Article
Histamine Receptor Expression (H1R, H2R) and Allergic Comorbid Diseases Predispose for Complicated Courses of Acute Sigmoid Diverticulitis
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Authors
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Burkhard H. A. von Rahden
- Universität Würzburg, Klinik für Allg.-, Visc.-, Gef.- und Kinderchirurgie, Würzburg
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Martin Grimm
- Universität Würzburg, Klinik für Allg.-, Visc.-, Gef.- und Kinderchirurgie, Würzburg
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Matthias Jung
- Universität Würzburg, Klinik für Allg.-, Visc.-, Gef.- und Kinderchirurgie, Würzburg
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Denise Landmann
- Universität Würzburg, Klinik für Allg.-, Visc.-, Gef.- und Kinderchirurgie, Würzburg
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Stefan Kircher
- Universität Würzburg, Institut für Pathologie, Würzburg
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Maria Lazariotou
- Universität Würzburg, Klinik für Allg.-, Visc.-, Gef.- und Kinderchirurgie, Würzburg
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Christoph-Thomas Germer
- Universtitätsklinikum Würzburg, Klinik und Poliklinik für Allgemein- und Viszeralchirurgie, Würzburg
| Published: | May 20, 2011 |
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Outline
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Introduction: Comorbid diseases, especially immunosuppression and intake of steroids, are significantly associated with complicated types of sigmoid diverticulitis. We aimed to evaluate the hypothesis, that allergic comorbid diseases and expression of histamine receptors on molecular level, might predispose for complicated courses of acute diverticulitis as well.
Materials and methods: Expression of histamine and histamine receptors (H1R, H2R) were analyzed on protein level (IHC/ IF) as well as mRNA level (RT-PCR) in surgical specimen of patients with complicated and uncomplicated sigmoid diverticulitis. Results were correlated with clinical parameters.
Results: The mean number of comorbid diseases per patient was 1.76 ± 1.25. Thirty-nine of 100 patients (39%) exhibited allergic disposition (grass poll, food, drug, pets, etc.). Comorbid diseases were significantly associated with complicated diverticulitis (p = 0.027). Complicated sigmoid diverticulitis of the sigmoid colon was significantly associated with high H1R and H2R expression, in comparison to uncomplicated types (p=0.0304). Furthermore, an association of complicated diverticulitis with allergic preconditions was found (OR= 3.2; 95% confidence interval: 1.3271–7.8239, p=0.0097). IF double-labelling experiments showed a strong correlation of increased histamine expression on H1R as well as H2R expressing intestinal enterocytes (histamine/H1R, rho=0.841, p<0.0001 and Histamine/H2R, rho=0.806, p<0.0001). The results of increased H1R and H2R expression in complicated sigmoid diverticulitis were confirmed on mRNA-level (RT-PCR, p=0,009).
Conclusion: Our findings suggest that allergic predisposition is another important risk factor for complicated courses of acute sigmoid diverticulitis, and linked with histamine receptor expression. Similar to immunsuppressed patients and patients on steroids, early elective surgical resection should be considerer in patients with allergic comorbid diseases. Supportive therapies with antihistaminic drugs could be an option in addition to antibiotic standard pre-treatment.
