In Vitro Pathophysiological Studies of Hirschsprung's Disease and Allied Disorders (Hypoganglionosis and Neuronal Intestinal Dysplasia).

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To clarify the significance of peptidergic nerves in Hirschsprung's disease (aganglionosis), hypoganglionosis, and neuronal intestinal dysplasia (NID), we investigated enteric nerve responses in colonic tissues obtained from patients with these diseases.<BR>Colonic tissue specimens were obtained from 10 patients with aganglionosis, 6 patients with hypoganglionosis, and 5 patients with NID. Colon specimens from 16 patients without constipation were used as the controls.<BR>A mechanograph was used to evaluate in vitro colonic responses to electrical field stimulation (EFS) of the sympathetic and parasympathetic nerve before and after treatment with various autonomic nerve blockers and gastrointestinal hormones.<BR>1) Non-adrenergic inhibitory nerves were found to act on the normal human colon and to a lesser extent in colons with hypoganglionosis or NID, but had no effect on the enteric nerves in colons with aganglionosis. 2) Peptidergic neurotransmitters such as VIP, SP, and NT apparently act in the normal human colon, and to a lesser extent in the colons with hypoganglionosis or NID, but their effect was almost absent in aganglionosis. 3) VIP acts via neural mechanisms, while SP and NT may act both via nerves and also directly on the bowel smooth muscle.
日本大腸肛門病学会の論文