TY - JOUR
T1 - Composition of the cellular infiltrate in patients with simple and complex appendicitis
AU - Gorter, Ramon R.
AU - Wassenaar, Emma C.E.
AU - de Boer, Onno J.
AU - Bakx, Roel
AU - Roelofs, Joris J.T.H.
AU - Bunders, Madeleine J.
AU - van Heurn, L. W.Ernst
AU - Heij, Hugo A.
PY - 2017/6/15
Y1 - 2017/6/15
N2 - Background It is now well established that there are two types of appendicitis: simple (nonperforating) and complex (perforating). This study evaluates differences in the composition of the immune cellular infiltrate in children with simple and complex appendicitis. Materials and methods A total of 47 consecutive children undergoing appendectomy for acute appendicitis between January 2011 and December 2012 were included. Intraoperative criteria were used to identify patients with either simple or complex appendicitis and were confirmed histopathologically. Immune histochemical techniques were used to identify immune cell markers in the appendiceal specimens. Digital imaging analysis was performed using Image J. Results In the specimens of patients with complex appendicitis, significantly more myeloperoxidase positive cells (neutrophils) (8.7% versus 1.2%, P < 0.001) were detected compared to patients with a simple appendicitis. In contrast, fewer CD8+ T cells (0.4% versus 1.3%, P = 0.016), CD20 + cells (2.9% versus 9.0%, P = 0.027), and CD21 + cells (0.2% versus 0.6%, P = 0.028) were present in tissue from patients with complex compared to simple appendicitis. Conclusions The increase in proinflammatory innate cells and decrease of adaptive cells in patients with complex appendicitis suggest potential aggravating processes in complex appendicitis. Further research into the underlying mechanisms may identify novel biomarkers to be able to differentiate simple and complex appendicitis.
AB - Background It is now well established that there are two types of appendicitis: simple (nonperforating) and complex (perforating). This study evaluates differences in the composition of the immune cellular infiltrate in children with simple and complex appendicitis. Materials and methods A total of 47 consecutive children undergoing appendectomy for acute appendicitis between January 2011 and December 2012 were included. Intraoperative criteria were used to identify patients with either simple or complex appendicitis and were confirmed histopathologically. Immune histochemical techniques were used to identify immune cell markers in the appendiceal specimens. Digital imaging analysis was performed using Image J. Results In the specimens of patients with complex appendicitis, significantly more myeloperoxidase positive cells (neutrophils) (8.7% versus 1.2%, P < 0.001) were detected compared to patients with a simple appendicitis. In contrast, fewer CD8+ T cells (0.4% versus 1.3%, P = 0.016), CD20 + cells (2.9% versus 9.0%, P = 0.027), and CD21 + cells (0.2% versus 0.6%, P = 0.028) were present in tissue from patients with complex compared to simple appendicitis. Conclusions The increase in proinflammatory innate cells and decrease of adaptive cells in patients with complex appendicitis suggest potential aggravating processes in complex appendicitis. Further research into the underlying mechanisms may identify novel biomarkers to be able to differentiate simple and complex appendicitis.
KW - Appendicitis
KW - Cellular immunity
KW - Complex appendicitis
KW - Etiology
KW - Neutrophils
UR - http://www.scopus.com/inward/record.url?scp=85017357363&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jss.2017.02.062
DO - https://doi.org/10.1016/j.jss.2017.02.062
M3 - Article
C2 - 28624043
SN - 0022-4804
VL - 214
SP - 190
EP - 196
JO - Journal of Surgical Research
JF - Journal of Surgical Research
ER -