Immuno-histochemical features of chronic gastro-duodenitis in children with connective tissue dysplasia

摘要

Aim of the work: Better predicting the outcome of chronic gastro-duodenitis (CGD) and plan therapeutic intervention in children with connective tissue dysplasia (CTD) requires the accurate account of the pathological processes associated with CTD. Evaluations of histochemical and immune-histochemical changes in the small intestinal (SI) and stomach mucosa, particularly changes in collagen IV expression, improve the diagnostics of chronic CGD and predicting the disease outcome, providing a rationale for therapy approaches.The aim of research: to define histochemical and immuno-histochemical characteristics of stomach and duodenal mucus in children with CGD combined with CTD.Materials and methods. Stomach and SI biopsies from 63 children with CTD were examined using histological, histochemical and immune-histochemical approaches. Collagen Type IV (Ab-3) expression in each group was measured indirectly via streptavidin-peroxidase assay (Thermo Scientific), while the content of neutral glycosaminoglycanes was examined by PAS-staining.Results. Most patients without CTD have elevated PAS-reaction OR=7,0 (CI 1,14–42,971), when 87.5 % of children with CGD on a CTD background show significant decrease or absence of PAS-positive staining. The highest number of children with PAS-negative staining was identified in the groups with pronounced CTD. In children with the combined pathologies, the intensity of Collagen IV expression in BM of surface and glandular epithelium is 1.72 times (р=0.003) higher than in children without dysplasia while its spread is also 1.6 times higher (р=0.009)Conclusions. The greatest number of children having PAS-negative staining was found in a group with well manifested CTD, which reflects the changes in saliva production, the decrease in mucins and mucoids, and also changes in physicochemical properties of the mucus that lead to a true mucus dystrophy. In children having CGD combined with CTD, the Collagen IV expression in BM of surface and glandular epithelium is 1.72 times higher than in children without dysplasia, while its spread is 1.6 times higher. This indicates the damage of epithelial and endothelial BM and is one of the major causes of fibrosis development.