Distribution of ınterstitial cajal cells in rat fetus esophagus in the model of experimental adriamisin esophageal atresia

Introduction and Objective: Esophageal atresia is a developmental anomaly seen once per 3000 live births. The current treatment approach is esophago-esophagostomy. In patients who underwent an esophageal atresia repair, such problems as anastomotic stricture which lead to nutritional problems and esophagus motility up to 90 % can appear in the postoperative period. These patients can suffer from dysphagia, vomiting and gastroesophageal reflux disease (GERD) depending on the motility disorder. It was determined that motility disorders of esophagus appearing following the esophageal atresia may result from primary malformation of neural structure or nerve tissue injuries during the operation. It was also argued that malformations of neural tissue may originate from branching faults of nervus vagus.Interstitial Cajal cells indicated in the gastrointestinal system act as motility regulating ?intrinsic pacemaker?. It is thought that these cells are composed of smooth muscle precursors. In a study carried out on adult patients suffering from gastrointerstinal system motility disorder with GERD, it was demonstrated that electrical activity of interstitial Cajal cells reduced in esophagus. Experimentally, esophageal atresia-tracheoesophageal fistula can be obtained in rat fetus by benefiting from the teratojenic feature of adriamycin. In this study, it was aimed at evaluating the number and distribution of interstitial Cajal cells by using the experimental adriamycin esophageal atresia in rat fetus. 4Material and Method: In this study, Wistar albino rats were used. 4 doses of adriamycin, 2 mg/kg each, were administered to pregnant rats between the 6th and 9th days of pregnancy. Fetuses were made deliver the babies with caesarian operation at the 20th day of the pregnancy. Esophagus of the fetus were dissected and viewed via microscope. At the end of dissection, fetuses were grouped into two categories: accompanied by esophageal anomaly and not accompanied by esophageal anomaly. Afterwards, tissue samples were taken from esophagus of both groups.In this study, three groups were created: control group which includes normal rat fetus which did not undergo an effect, the group consisting of rat fetus which developed esophageal atresia following adriamycin administration and the group consisting of rat fetus which did not develop esophageal atresia. Experiments continued until 7 fetuses were obtained in each group. Esophageal tissues taken from fetus were detected with 4 % paraformaldehyde. The presence of interstitial Cajal cells was examined through the immunohistochemical method (C-kit, CD117).Results: Rat fetuses esophagus tissues obtained from all groups were dyed with immunohistochemical method /C-kit, CD117) and they were compared in terms of the structure and distribution of interstitial Cajal cells. It was detected that the number and distribution of interstitial Cajal cells in the rat fetus with esophageal atresia reduced significantly when compared to the other groups (p<0.05).Conclusion: The decrease of interstitial Cajal cell intensity in the experimental esophageal atresia adriamycin rat model may cause esophageal motility problems by leading to a reduction in the relaxation response in the esophageal smooth muscle tissue. Esophageal motility disorder symptoms seen in patients who underwent esophageal atresia repair can be associated with the decrease of interstitial Cajal cell intensity.Key Words: Esophageal atresia, interstitial Cajal cells, C-kit, esophageal motility