A Glimpse Towards the Vestigiality and Fate of Human Vermiform Appendix-A Histomorphometric Study

Sarkar, Aniruddha; Saha, Anubha; Roy, Sohini; Pathak, Santanu; Mandal, Shramana

doi:10.7860/jcdr/2015/11178.5581

Cited by 8 publications

(8 citation statements)

References 10 publications

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“…The second finding of this study was that appendectomy led to a significantly higher risk of sepsis in the middle aged (20-49 years) patients (aHR 1.58, 95% CI, 1.50-1.68) than in those with prior appendectomy at >65 years (aHR 1.13, 95% CI, 1.09, 1.18). In elderly individuals, the function of the appendix might be attenuated, given the length/diameter and the number of lymphoid follicles of the human vermiform appendix degenerate with age 20 . Therefore, appendectomy might be less likely to affect their immune defences.…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk of sepsis following appendectomy: a nationwide population-based cohort study

Tsou

Lin

et al. 2020

Sci Rep

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Appendectomy is a frequently performed surgical procedure; however, long-term consequences have not been fully explored. We used a nationwide population-based cohort to determine whether patients undergoing appendectomy are at an increased risk of sepsis. Overall, 252,688 patients undergoing appendectomy and 252,472 matched controls were identified from the National Health Insurance Research Database in Taiwan. A propensity score analysis was used for matching age, sex, index year and comorbidities at a ratio of 1:1. Multiple Cox regression and stratified analyses were used to estimate the adjusted hazard ratio (aHR) of developing sepsis. Patients undergoing appendectomy had a 1.29 times (aHR: 1.29; 95% confidence interval [CI], 1.26-1.33) higher risk of developing sepsis than those not undergoing. Patients aged 20-49 years had a 1.58-fold higher risk of sepsis in the appendectomy cohort (aHR; 95% CI, 1.50-1.68). Also, having undergone appendectomy, patients had a higher likelihood of sepsis, regardless of sex and with or without comorbidities. Patients with <1 year follow-up showed a 1.98-fold risk of sepsis in the appendectomy cohort. Patients with 1-4 and ≥5 years follow-up showed a 1.29 and 1.11-fold risk of sepsis, respectively. Future research is required to elucidate the possible immuno-pathological mechanisms of these associations. Sepsis is a clinical heterogeneous syndrome that is defined as a 'life-threatening organ dysfunction caused by a dysregulated host response to an infection' 1,2. Sepsis and the subsequent systemic inflammatory response can lead to multiple organ dysfunction and even death 1. It remains a clinical challenge for clinicians and researchers. Appendectomy is one of the most frequently performed emergent abdominal procedures worldwide. However, it has recently been recognised that the appendix is not just a vestigial structure of the gut, but rather is an important organ for the development and preservation of the gut immune system 3,4. The human vermiform appendix provides a continuous source of commensal flora, thereby crowding out potentially unhealthy microorganisms, restoring diversity and stability of the gut microbiome and contributing to defensive immune mechanisms over a lifetime. Thus, it is known as a 'safe house' for normal gut flora. The appendix has been significantly associated with recurrent Clostridioides difficile infection 4 and recurrence of small bowel bacterial overgrowth after antibiotics administration 5. Studies have also examined the association between antecedent removal of the appendix and the risk of various diseases such as systemic lupus erythematosus 6 , rheumatoid arthritis 7 , inflammatory bowel disease 8 and cancers 9-11. These conditions reflect the important role of the appendix in microbial ecology and intestinal mucosal immunity.

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Section: Discussionmentioning

confidence: 99%

Incidence and risk of sepsis following appendectomy: a nationwide population-based cohort study

Tsou

Lin

et al. 2020

Sci Rep

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“…The most important reason that justifies the higher incidence rate of appendicitis in children and young people is its functional role. The appendix works as a part of the immune system in the early years of life; however, it loses its function with age, especially in the middle ages (17). Therefore, it seems that appendicitis occurs mostly during the period in which the appendix plays a functional role.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological aspects of patients underwent appendectomy in Birjand, Iran, from May 2017 to 2019

et al. 2019

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Introduction: Appendectomy is one of the most performed surgeries worldwide. There are lots of factors involved in the incidence of appendicitis, and most of them vary among populations. Therefore, the present study aimed to evaluate the epidemiological aspects of appendicitis in Birjand, Iran, for the first time.Methods: This prospective study included 666 cases out of 673 acute appendicitis patients treated surgically in Imam Reza Hospital in Birjand, Iran, from May 2017 to 2019. The data were analyzed regarding gender, age groups, and season in SPSS software (version. 22) using a t-test and the Chi-square test. A p-value less than 0.05 was considered statistically significant. Results:The annual incidence of acute appendicitis in Birjand was 12.74 per 10.000 population with the mean age of 25.43±14.97 years. The highest frequency of appendectomy was observed in 11-20-year-old groups (32.1%) and then in 21-30-year-old groups (27.3%). The frequency of the appendectomy was higher in male than female (P=0.005), and the peak of the surgeries was in the summer. Moreover, the majority of the admitted patients in the summer were male (n=123), whereas the frequency of female patients in the autumn was higher than that of male (n=81). The most frequent pathological diagnosis in both genders was acute gangrenous appendicitis (i.e., 44% in female and 40% in male). Furthermore, the incidence rates of advanced stages of appendicitis, such as "acute supportive appendicitis and periappendicitis" and "acute supportive appendicitis and priappendicitis with perforation" were significantly higher in male than female (P<0.05). Conclusions:The findings of this study provide basic epidemiological information for the first time regarding appendicitis status in Birjand, Iran. Since the appendicitis was more frequent among youth and was more complicated in male, it is essential to inform these target groups about the signs and symptoms of this medical emergency.

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“…For example, the size and structure of the cecum and the presence of an appendix vermiformis is characteristic only of apes and humans . The appendix of these species is considered to be place of biofilm formation, protecting and preserving the commensal bacteria . The cecum of the Old World non‐human primates is shorter relative to the total length of the large intestine, compared to anthropoids and the baboon cecum contains a different biofilm than the human appendix .…”

Section: Discussionmentioning

confidence: 99%

“…[55][56][57] The appendix of these species is considered to be place of biofilm formation, protecting and preserving the commensal bacteria. 58,59 The cecum of the Old World non-human primates is shorter relative to the total length of the large intestine, compared to anthropoids and the baboon cecum contains a different biofilm than the human appendix. 60 Interestingly, gut proportions differ between human and other primates, including apes.…”

Section: Comparative Gut Topographymentioning

confidence: 99%

Papio spp. Colon microbiome and its link to obesity in pregnancy

Rensing

Taylor

et al. 2018

J of Medical Primatology

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A Glimpse Towards the Vestigiality and Fate of Human Vermiform Appendix-A Histomorphometric Study

Cited by 8 publications

References 10 publications

Incidence and risk of sepsis following appendectomy: a nationwide population-based cohort study

Incidence and risk of sepsis following appendectomy: a nationwide population-based cohort study

Epidemiological aspects of patients underwent appendectomy in Birjand, Iran, from May 2017 to 2019

Papio spp. Colon microbiome and its link to obesity in pregnancy

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