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

Jouko J. Laurila ^1*, Tuomo Karttunen ¹, Vesa Koivukangas ¹, Päivi A. Laurila ¹, Hannu Syrjälä ¹, Juha Saarnio ¹, Ylermi Soini ¹ and Tero I. Ala-Kokko ¹

¹ Division of Intensive Care, Department of Anesthesiology (JJL,PAL,TIA-K), Surgery (VK,JS), and Infection Control (HS), Oulu University Hospital, Oulu, Finland, and Department of Pathology, Oulu University, Oulu, Finland (TK,YS)

^* To whom correspondence should be addressed. E-mail: jouko.laurila{at}pp.fimnet.fi.

Submitted on November 22, 2006
Accepted on 17 January 2007

	Abstract

There is only scanty 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 (AAC) and calculous cholecystitis (ACC). We investigated by immunohistochemistry the expression of TJ proteins claudin-1, -2, -3, and -4, occludin, ZO-1, and E-cadherin in 9 normal gallbladders, in 30 gallbladders with AAC and in 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, the expression of cytoplasmic occludin and claudin-1 were decreased compared to normal gallbladder. In ACC, the expression of claudin-2 was increased, and the expression of claudin-1, -3, and -4, occludin, and ZO-1 were decreased compared to normal gallbladder or AAC. We conclude that there are significant differences in the expression of TJ proteins in AAC and ACC supporting the idea that AAC represents a manifestation of systemic inflammatory disease, while ACC is a local inflammatory and often infectious disease.

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

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