Copyright
©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Structure of the myenteric plexus in normal and diseased human ileum analyzed by X-ray virtual histology slices
Bela Veress, Niccolò Peruzzi, Marina Eckermann, Jasper Frohn, Tim Salditt, Martin Bech, Bodil Ohlsson
Bela Veress, Department of Pathology, Skåne Universiity Hospital, Malmö 205 02, Sweden
Niccolò Peruzzi, Martin Bech, Medical Radiation Physics, Department of Clinical Sciences, Lund University, Lund 221 00, Sweden
Marina Eckermann, Jasper Frohn, Tim Salditt, Institute for X-Ray Physics, University of Göttingen, Göttingen 37077, Germany
Marina Eckermann, Tim Salditt, Cluster of Excellence “Multiscale Bioimaging: from Molecular Machines to Networks of Excitable Cells” (MBExC), University of Göttingen, Göttingen 37077, Germany
Marina Eckermann, ESRF, The European Synchrotron, Grenoble 38043, France
Bodil Ohlsson, Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö S-205 02, Sweden
Author contributions: Veress B performed the histochemical and pathological analyses of the X-ray data and wrote the initial draft together with Ohlsson B; Peruzzi N, Eckermann M, and Frohn J scanned the samples; Peruzzi N analyzed the technical data; all authors planned and designed the study, contributed to intellectual analysis of the results, and approved the final version of the manuscript.
Supported by the Development Foundation of Region Skåne, No. REGSKANE-818781 and No. 2018-Projekt0024; and the Foundation Skåne University Hospital, No. 2020-0000028.
Institutional review board statement: The study was reviewed and approved by the Regional Ethics Review Board at Lund University (2009/209, Date of approval 28/04/2009; 2012/527, Date of approval 16/10/2012 and 2018/132, Date of approval 02/08/2018) and the Swedish Biobank Act.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data is available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Bodil Ohlsson, MD, PhD, Full Professor, Department of Internal Medicine, Skåne University Hospital, Lund University, 15 Jan Waldenströms Street, Malmö S-205 02, Sweden.
bodil.ohlsson@med.lu.se
Received: April 28, 2022
Peer-review started: April 28, 2022
First decision: May 11, 2022
Revised: May 18, 2022
Accepted: July 11, 2022
Article in press: July 11, 2022
Published online: August 7, 2022
Processing time: 96 Days and 16.8 Hours
ARTICLE HIGHLIGHTS
Research background
The enteric nervous system (ENS) is difficult to study because of its deep localization in the intestinal wall. The limited sections visualized by light microscopy cannot show the size of the neurons or the interconnection between different parts of the ENS or different cell types.
Research motivation
Since the ENS is difficult to examine, patients with gastrointestinal dysmotility are not properly examined, diagnosed, and treated. They can experience symptoms for several years before a proper diagnosis is established.
Research objectives
The main objective of this study was to examine whether X-ray phase-contrast tomography could improve the visualization of the ENS. We realized that the ENS could be visualized without any prior staining, and the information provided was superior to conventional light microscopy in some respects. Thus, this method should be further evaluated in future studies.
Research methods
Full-thickness biopsies from the ileum of patients with dysmotility and controls were examined using X-ray phase-contrast tomography. For comparison, the same samples were examined using immunohistochemistry. This is the first time that bowel biopsies have been examined using X-ray tomography, and the histopathology has been described in detail.
Research results
This study showed that X-ray phase-contrast tomography can be used to study the ENS in detail to describe normal and pathological cells and tissue structures. The interconnections between the cells and structures can be visualized. Some new findings could not have been observed using conventional light microscopy.
Research conclusions
Virtual sectioning by X-ray phase-contrast nanotomography provides a unique analysis of the myenteric ganglion, revealing minor pathological changes that cannot be discovered by light microscopy, to follow the relationship between various tissue components.
Research perspectives
This method needs to be further studied in larger cohorts, with scanning of whole paraffin blocks combined with different staining methods to try to improve the identification of different cell types and tissue structures. More healthy controls should be examined to obtain reference values for health and disease.
