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A Possible Association Between Interstitial Cells of Cajal and Neuronal Nitric Oxide Synthase in Infantile Hypertrophic Pyloric Stenosis (Abstract)

Christina Panteli¹, Antonios Filippopoulos¹, Eleni Vrettou², Konstantinos Kallergis¹, Athanasios Zavitsanakis¹

¹1st  Department of Paediatric Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece

²Department of Pathology, Aristotle University of Thessaloniki, Thessaloniki, Greece



Aim: Despite numerous hypotheses, the pathogenesis of infantile hypertrophic pyloric stenosis (IHPS) remains unknown. Interstitial cells of Cajal (ICC) serve as pacemakers and neurotransmission mediators along the gastrointestinal tract. Nitric oxide (NO) is the primary inhibitory nonadrenergic - noncholinergic neurotransmitter of the enteric nervous system. ICC and NO have been studied separately with regards to their possible role in the pathogenesis of IHPS. The aim of this study was to explore the association between ICC and NO in the normal pylorus and in IHPS.

Material and methods: Specimens obtained from 19 patients with IHPS and 2 control specimens were immunohistochemically stained with antibodies to c-kit and neuronal Nitric Oxide Synthase (nNOS) for ICC and NO respectively and a semiquantitative analysis was carried out.

Results: Control specimens showed strong immunopositivity for both c-kit positive ICC and nNOS. ICC were markedly reduced in IHPS, or absent. The expression of nNOS was moderately or significantly reduced in the majority of specimens in IHPS. The correlation between c-kit immunoreactivity and nNOS staining intensity was statistically significant.

Conclusions: Reduced expression of both c-kit positive ICC and nNOS may suggest an interaction between ICC and NO, either by ICC mediating inhibitory neurotransmission in the pylorus or by NO acting as a survival factor for ICC. The association between ICC and NO may have a key role in the pathogenesis of IHPS. 

Key words: pyloric stenosis, interstitial cells of cajal, nitric oxide


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