Cross linking of collagen is increased in colonic diverticulosis.

Abstract

Development of colonic diverticulosis is a function of age and declining colonic wall mechanical strength. The latter is partly a consequence of changes in the collagen structure. Collagen from unaffected human colons (n=20, age range 20-80 years) and those with colonic diverticulosis (n=5, age range 67-80 years) were obtained at necropsy. The total collagen content was measured as the hydroxyproline content and cross linkage by collagen solubility in weak acid was studied. The colonic total collagen content was constant with age (mean (SD) 15-8 (0.3) mg/100 mg wet weight of tissue). The acid solubility of the collagen, however, increased after the age of 40 years: at over 60 years, colonic diverticulosis was associated with an increased acid solubility ratio compared with values in unaffected colons (15.3 (0.2); compared with 9.2 (0.2), p<0.OOl). The cross linking of colonic collagen increases with age. These changes seem to be a factor in the aetiology of colonic diverticulosis.

Colonic Diverticular Disease: Pathophysiology and Clinical Picture

“…The viscoelastic properties of elastin and collagen give the colonic wall its stability, strength and maintenance of the shape [15, 16, 34, 35]. Collagen has inter- and intramolecular cross-links that stabilize and give strength to the tissue where it is located, but excessive cross-linking of collagen is believed to lead to rigidity and loss of tensile strength [36]. An autopsy study by Wess et al [36] showed that – although the total amount of collagen was not elevated in diverticular colon compared to controls – differences in collagen nature with increased cross-linking were noted with increasing age and in diverticular colon, which might cause the rigidity and inflexibility of the colonic wall.…”

“…Collagen has inter- and intramolecular cross-links that stabilize and give strength to the tissue where it is located, but excessive cross-linking of collagen is believed to lead to rigidity and loss of tensile strength [36]. An autopsy study by Wess et al [36] showed that – although the total amount of collagen was not elevated in diverticular colon compared to controls – differences in collagen nature with increased cross-linking were noted with increasing age and in diverticular colon, which might cause the rigidity and inflexibility of the colonic wall. Two animal studies from the same group also suggested that fiber content in diet might determine the nature of collagen, and the development of diverticular disease [15, 16].…”

What Are the Risk Factors of Colonoscopic Perforation?

“…A possible explanation for this finding is that the elderly might have a declining colonic wall mechanical strength which is partly a consequence of changes in the collagen structure [18]. Perhaps, an increasing number of diverticular diseases in the elderly may contribute to a higher rate of CP because an endoscopist could inadvertently push a scope through a large diverticulum (see Table 1.…”

Failure to Use Ultrasound Is a Glaring Shortcoming

“…Aufgrund des Nachweises einer vermehrten Elastineinlagerung in der Längsmuskulatur [28,29,32] wird angenommen, dass es dadurch zu einer Kontraktion der Taenien mit Verkürzung des Darmrohres ("Concertina-Kolon") [29][30][31] [33,34]. In einzelnen Untersuchungen wurde gezeigt, dass der Gesamtkollagengehalt [28,32] sowie die Verknüpfung (cross-linking) der Kollagenfasern bei der Divertikelkrankheit erhöht ist [35]. Es wird vermutet, dass dadurch die Anpassungsfähigkeit des Darmrohres an die wechselnden intraluminalen Drücke herabgesetzt ist.…”