajal are diminished in critically ill patients: Autopsy cases.

    • Kentaro Shimizu, Hiroshi Ogura, Naoya Matsumoto, Mitsunori Ikeda, Hirofumi Yamamoto, Masaki Mori, Eiichi Morii, and Takeshi Shimazu.
    • Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. Electronic address: shimiken@hp-emerg.med.osaka-u.ac.jp.
    • Nutrition. 2020 Feb 1; 70: 110591.

    ObjectiveGastrointestinal dysmotility in critically ill patients is important as enteral nutrition is crucial. However, normal gut motility is impaired under conditions of critical illness subsequent to severe insult. Interstitial cells of Cajal (ICC) form an extensive network associated with the myenteric plexus in the enteric nervous system. There are few reports about ICC distribution in critically ill patients. The aim of this study was to evaluate ICC in critically ill patients.MethodsPostmortem colon harvest was obtained from critically ill patients. Control specimens were obtained from patients without bowel movement problems who underwent hemicolectomy. The tissues were stained with c-Kit for ICC. The number of ICC was identified by counting from 10 high-power fields (HPFs).ResultsSpecimens from six patients were analyzed and compared with those from six control patients. All patients had abnormalities of crypt architecture and inflammatory cell infiltrations. Mucosal thickness tended to be lower in the critically ill patients than in the controls (147 ± 47 versus 231 ± 127 μm; P = 0.15). Muscle layer thickness tended to be higher in the critically ill patients than in the controls (494 ± 163 versus 394 ± 258 μm; P = 0.44). ICC in the critically ill patients were almost depleted in the colon compared with those in the controls. Significantly fewer ICC were present in the critically ill patients than in the controls (0.45 versus 7.25 cells/HPF; P < 0.05).ConclusionsCritical illness is associated with diminished numbers of ICC in the colon. This finding could have implications for dysmotility in critically ill patients.Copyright © 2019 Elsevier Inc. All rights reserved.

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