A radioanatomical study of 3rd segment terminal branches of the maxillary artery in the pterygopalatine fossa.

This study describes the clinical anatomical topography and relationship of the terminal branches of the maxillary artery to the bony wall of the maxillary sinus in the pterygopalatine fossa (PPF) to estimate the bleeding risk during surgical interventions. Using contrasted computer tomography records, (i) the route of the maxillary artery in the infratemporal fossa, (ii) the number of the arteries in the critical PPF surgery plane, (iii) the diameter of the largest artery in the area and (iv) its relation to the posterior wall of the maxillary sinus were examined. Furthermore, measurements were extended with (v) the minerality of the bony posterior wall of the maxillary sinus on bone-window images. For statistical analyses Student's t- and Fisher-test were applied. 50 patients (n = 50, 100 cases including both sides) were examined in this study. The maxillary artery reached the pterygomaxillary fissure on the lateral side of the lateral pterygoid muscle in 56% of the cases (n = 32), in 37% (n = 23) on its medial side and in 7% (n = 4) on both sides. The number of arteries at the level of the Vidian canal in the PPF varied between 1 and 4 with a median of 2. The diameter of the biggest branch was 1.2-4.7 mm, the median diameter was 1.90 mm. In 41% (n = 30) of the cases the biggest artery directly contacted the posterior wall of the maxillary sinus, and the mineral density of the posterior wall was decreased in 14.3% (n = 12) of all investigated cases. The present description and statistical analysis of the vasculature of the PPF optimizes operative planning-like clip size or the type and direction of the surgical approach-in this hidden and deep head/neck region.

Neuroimmunomodulation in the mucosa of the alimentary tract / Neuroimmun-moduláció az emésztocsatorna nyálkahártyájában.

Neuropeptides synthetised in the enteric nervous system can change the function of the immunocells and play a role in inflammatory processes. In our review the effects of inflammation on the neuropeptide content of nerves and immune cells were compared. Inflamed tissue samples (human gastritis and animal models with experimental colitis and streptozotocin-induced diabetes mellitus) were examined. The number and contacts of neuropeptide-containing nerves and immune cells were studied using immunohistochemistry, confocal laser microscopy and electronmicroscopy. In inflammation, the number of substance P, vasoactive intestinal polypeptide and neuropeptide Y nerve fibres was increased significantly in parallel with the strongly increased number of immunocompetent cells (p<0.001). In inflammatory diseases, a large number of lymphocytes and mast cells were also positive for these neuropeptides. Very close morphological relationship between substance P and neuropeptide Y immunoreactive nerve fibres and immunocells could be demonstrated only in inflamed mucosa. Some of the substance P immunoreactive immunocells were also immunoreactive for tumor necrosis factor alpha and nuclear factor kappa B in the case of inflammation. The increased number of tumor necrosis factor alpha and nuclear factor kappa B immunoreactive immune cells correlated with the increased number of substance P-containing nerve fibres. Substance P, vasoactive intestinal polypeptide and neuropeptide Y released from nerve fibres and immunocells can play a role in inflammation. Our results suggest that using substance P antagonists or vasoactive intestinal polypeptide and neuropeptide Y peptides might be a novel therapeutic concept in the management of inflammation. Orv Hetil. 2020; 161(35): 1436-1440.

[Changes of the innervation in the mucous membrane and glands of the tongue in early and late experimental diabetes mellitus]. / A nyelv nyálkahártya és mirigyek innervációjának változása korai és késoi kisérletes diabetes mellitusban.

The number of the different neuropeptides-containing nerve fibres and immunocompetent cells was changed in diabetes mellitus (DM) in different organs. In this work we investigated the effect of DM on quantitation of the nerve fibres using immunhistochemistry. After two weeks of the DM the quantitiy of the different nerve fibres increased significantly both in the mucous membrane and glands of the tongue. The number of the immunocompetent cells (lymphocytes, plasma cells, mast cells) increased as well significantly. Some of these cells showed also immunoreactivity for substance P and neuropeptide Y. A few substance P cells were in very close relation to the SP immunoreactive nerve fibres. After four weeks of DM the number of the nerve fibres was decreased compared to the 2 weeks treatment, however, the number of them was higher compared to the control. The close correlation between the nerve fibres and immune cells might play a crucial role in maintaining the homeostasis in the mucous membrane and glands of the tongue as well as in the increasing inflammation and elimination of it.

Neuropeptide analysis of oral mucosa in diabetic rats.

