Comparative study of collagen deposition in the colon wall of patients operated for sigmoid diverticular disease

Abstract

PURPOSE:To investigate the deposition of collagen in the colon wall of patients with sigmoid diverticulitis. METHODS:Samples of sigmoid tissue from 15 patients (disease group), seven men and eight women aged 37-77 years who underwent surgery for the treatment of diverticulitis, were selected. For the control group, specimens from five patients, three men and two women aged 19-58 years undergoing emergency surgery for sigmoid trauma were selected. These subjects had no associated diseases. The histological study of the surgical specimens was performed by staining with hematoxylin-eosin and picrosirius and using a histochemical method for collagen quantification. RESULTS:Collagen deposition in the colon wall in terms of area (F), glandular epithelium (E) and total area was significantly higher in the disease group compared to control (p=0.003, p=0.026 and p=0.010, respectively). The collagen volume fraction (F fraction) and muscle tissue (M fraction) were also significantly higher compared to control (p=0.044 and p=0.026, respectively). The muscle (M area) and volume fraction of glandular epithelium (E fraction) did not differ significantly between the two groups, (p=0.074 and p=1.000, respectively). CONCLUSION:In this study, collagen deposition in the colon wall of the patients operated for sigmoid diverticulitis was higher compared to patients without the disease.

Etiopathogenetic Mechanisms in Diverticular Disease of the Colon

“…These observations might explain the higher prevalence of distal diverticulosis in Western populations. Collagen accounts for mechanical stability of connective tissues, and is altered in patients with a history of recurrent diverticulitis, as a reaction to chronic inflammation 28, 29, 30. In diverticulosis without diverticulitis, there is evidence for higher expression of matrix metalloproteinase-1 (ubiquitously expressed interstitial collagenase) and altered connectives tissues 31, 32, 33, 34, 35.…”

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery

“…Alterations in colonic muscle properties, collagen metabolism and in the interactions of the extracellular matrix components may play a role in remodelling of the gut wall in diverticular disease [ 33 ]. Collagen deposition in the colon wall of patients operated for sigmoid diverticulitis is higher compared to patients without the disease [ 38 ]. A number of rare hereditable disorders of collagen and elastin are associated with complicated diverticular disease at an early age [ 39 , 40 ].…”

Predictors of colonic diverticulosis in non-elderly patients

“…Two major extracellular matrix components, collagen and elastin, have been found to be altered in diverticulosis. The smaller, more densely packed collagen fibrils and an overexpressed cross linking of collagen molecules with increased rigidity and a subsequent loss of tensile strength occur (20). An increase of elastic fibers confined to the longitudinal muscle layer results in the thickening of the colonic wall (21).…”