Enteric nerves and interstitial cells of Cajal are altered in patients with slow-transit constipation and megacolon.

Abstract:

BACKGROUND & AIMS:A variety of gastrointestinal motility disorders have been attributed to alterations of interstitial cells of Cajal and malformations of the enteric nervous system. This study evaluates both the distribution of interstitial cells of Cajal and the pathohistology of the enteric nervous system in 2 severe human colorectal motility disorders. METHODS:Colonic specimens obtained from patients with slow-transit constipation (n = 11), patients with megacolon (n = 6), and a control group (n = 13, nonobstructing neoplasia) were stained with antibodies against c-kit (marker for interstitial cells of Cajal) and protein gene product 9.5 (neuronal marker). The morphometric analysis of interstitial cells of Cajal included the separate registration of the number and process length within the different regions of the muscularis propria. The structural architecture of the enteric nervous system was assessed on microdissected whole-mount preparations. RESULTS:In patients with slow-transit constipation, the number of interstitial cells of Cajal was significantly decreased in all layers except the outer longitudinal muscle layer. The myenteric plexus showed a reduced ganglionic density and size (moderate hypoganglionosis) compared with the control group. Patients with megacolon were characterized by a substantial decrease in both the number and the process length of interstitial cells of Cajal. The myenteric plexus exhibited either complete aganglionosis or severe hypoganglionosis. CONCLUSIONS:The enteric nervous system and interstitial cells of Cajal are altered concomitantly in slow-transit constipation and megacolon and may play a crucial role in the pathophysiology of colorectal motility disorders.

journal_name

Gastroenterology

journal_title

Gastroenterology

authors

Wedel T,Spiegler J,Soellner S,Roblick UJ,Schiedeck TH,Bruch HP,Krammer HJ

doi

10.1053/gast.2002.36600

keywords:

subject

Has Abstract

pub_date

2002-11-01 00:00:00

pages

1459-67

issue

5

eissn

0016-5085

issn

1528-0012

pii

S0016508502002792

journal_volume

123

pub_type

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