1 Medical Science Doctoral Program, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia.
2 Department of Pediatric Surgery, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.
3 Anaesthesia and Intensive Care Department, Elmergib University, Alkhums, Libya.
4 Department of Public Health, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.
5 Pediatric Department, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.
6 Department of Anatomical Pathology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.
7 Biomedical Science Master Program, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.
8 Department of Biochemistry, Biomolecular, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.
Research Article
GSC Biological and Pharmaceutical Sciences, 2025, 33(01), 190-195.
Article DOI: 10.30574/gscbps.2025.33.1.0393
Received on 07 September 2025; revised on 14 October 2025; accepted on 16 October 2025
Background: The most dangerous consequence of Hirschsprung's disease (HD) is Hirschsprung-associated enterocolitis (HAEC), which can have a 30% fatality rate. Due to a lack of trustworthy biomarkers, early diagnosis and prediction are still difficult. The expression of tumor necrosis factor alpha (TNF-α) was examined in this study as a potential biomarker for the development of HAEC.
Methods: From January 2024 to June 2025, a case-control study was carried out at the Dr. Saiful Anwar Hospital in Malang, Indonesia. Twelve children were recruited, five of whom had HAEC and seven of whom had HD without. Both ganglionic and aganglionic intestinal segments were subjected to histopathological investigation utilizing hematoxylin and eosin staining and immunohistochemistry evaluation of TNF-α expression. The number of positive cells per high-power field was used to quantify TNF-α expression.
Results: In the aganglionic segments of HAEC patients, TNF-α expression was substantially higher than that of HD patients (50.80 ± 8.47 vs. 25.14 ± 6.23 positive cells/field; p = 0.0127). Ganglionic segments did not significantly differ across groups (28.20 ± 5.67 vs. 21.43 ± 5.24; p = 0.0778). More severe histological grades, including neutrophil infiltration, mucosal ulceration, and widespread crypt abscesses, were seen in HAEC patients.
Conclusions: The expression of TNF-α in aganglionic segments is a trustworthy biomarker for the development of HAEC. In order to improve patient outcomes, elevated TNF-α levels may aid in early diagnosis and direct focused therapy measures.
Hirschsprung Disease; Enterocolitis; TNF-Alpha; Biomarker; Inflammation; Pediatric Surgery
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Ali Alsaeidi, Lulik Inggarwati, Mohammed Husyan Jaabh, Holipah, Wisnu Barlianto, M. Luqman Fadli, Mohammed Jamaleldeen and Happy Kurnia Permatasari. Tumor Necrosis Factor Alpha as a Predictive Biomarker for Hirschsprung-Associated Enterocolitis: A Case-Control Study. GSC Biological and Pharmaceutical Sciences, 2025, 33(1), 190-195. Article DOI: https://doi.org/10.30574/gscbps.2025.33.1.0393