Pathogenesis of congenital adhesions: cytokines and human β-defensin 2
Intestinal malrotation is a failure of the bowel to attain the correct position during 5th to 10th week of embryogenesis that results in fixation of caecum to the upper part on the right side of abdominal wall with congenital peritoneal adhesions also known as Ladd’s bands. There are several factors speculated to have an impact on formation of the congenital adhesions, including intrauterine mesothelial trauma due to ischemia or an infectious agent. Therefore, the aim was to research expression of local pro- and anti-inflammatory factors, ischemia related factors and antimicrobial peptides in the tissue of congenital adhesions.
Biopsy samples of congenital peritoneal adhesions from 20 neonates that were 0 to 4 days old were gathered from the collection of Institute of Anatomy and Anthropology of Riga Stradins University. All biopsy samples were obtained during a primary laparotomy due to obstructive gut malrotation. Tissue samples were stained with hematoxylin and eosin, as well as immunohistochemical staining with antibodies to VEGF, IL-1, IL-6, IL-10 and human β-defensin 2 was also performed.
Relatively increased quantity of IL-10, IL-6 and human β-defensin 2 was discovered, that suggests an activation of an anti-inflammatory response, possibly due to an intrauterine infection. Additionally, a relatively increased amount of IL-10 and IL-6 positive macrophages and fibroblasts suggests that a persistant inflammation triggered development of fibrous tissue. Increased quantity of human β-defensin 2 positive and decreased quantity of VEGF positive endothelial cell suggests that angiogenesis was mediated by β-defensin 2 independentaly from VEGF pathway.