Telocytes: new insight into the pathogenesis of gallstone disease

Abstract

The major mechanisms of gallstone formation include biliary cholesterol hypersecretion, supersaturation and crystallization, mucus hypersecretion, gel formation and bile stasis. Gallbladder hypomotility seems to be a key event that triggers the precipitation of cholesterol microcrystals from supersaturated lithogenic bile. Telocytes, a new type of interstitial cells, have been recently identified in many organs, including gallbladder. Considering telocyte functions, it is presumed that these cells might be involved in the signalling processes. The purpose of this study was to correlate the quantity of telocytes in the gallbladder with the lithogenicity of bile. Gallbladder specimens were collected from 24 patients who underwent elective laparoscopic cholecystectomy for symptomatic gallstone disease. The control group consisted of 25 consecutive patients who received elective treatment for pancreatic head tumours. Telocytes were visualized in paraffin sections of gallbladders with double immunofluorescence using primary antibodies against c-Kit (anti-CD117) and anti-mast cell tryptase. Cholesterol, phospholipid and bile acid levels were measured in gallbladder bile. The number of telocytes in the gallbladder wall was significantly lower in the study group than that in the control group (3.03 ± 1.43 versus 6.34 ± 1.66 cell/field of view in the muscularis propria, P < 0.001) and correlated with a significant increase in the cholesterol saturation index. The glycocholic and taurocholic acid levels were significantly elevated in the control subjects compared with the study group. The results suggest that bile composition may play an important role in the reduction in telocytes density in the gallbladder.

Telocytes (interstitial Cajal-like cells) in human Fallopian tubes

“…Some of them probably contribute to tissue repair and regeneration (Bei et al, 2015), especially inside the liver , skin (Caefalan et al, 2012), or heart (Tao et al, 2015). In other organs, ICLCs have an important signaling function among different cell populations (Edelstein and Smythies, 2014) and they work as "pacemaker" cells, such as in gallbladder (Matyja et al, 2013),urinary bladder (Rusu et al, 2014) or exocrine pancreas (Nicolescu and Popescu, 2012). ICLCs were also described in some of the female reproductive organs, for the fi rst time in the wall of the uterus (Duquette et Obviously, the ICLCs are morphologically and functionally different from the "original" interstitial Cajal cells in gut.…”

Cholesterol gallstone disease: focusing on the role of gallbladder

“…31 Furthermore, a negative correlation between the number of ICLCs and bile CSI was discovered. 32,33 It remains unknown whether lithogenic bile also demonstrates an adverse effect on ICLCs. There is evidence that a high cholesterol diet significantly reduces the expression of c-Kit, which is important in regulating the proliferation and survival of ICLCs.…”

The functional morphology and role of cardiac telocytes in myocardium regeneration

“…In some organs, ICLCs have important signaling functions among different cell populations such as nerve cells, muscle cells, immune cells, or stem cells (Edelstein and Smythies 2014). They may function as "pacemaker" cells in organs such as the gall bladder (Matyja et al 2013), urinary bladder (Rusu et al 2014), or exocrine part of the pancreas (Nicolescu and Popescu 2012). ICLCs are also part of the cellular microenvironment of some female and male reproductive organs such as D r a f t the uterus, uterine tubes, mammary gland, placenta, or prostate.…”

“…However, this is not the case in other organs. For example, loss of telocytes in the uterine tubes (due to inflammatory diseases or endometriosis) causes tubal infertility (Dixon et al 2010;Yang et al 2015), and the loss of telocytes within the wall of the gallbladder causes hypomotility of the muscle layer and consecutive gallstone disease (Matyja et al 2013). Richter and Kostin (2015) demonstrated the decreased number of cardiac telocytes in the end-stage failing heart of patients who underwent heart transplantation.…”