OBJECTIVE: Increasing evidence indicates that different neuropeptide-containing nerve elements are involved in the immune system and influence the inflammation of the gastrointestinal tract. The aim of this study was to investigate the morphological localization and distribution of the different immunoreactive (IR) nerve fibers and immunocompetent cells in the oral mucosa (e.g. tongue, gingiva) and compare the results with data received from streptozotocin (STZ)-induced diabetic rats. MATERIALS AND METHODS: The different nerve elements and immunocytes were detected by ABC immunohistochemistry. RESULTS: The IR nerve fibers were found in the tunica propria of oral mucosa with different densities. These IR nerve fibers were mainly located beneath the epithelial lining, around the blood vessels and glands, and some of them were also located in the taste buds. After 2 weeks of STZ treatment the total number of IR nerve fibers, especially the SP and neuropeptide Y (NPY) IR ones, was significantly increased (p < 0.05), as was also the number of immunocytes (lymphocytes, plasma cells, mast cells). Some of these cells also showed immunoreactivity for substance P (SP) and NPY. In several cases the SP IR nerve fibers were found in close proximity to the immunocytes. Electron microscopic investigation also revealed the close association between the IR nerve fibers and immunocompetent cells where the gap was 1 µm or even less. CONCLUSIONS: The close anatomical associations suggest communication between nerve fibers and immune cells which can be crucial for maintaining mucosal homeostasis and for ensuring an appropriate response to injury.

Neuroimmunomodulation in human autoimmune liver disease.

Bidirectional interaction between immune and nervous systems is considered an important biological process in health and disease. However, little is known about the mechanisms involved in their interaction in the human liver. This study examines the distribution of intrahepatic NPY, SP immunoreactive (IR) nerve fibers and their antomical relationship with immunocells containing tumor necrosis factor-α (TNF-α) and nuclear factor κB (NF-κB) in patients with autoimmune hepatitis. Liver specimens were obtained from control liver and autoimmune hepatitis patients. The immunoreactivity was determined by immunohisto- and immunocytochemistry and confocal laser microscopy. In hepatitis, the number of NPY-IR and SP-IR nerve fibers increased significantly. These IR nerve fibers were in very close contact with the lymphocytes. In healthy controls, no NPY-IR, SP-IR or NF-κB IR lymphocytes and only a few TNF-α positive cells, were observed. In hepatitis, some of the lymphocytes showed immunoreactivity for SP and NPY in the portal area. Fluorescent double-labeled immunostaining revealed that in these cells NPY did not colocalize with TNF-α or NF-κB. However, some of the SP fluorescence-positive immune cells exhibited immunostaining for p65 of NF-κB, where their labeling was detected in the nuclei. Under the electronmicroscope, these cells could be identified (lymphocytes, plasmacells and mast cells). The gap between the IR nerve fibers and immunocells was 1 µm or even less. Overexpression of SP in lymphocytes may amplify local inflammation, while NPY may contribute to liver homeostasis in hepatitis. Neural immunomodulation (SP antagonists and NPY) might be a novel therapeutic concept in the management of liver inflammation.

[Changes in the innervation of the taste buds in diabetic rats]. / Ízlelobimbók beidegzésének változása diabetes mellitusban patkányban.

INTRODUCTION: Abnormal sensations such as pain and impairment of taste are symptoms of approximately 10% of patients having diabetes mellitus. AIM: The aim of the study was to investigate and quantify the different neuropeptide containing nerve fibres in the vallate papilla of the diabetic rat. METHODS: Immunohistochemical methods were used to study the changes of the number of different neuropeptide containing nerve terminals located in the vallate papillae in diabetic rats. Diabetes was induced in the rats with streptozotocin. RESULTS: Two weeks after streptozotocin treatment the number of the substance P, galanin, vasoactive intestinal polypeptide and neuropeptide Y immunoreactive nerve terminals was significantly increased (p<0.05) in the tunica mucosa of the tongue. The number of the lymphocytes and mast cells was also increased significantly. Some of the immunoreactive nerve terminals were located in the lingual epithelium both intragemmally and extragemmally and were seen to comprise dense bundles in the lamina propria just beneath the epithelium. No taste cells were immunoreactive for any of the investigated peptides. Vasoactive intestinal polypeptide and neuropeptide Y immunoreactive nerve fibres were not detected in the taste buds. For weeks after streptozotocin administration the number of the substance P, calcitonin gene related peptide and galanin immunoreactive nerve terminals was decreased both intragemmally and intergemmally. In case of immediate insulin treatment, the number of the immunoreactive nerve terminals was similar to that of the controls, however, insulin treatment given 1 week later to diabetic rats produced a decreased number of nerve fibers. Morphometry revealed no significant difference in papilla size between the control and diabetic groups, but there were fewer taste buds (per papilla). CONCLUSIONS: Increased number of immunoreactive nerve terminals and mast cells 2 weeks after the development of diabetes was the consequence of neurogenic inflammation which might cause vasoconstriction and lesions of the oral mucosa. Taste impairment, which developed 4 weeks after streptozotocin treatment could be caused by neuropathic defects and degeneration or morphological changes in the taste buds and nerve fibres.

