Literature DB >> 15479676

Deranged smooth muscle alpha-actin as a biomarker of intestinal pseudo-obstruction: a controlled multinational case series.

C H Knowles1, D B A Silk, A Darzi, B Veress, R Feakins, A H Raimundo, T Crompton, E C Browning, G Lindberg, J E Martin.   

Abstract

BACKGROUND AND AIMS: Chronic idiopathic intestinal pseudo-obstruction (CIIP) is a severe motility disorder associated with significant morbidity. Several histopathological (neuropathic and myopathic) phenotypes have been described but only a single adult with jejunal smooth (circular) muscle alpha-actin deficiency. We present a prospective multinational case series investigating smooth muscle alpha-actin deficiency as a biomarker of this disease.
METHODS: A total of 115 fully clinically and physiologically (including prolonged (24 hour) ambulatory jejunal manometry) characterised CIIP patients from three European centres were studied. Immunohistochemical localisation of actins and other cytoskeletal proteins were performed on laparoscopic full thickness jejunal biopsies and compared with adult controls. Distribution of alpha-actin was also characterised in other gut regions and in the developing human alimentary tract.
RESULTS: Twenty eight of 115 (24%) CIIP patient biopsies had absent (n = 22) or partial (n = 6) jejunal smooth muscle alpha-actin immunostaining in the circular muscle layer. In contrast, smooth muscle alpha-actin staining was preserved in the longitudinal muscle and in adult jejunal controls (n = 20). Comparative study of other adult alimentary tract regions and fetal small intestine, suggested significant spatial and temporal variations in smooth muscle alpha-actin expression.
CONCLUSIONS: The ability to modulate alpha-smooth muscle actin expression, evident in development, is maintained in adult life and may be influenced by disease, rendering it a valuable biomarker even in the absence of other structural abnormalities.

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Year:  2004        PMID: 15479676      PMCID: PMC1774262          DOI: 10.1136/gut.2003.037275

Source DB:  PubMed          Journal:  Gut        ISSN: 0017-5749            Impact factor:   23.059


  38 in total

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Authors:  V V Smith; P J Milla
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Review 2.  Molecular analysis of gastrointestinal smooth muscle development.

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Review 3.  Diagnosis and treatment of chronic intestinal pseudo-obstruction in children: report of consensus workshop.

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4.  Altered expression of alpha-smooth muscle isoactin in Hirschsprung's disease.

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5.  Laparoscopic technique for small bowel biopsy.

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  25 in total

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Review 7.  Small Bowel Dysmotility, Pseudoobstruction, and Functional Correlation with Histopathology: Lessons Learned.

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Review 8.  Beyond hematoxylin and eosin: the importance of immunohistochemical techniques for evaluating surgically resected constipated patients.

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Review 10.  New techniques in the tissue diagnosis of gastrointestinal neuromuscular diseases.

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