Prevalence of Alpha-1 Adrenergic Receptor in Haemorrhoidal Tissue - Abstract
This study is a pilot study to identify the presence of Alpha-1 Adrenergic receptor in hemorrhoidal tissue and to analyze the association between the presence of Alpha-1 Adrenergic receptor and the clinical effect of taking micronised flavonoid.
Method: Immunofluorescence method was performed on hemorrhoidal tissue taken from patient with second to fourth degree hemorrhoid from 1 June 2012 to 30 November 2013. The primary outcome was identification of the presence of Alpha-1 Adrenergic receptor in hemorrhoidal tissue and secondary outcome to clinical improvement of symptoms with usage of micronized flavonoid.
Result: Total number of 34 patients was recruited. There were 18(52.9%) Malay, 14(41.2%) Chinese and 2(5.9%) others. 15(44.1%) were male and 19(55.9%) were female patients. 4(11.8%) were second degree disease, 14(14.2%) were third degree disease and 16(47.1%) were fourth degree disease. 15(44.1%) did not took micronized flavonoid within 6 months prior to inclusion and 19(55.9%) took micronized flavonoid before. Immunofluorescence study showed 26(76.5%) samples contained Alpha-1 Adrenergic receptor and 8(23.5%) did not. Two (5.9%) of the receptors produced signal strength at 1+, 12(35.3%) at 2+, another 12(35.5%) at 3+. Of those patients who used micronised flavonoid within 6 months of surgery, there was no correlation between presence of Alpha-1 Adrenergic receptors and subjective clinical improvement of symptoms (Pearson Chi-Square Test = 0.656).
Conclusion: Alpha-1 Adrenergic Receptor is detected in hemorrhoidal tissue in majority of the patients. However there was no correlation between presence of the receptor and subjective clinical improvement of symptoms with usage of micronized flavonoid. This may suggest that micronized flavonoid does help in relieving symptoms even in absence of the receptors. A larger sample in the future would be useful to see the quantitative analysis of clinical improvement with micronised flavonoid in the presence of Alpha-1 Adrenergic receptors.