Colocalization of substance P with tumor necrosis factor-α in the lymphocytes and mast cells in gastritis in experimental rats.

OBJECTIVE: Substance P (SP) elicits numerous potent neuroimmunomodulatory effects, increasing the release of tumor necrosis factor alpha (TNF-α). The study aimed to investigate immunoneural communication in experimentally-induced gastritis in rats. METHODS: SP-containing nerve fibers and lymphocytes and mast cells were counted in the mucosa of the stomachs of rats using double immunohistochemical and confocal laser microscopic methods, proving colocalization of SP and TNF-α in the lymphocytes and mast cells. RESULTS: In controls, only the nerve fibers showed SP immunoreactivity (IR). However, in gastritis the number of SP-IR fibers and TNF-α IR lymphocytes and mast cells increased significantly (P < 0.001); SP-IR fibers were seen in close contact with lymphocytes and mast cells. Numerous lymphocytes (13.1%) and mast cells (10.8%) showed IR for both SP and TNF-α (colocalization) within the same cells. CONCLUSION: SP release from nerve fibers, lymphocytes and mast cells together with TNF-α can enhance the development of gastric inflammation and participate in tissue damage in gastritis.

Distribution and possible origin of neuropeptide-containing nerve elements in the mammalian liver.

The intrahepatic distribution of nerve fibres is highly species dependent, therefore we searched for a species where the innervation pattern is similar to that of the human liver. Livers of rats, cats, guinea pigs and humans were used. The different nerve elements were identified by ABC immunohistochemistry and analysed semiquantitatively. Large numbers of neuropeptide Y (NPY) and dopamine-beta-hydroxylase immunoreactive (IR) nerve fibres were observed in the human and guinea pig liver, and they were in close contact with portal triads, central veins and ran parallel with liver sinuses. A few substance P, somatostatin and vasoactive intestinal polypeptide IR nerve fibres were also detected intralobularly, while galanin nerve fibres were only observed around portal triads. In the rat liver only a few NPY-positive nerve fibres were found, exclusively in portal tracts. Some nerve cell bodies (IR for NPY and somatostatin) were also found in the liver of guinea pigs, young cats and humans, therefore some of the nerve terminals might originate from these intrinsic ganglia. It can be concluded that the innervation pattern of the guinea pig liver shows the highest similarity to that of the human liver.

Correlation and immunolocalization of substance P nerve fibers and activated immune cells in human chronic gastritis.

UNLABELLED: Neuropeptides are able to modulate cytokine production by macrophages in response to various stimulators and have a major role in inflammation of different organs. Mammalian poly (ADP-ribose) polymerase (PARP) and nuclear factor kappa B (NF-kappaB) both have been suggested to play a crucial role in inflammatory disorders. Unregulated increase of tumor necrosis factor-alpha (TNF-alpha) may also be pathogenic in inflammatory diseases. The aim of this study was to investigate the correlation between the number of Substance P (SP) containing nerve fibers and activated immune cells using immunohisto-, immunocytochemical (EM) and confocal laser microscopic methods. To investigate expression and activation of immune cells gastric biopsy samples from patients with chronic gastritis were used. The number of SP containing nerve fibers and activated immune cells increased significantly in gastritis. Using monoclonal p65 antibody, activated NF-kappaB was found in inflamed mucosa but was absent in uninflamed mucosa. Immunobinding for the activated form of p65 of NF-kappaB was found in 22% of macrophages and 45% of lymphocytes. The number of immune cells showing IR for NF-kappaB, PARP and TNF-alpha correlated with the increasing number of SP containing fibres. Confocal laser microscopy was used to confirm the colocalization of SP in TNF-alpha and NFkappaB positive lymphocytes and mast cells in inflamed mucosa. Immunoelectronmicroscopic investigation confirmed that these cells belong to lymphocytes, mast cells and macrophages. CONCLUSIONS: The increase of SP in nerve fibers and in activated immune cells further activate the production of other proinflammatory mediators (e.g. TNF-alpha) and therefore generate the chronic inflammation.