Association between gallstone-evoked pain, inflammation and proliferation of nerves in the gallbladder: A possible explanation for clinical differences

Rene Hennig, Jiang Zanli, Tarek Osman, Irene Esposito, Tewelde Berhane, Morten Vetrhus, Karl Søndenaa, Markus W. Büchler, Helmut Friess

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Objective. To investigate whether enhanced neuroproliferation could be involved in the pathogenesis of gallstone pain. Material and methods. Gallbladders from 117 patients with gallstones and 43 controls were examined. The gallbladder samples were immunostained against the pan-neuronal marker PGP 9.5 and the number of nerves and nerve area per tissue area estimated. Results. More nerves and an increased nerve area per tissue area were found in uncomplicated symptomatic gallstone disease. In comparison, acute cholecystitis displayed a significantly (p=0.01) decreased number of nerves and nerve area per tissue area. In both categories, the gallbladder neck contained more nerves (p=0.06 and 0.04, respectively) and an increased nerve area per tissue area (p=0.034 and 0.008, respectively) than the body. Conclusions. Uncomplicated disease showed enhanced neuroproliferation, significantly more in the gallbladder neck, whereas significantly fewer nerves were observed in acute cholecystitis. Nerve growth alteration may play a role in uncomplicated gallstone pain but the pathology may be different in inflammation.

Original languageEnglish
Pages (from-to)878-884
Number of pages7
JournalScandinavian Journal of Gastroenterology
Volume42
Issue number7
DOIs
StatePublished - 2007
Externally publishedYes

Keywords

  • Cholecystitis
  • Gallstones
  • Nerve growth alteration
  • PGP 9.5
  • Pain

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