Affiliation:
1. Division of Translational Medical Sciences Nottingham Digestive Diseases Centre School of Medicine University of Nottingham Queen's Medical Centre Nottingham UK
2. National Institute for Health Research Nottingham Biomedical Research Centre Nottingham University Hospitals and University of Nottingham Queen's Medical Centre Nottingham UK
3. MRC Versus Arthritis Centre for Musculoskeletal Ageing Research School of Life Sciences University of Nottingham Queen's Medical Centre Nottingham UK
4. Divison of Surgery Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA
Abstract
AbstractBackgroundThe aim of this study was to establish features of inflammation in histologically normal gallbladders with gallstones and compare the expression of inflammatory markers in acutely and chronically inflamed gallbladders.MethodsImmunohistochemistry was performed on formalin‐fixed paraffin‐embedded gallbladders for tumor necrosis factor (TNF)‐α, interleukin (IL)‐6, IL‐2R, and substance p in three groups: Group I (n = 60) chronic cholecystitis, Group II (n = 57) acute cholecystitis and Group III (n = 45) histologically normal gallbladders with gallstones. Expression was quantified using the H‐scoring system.ResultsMedian, interquartile range expression of mucosal IL‐2R in Groups I (2.65, 0.87–7.97) and II (12.30, 6.15–25.55) was significantly increased compared with group III (0.40, 0.10–1.35, p < 0.05). Submucosal IL‐2R expression in Groups I (2.0, 1.12–4.95) and II (10.0, 5.95–14.30) was also significantly increased compared with Group III (0.50, 0.15–1.05, p < 0.05). There was no difference in the lymphoid cell IL‐6 expression between Groups I (5.95, 1.60–18.15), II (6.10, 1.1–36.15) and III (8.30, 2.60–26.35, p > 0.05). Epithelial IL‐6 expression of Group III (8.3, 2.6–26.3) was significantly increased compared with group I (0.5, 0–10.2, p < 0.05) as was epithelial TNF‐α expression in Group III (85.0, 70.50–92.0) compared with Groups I (72.50, 45.25.0–85.50, p < 0.05) and II (61.0, 30.0–92.0, p < 0.05). Lymphoid cell Substance P expression in Groups I (1.90, 1.32–2.65) and II (5.62, 2.50–20.8) was significantly increased compared with Group III (1.0,1.0–1.30, p < 0.05). Epithelial cell expression of Substance P in Group III (121.7, 94.6–167.8) was significantly increased compared with Groups I (75.7, 50.6–105.3, p < 0.05) and II (78.9, 43.5–118.5, p < 0.05).ConclusionHistologically normal gallbladders with gallstones exhibited features of inflammation on immunohistochemistry.