Topography and morphometric analysis of intestinal mast mucous membrane cells in children with Hirschsprung's disease

Abstract

Purpose of the study . To study the morphological and functional features of mucous membrane of the large intestine of children who underwent surgery for Hirschsprung's disease by analyzing the cellular interactionsresponsible for ensuring regenerative processes. Materials and methods. Using histochemical, immunohistochemical and morphometric research methods, the operational material of the rectum wall and sigmoid colon of 16 children aged 3 months to 7 years (9 girls, 7 boys) operated on for Hirshprung disease was studied. Formed two clinical groups: with the presence of areas of total agangliosis of the colon (n = 12) – group I and hypogangliosis (n = 4) – II group. The comparison group consisted of children with unchanged mucous membrane of the intestine, determined in the process of morphological study of colon biopsy specimens with suspected inflammatory bowel disease (IBD). In colonic mucous membrane, the quantitative, population composition and topography of mast cells were studied as forms that affect the cellular interactions of the multicomponent mucosa in the regeneration process. Results. It was shown that a high level of tryptase-producing mast cells of the muscular and submucosal layer of children of group I against the background of an increased total number of mast cell indicators combined with significant changes in the nerve trunks with complete absence of ganglia and their replacement by nerve fibers and small cells of glial elements. For children of group II, there was also a slight increase in mast cells, but with a minimal content of tryptaz-producing forms, which was combined with less pronounced degenerative changes in the nervous system. Conclusion. The determined correlation of the number of tryptase-producing mast cells with the number of nerve trunks with their inherent changes indicates the existing structural and functional connection between them and reflects the direction of the regenerative process. The absence or minimum content of tryptase-producing mast cells in connection with the nerve and muscle fibers, apparently helps to optimize the processes of regeneration in the mucous membrane of the colon with the ability to restore its function.