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Tight Junction Proteins in Gallbladder Epithelium: Different Expression in Acute Acalculous and Calculous Cholecystitis

Jouko J. Laurila, Tuomo Karttunen, Vesa Koivukangas, Päivi A. Laurila, Hannu Syrjälä, Juha Saarnio, Ylermi Soini and Tero I. Ala-Kokko

Division of Intensive Care, Department of Anesthesiology (JJL,PAL,TIA-K), Department of Surgery (VK,JS), and Department of Infection Control (HS), Oulu University Hospital, Oulu, Finland, and Department of Pathology, Oulu University, Oulu, Finland (TK,YS)

Correspondence to: Dr. Jouko Laurila, MD, Department of Anesthesiology, Oulu University Hospital, P.O. Box 21, Oulu, Finland, 90029. E-mail: jouko.laurila{at}pp.fimnet.fi

There is a paucity of information of tight junction (TJ) proteins in gallbladder epithelium, and disturbances in the structure of these proteins may play a role in the pathogenesis of acute acalculous cholecystitis (AAC) and acute calculous cholecystitis (ACC). Using immunohistochemistry, we investigated the expression of TJ proteins claudin-1, -2, -3, and -4, occludin, zonula occludens (ZO-1), and E-cadherin in 9 normal gallbladders, 30 gallbladders with AAC, and 21 gallbladders with ACC. The number of positive epithelial and endothelial cells and the intensity of the immunoreaction were determined. Membrane-bound and cytoplasmic immunoreactivities were separately assessed. We found that TJ proteins were uniformly expressed in normal gallbladder epithelium, with the exception of claudin-2, which was present in less than half of the cells. In AAC, expression of cytoplasmic occludin and claudin-1 were decreased, as compared with normal gallbladder. In ACC, expression of claudin-2 was increased, and expression of claudin-1, -3, and -4, occludin, and ZO-1 were decreased, as compared with normal gallbladder or AAC. We conclude that there are significant differences in expression of TJ proteins in AAC and ACC, supporting the idea that AAC represents a manifestation of systemic inflammatory disease, whereas ACC is a local inflammatory and often infectious disease. (J Histochem Cytochem 55:567–573, 2007)

Key Words: acalculous cholecystitis • cholecystitis • claudins • critical illness • gallbladder • occludin • tight junction

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