@article{MAKHILLRJMS202418631874,
    title = {Study of Mast Cells, Eosinophils, Nerves and Ganglion Cells in Surgically Resected Specimens of Appendices},
    journal = {Research Journal of Medical Sciences},
    volume = {18},
    number = {6},
    pages = {615-621},
    year = {2024},
    issn = {1815-9346},
    doi = {makrjms.2024.6.615.621},
    url = {https://makhillpublications.co/view-article.php?issn=1815-9346&doi=makrjms.2024.6.615.621},
    author = {S.,N. and},
    keywords = {Histologically, infiltration},
    abstract = {Appendicitis remains the most common acute surgical emergency
worldwide. Although neutrophilic infiltration is the hallmark
histopathological feature, the contribution of other immune cells, such
as mast cells and eosinophils, as well as alterations in the enteric nervous
system (ENS), are less understood. Eosinophils are typically linked to
parasitic infections, gastrointestinal inflammation, and allergic responses,
whereas mast cells function as inflammatory effector cells with key
neuro‐immune interactions. Disruption of the ENS in appendicitis may
exacerbate ischemia and motility disturbances. The present study aimed
to evaluate eosinophil and mast cell infiltration, alongside changes in ENS
components including ganglion cells and nerve fibers, in surgically
resected appendices. A prospective observational study was conducted
on 120 appendectomy specimens, including approximately 20 ± 10
controls and 80 ± 20 cases of acute appendicitis. Mast cells were
identified using toluidine blue staining, eosinophils with
hematoxylin–eosin, nerve fibers and ganglion cells with
immunohistochemistry markers (S‐100, neurofilament, and calretinin).
For each specimen, cell counts per high‐power field (HPF) were obtained
by averaging five randomly selected fields, independently evaluated by
two observers who were unaware of the specimen grouping. Statistical
analyses were performed using Student’s t‐test, Pearson correlation,
ANOVA, and multivariate regression. Patients with appendicitis had much
higher mast cell counts compared to controls (22 ± 6 vs. 5 ± 3/HPF; p <
0.001). Eosinophil counts increased slightly (8 ± 4 vs. 2 ± 2/HPF; p < 0.01).
Conversely, nerve fiber density and ganglion cell numbers reduced
significantly (3.2 ± 1.0 vs. 5.6 ± 1.2/HPF, p < 0.001; 1.1 ± 0.5 vs. 2.0 ±
0.6/HPF, p < 0.01). A negative relationship was observed between mast
cell density and ganglion cell number (r = –0.45; p < 0.01). Loss of
ganglion cells was predicted independently by mast cell density, as
revealed by regression (ß = –0.42, p < 0.001). Acute appendicitis is
associated with reduced ENS elements along with increased mast cell and
eosinophil infiltration. These findings suggest that mast cells may
contribute to ganglion cell loss, highlighting a potential neuro‐immune
interaction in the pathophysiology of appendicitis.}
    }