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Related Experiment Videos

Is a histologically normal appendix following emergency appendicectomy alway normal?

Y Wang1, D J Reen, P Puri

  • 1Children's Research Centre, Our Lady's Hospital for Sick Children, Dublin, Ireland.

Lancet (London, England)
|April 20, 1996
PubMed
Summary

Cytokine expression, including tumor necrosis factor alpha (TNFalpha) and interleukin-2 (IL-2) mRNA, is a sensitive indicator of appendicitis inflammation. Even histologically normal appendixes can show increased cytokine levels, suggesting inflammation.

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Area of Science:

  • Gastroenterology
  • Immunology
  • Pathology

Background:

  • Histological examination of appendixes from appendicitis patients often appears normal.
  • Cytokine expression can indicate an inflammatory response.

Purpose of the Study:

  • To examine appendix specimens for abnormal cytokine expression as a marker for appendicitis.
  • To investigate the expression of tumor necrosis factor alpha (TNFalpha) and interleukin-2 (IL-2) in appendicitis.

Main Methods:

  • In-situ hybridization was used to measure TNFalpha and IL-2 mRNA expression in appendicitis, normal appendix, and clinically diagnosed appendicitis with normal histology specimens.
  • Cytokine-specific RNA antisense probes were labeled and detected using immunohistochemical methods.
  • Sense probes served as negative controls.

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Main Results:

  • Acute appendicitis specimens showed intense TNFalpha mRNA expression in germinal centers and moderate expression in the mucosa.
  • IL-2 mRNA was strongly expressed in the lamina propria and moderately in germinal centers of appendicitis specimens.
  • Normal appendixes exhibited minimal TNFalpha and IL-2 mRNA expression, while some histologically normal appendixes from patients with clinical appendicitis showed significant cytokine expression.

Conclusions:

  • TNFalpha and IL-2 mRNA expression serves as a sensitive marker for inflammation in appendicitis.
  • A significant number of histologically normal appendixes displayed evidence of inflammation through elevated cytokine expression.