Specific features of the adhesion process of the abdominal cavity in children with different degrees of connective tissue dysplasia

Aim. To assess adhesions of the abdominal cavity in children with varying degrees of connective tissue dysplasia (CTD) severity.

Methods. A total of 91 children with average age of 10.6 ± 1.4 years were observed from 2005 to 2019. Composed of 53 boys (58.2%) and 38 girls (41.8%). Patients were divided into two groups: group 1 (69 children without CTD) and group 2 (22 children with CTD). Clinical data and screening cards were used to diagnose DST. All patients underwent an assessment for the clinical course, a macroscopic visual assessment adhesive process severity in the abdominal cavity according to three different scales (Nair, F. Coccolini, N.I. Ayushinova). Immunohistochemistry was performed against collagen I, III, IV type, Laminin γ1, angiogenesis factors, transforming growth factor beta (TGF-β), and Fibroblast Growth Factor Receptor 1 (FGFR1). A semi-quantitative counting method was used to record the relative number of immunopositive structures. Statistical analysis was carried out by methods of variation statistics using the Chi-square test and Mann–Whitney U-tests, as well as the Spearman rank correlation method for the reliability of differences between groups.

Results. In the adhesive process visualization, the N.I. Ayushinov scale was revealed to be the most informative, showing the average score of 7 ± 0.8 points in group 2 and 14 ± 1.2 in group 1 (rs < 0.35; p < 0.05). In group 2, the adhesive material showed no (56%) or chaotic fragments (44%) of type I collagen, and the ratio of type I to type III collagen is 2.7: 5.1. In group 1, the ratio of type I to type III collagen is 5.9:1.8. The ratio of collagen IV to type I is 6.5: 2.9. Both groups have a moderate (++) amount of TGF-β. TGF-β is positive with macrophages. FGFR1 was found in the control group (++++). A positive response was seen in fibroblasts and macrophages (U = 79.00; p = 0.006). Statistically significant analyzes of vascular endothelial growth factor in compared groups (rs = 0.632, p < 0.001) had a positive correlation..

Conclusion. Thus, the study showed features of clinical course and morphological changes during the development of adhesions in the abdominal cavity in children with varying degrees of severity of CTD. Data obtained dictate the need for an individual approach in predicting adhesive disease, as well as targeted preventive care.