Histologic Changes in Diabetic Gastroparesis

Overview

Journal Gastroenterol Clin North Am

Specialty Gastroenterology

Date 2015 Feb 11

PMID 25667021

Citations 22

Authors

Gianrico Farrugia

Affiliations

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Abstract

The cellular abnormalities that lead to diabetic gastroparesis are increasingly being understood. Several key cell types are affected by diabetes, leading to gastroparesis. These changes include abnormalities in the extrinsic innervation to the stomach, loss of key neurotransmitters at the level of the enteric nervous system, smooth muscle abnormalities, loss of interstitial cells of Cajal, and changes in the macrophage population resident in the muscle wall. This article reviews the current understanding with a focus on data from human studies when available.

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References

Vanderwinden J, Rumessen J, De Laet M, Vanderhaeghen J, Schiffmann S . CD34+ cells in human intestine are fibroblasts adjacent to, but distinct from, interstitial cells of Cajal. Lab Invest. 1999; 79(1):59-65. View

Rumessen J, Thuneberg L . Interstitial cells of Cajal in human small intestine. Ultrastructural identification and organization between the main smooth muscle layers. Gastroenterology. 1991; 100(5 Pt 1):1417-31. View

Ejskjaer N, Bradley J, Edmonds M, Howard E, Purewal T, Thomas P . Novel surgical treatment and gastric pathology in diabetic gastroparesis. Diabet Med. 1999; 16(6):488-95. DOI: 10.1046/j.1464-5491.1999.00086.x. View

Forster J, Damjanov I, Lin Z, Sarosiek I, Wetzel P, McCallum R . Absence of the interstitial cells of Cajal in patients with gastroparesis and correlation with clinical findings. J Gastrointest Surg. 2004; 9(1):102-8. DOI: 10.1016/j.gassur.2004.10.001. View

Horvath V, Vittal H, Ordog T . Reduced insulin and IGF-I signaling, not hyperglycemia, underlies the diabetes-associated depletion of interstitial cells of Cajal in the murine stomach. Diabetes. 2005; 54(5):1528-33. DOI: 10.2337/diabetes.54.5.1528. View

Abell T, Bernstein R, Cutts T, Farrugia G, Forster J, Hasler W . Treatment of gastroparesis: a multidisciplinary clinical review. Neurogastroenterol Motil. 2006; 18(4):263-83. DOI: 10.1111/j.1365-2982.2006.00760.x. View

Iwasaki H, Kajimura M, Osawa S, Kanaoka S, Furuta T, Ikuma M . A deficiency of gastric interstitial cells of Cajal accompanied by decreased expression of neuronal nitric oxide synthase and substance P in patients with type 2 diabetes mellitus. J Gastroenterol. 2006; 41(11):1076-87. DOI: 10.1007/s00535-006-1909-8. View

Gangula P, Maner W, Micci M, Garfield R, Pasricha P . Diabetes induces sex-dependent changes in neuronal nitric oxide synthase dimerization and function in the rat gastric antrum. Am J Physiol Gastrointest Liver Physiol. 2007; 292(3):G725-33. PMC: 2786258. DOI: 10.1152/ajpgi.00406.2006. View

Farrugia G . Interstitial cells of Cajal in health and disease. Neurogastroenterol Motil. 2008; 20 Suppl 1:54-63. DOI: 10.1111/j.1365-2982.2008.01109.x. View

10.

Pasricha P, Pehlivanov N, Gomez G, Vittal H, Lurken M, Farrugia G . Changes in the gastric enteric nervous system and muscle: a case report on two patients with diabetic gastroparesis. BMC Gastroenterol. 2008; 8:21. PMC: 2442096. DOI: 10.1186/1471-230X-8-21. View

11.

Choi K, Gibbons S, Nguyen T, Stoltz G, Lurken M, Ordog T . Heme oxygenase-1 protects interstitial cells of Cajal from oxidative stress and reverses diabetic gastroparesis. Gastroenterology. 2008; 135(6):2055-64, 2064.e1-2. PMC: 2796242. DOI: 10.1053/j.gastro.2008.09.003. View

12.

Gomez-Pinilla P, Gibbons S, Bardsley M, Lorincz A, Pozo M, Pasricha P . Ano1 is a selective marker of interstitial cells of Cajal in the human and mouse gastrointestinal tract. Am J Physiol Gastrointest Liver Physiol. 2009; 296(6):G1370-81. PMC: 2697941. DOI: 10.1152/ajpgi.00074.2009. View

13.

Harberson J, Thomas R, Harbison S, Parkman H . Gastric neuromuscular pathology in gastroparesis: analysis of full-thickness antral biopsies. Dig Dis Sci. 2009; 55(2):359-70. DOI: 10.1007/s10620-009-1071-2. View

14.

Kashyap P, Choi K, Dutta N, Linden D, Szurszewski J, Gibbons S . Carbon monoxide reverses diabetic gastroparesis in NOD mice. Am J Physiol Gastrointest Liver Physiol. 2010; 298(6):G1013-9. PMC: 3284279. DOI: 10.1152/ajpgi.00069.2010. View

15.

Choi K, Kashyap P, Dutta N, Stoltz G, Ordog T, Shea Donohue T . CD206-positive M2 macrophages that express heme oxygenase-1 protect against diabetic gastroparesis in mice. Gastroenterology. 2010; 138(7):2399-409, 2409.e1. PMC: 2883675. DOI: 10.1053/j.gastro.2010.02.014. View

16.

Chandrasekharan B, Anitha M, Blatt R, Shahnavaz N, Kooby D, Staley C . Colonic motor dysfunction in human diabetes is associated with enteric neuronal loss and increased oxidative stress. Neurogastroenterol Motil. 2010; 23(2):131-8, e26. PMC: 3020997. DOI: 10.1111/j.1365-2982.2010.01611.x. View

17.

Kurahashi M, Zheng H, Dwyer L, Ward S, Koh S, Sanders K . A functional role for the 'fibroblast-like cells' in gastrointestinal smooth muscles. J Physiol. 2010; 589(Pt 3):697-710. PMC: 3055552. DOI: 10.1113/jphysiol.2010.201129. View

18.

Mazzone A, Bernard C, Strege P, Beyder A, Galietta L, Pasricha P . Altered expression of Ano1 variants in human diabetic gastroparesis. J Biol Chem. 2011; 286(15):13393-403. PMC: 3075685. DOI: 10.1074/jbc.M110.196089. View

19.

Grover M, Farrugia G, Lurken M, Bernard C, Faussone-Pellegrini M, Smyrk T . Cellular changes in diabetic and idiopathic gastroparesis. Gastroenterology. 2011; 140(5):1575-85.e8. PMC: 3081914. DOI: 10.1053/j.gastro.2011.01.046. View

20.

Grover M, Bernard C, Pasricha P, Lurken M, Faussone-Pellegrini M, Smyrk T . Clinical-histological associations in gastroparesis: results from the Gastroparesis Clinical Research Consortium. Neurogastroenterol Motil. 2012; 24(6):531-9, e249. PMC: 3353102. DOI: 10.1111/j.1365-2982.2012.01894.x. View