CDX1, SHH, IHH Gene/Gene Protein Appearance and Distribution in Neonate’s Ladd’s Band: A Pilot Study

Abstract Objectives Congenital intraabdominal adhesions are fibrous ligaments that extend from the large bowel to the abdominal wall. Ladd's band is a type of congenital intraabdominal adhesions which may develop during abnormal intestinal rotation during embryonic period and lead to small bowel obstruction. Some studies suggest that dysregulated expression of some genes (CDX1, SHH, IHH) and their proteins may be associated with development of Ladd's band. Materials and Methods Specimens of 10 patients with Ladd’s band obtained during the first adhesion removal surgery were analyzed. The material of 8 patients obtained from processus vaginalis peritonei during inguinal hernia plastic served as controls. Gene (CDX1, IHH, SHH) expression was analyzed using in situ hybridization method and their proteins—using immunohistochemistry. Semi-quantitative method was used for positive cell count. Relationships between factors were analyzed using Spearman’s rank correlation coefficient. Results CDX1 protein was detected in similar number of fibroblasts, endotheliocytes, macrophages and mesotheliocytes of patients and control groups. CDX1 gene was expressed just in some fibroblasts. SHH protein appeared in increased number of fibroblasts, endotheliocytes, macrophages and mesotheliocytes of patients. The same gene was expressed just in some fibroblasts and endotheliocytes. Also, IHH gene positive structures appeared in similar number of different cell types in patients and control groups. Some moderate correlations were detected between different SHH protein and CDX1 protein positive cells. Conclusions SHH protein seems to appear as one of the significant factors in Ladd’s band formation indicating the tissue repair and regeneration. Generally rich expression of gene protein in fibroblasts indicates possible significance for embryonic adhesion development. CDX1 and IHH gene proteins seem to be less associated with this type of adhesion pathogenesis. SHH and CDX1 gene proteins, but not the same genes are probably playing role in the Ladd’s bands formation.