Synapse小胞に対するMonoclonal抗体を用いた正常ヒト腸管及び Hirschsprung病腸管壁内神経系のSynapse分布状態の検討

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The cause of constriction of the aganglionic intestine in Hirschsprung's disease still remains obscure and is controversial. An immunohistochemical approach was taken to clarify the reason of the abnormal constriction. The neuromuscular junctions and the synapses of normal (n = 4 ) and aganglionic intestines (n = 4 ) were stained with monoclonal antibody 171 B5 which is able to identify the synaptic vesicle-specific 38,000 Dalton protein. The distribution and quantity of the synaptic formations of the enteric nervous system in both the intestines of Hirschsprung's disease and the human normal intestine were obtained. Particular attention was paid to the synapses of the muscular tunicae and the nerve terminals of abnormally proliferated extrinsic nerve fibers in the aganglionic intestine. In normal intestines, many synapses which seemed to be neuromuscular junctions were identified as fluorescent spots in the muscular tunicae. They showed a regular and dense distribution that is well recognizable. A lot of synapses were seen densely gathered around the ganglion cells in the areas of the Auerbach and Meissner plexi. However, in the aganglionic intestion of Hirschsprung's disease, the synapses and the neuromuscular junctions were very coarsely distributed in the muscular tunicae and were seen as faint fluorescent spots. Some synapses were localized massively only around or near the abnormally innervated extrinsic nerve fiber bundies between the inner circular and the outer longitudinal muscle layers. Thus, the smooth muscles of the aganglionic segment seemed to be almost completely denervated. These findings indicate that the lack of the innervation of intestinal may be the main reason for intestinal constriction in Hirschsprung's disease.
日本小児外科学会の論文
1990-08-20

Synapse小胞に対するMonoclonal抗体を用いた正常ヒト腸管及び Hirschsprung病腸管壁内神経系のSynapse分布状態の検討

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