Document Detail

Neuronal anomalies and normal muscle morphology at the hypomotile ileocecocolonic region of patients affected by idiopathic chronic constipation.
MedLine Citation:
PMID:  10506928     Owner:  NLM     Status:  MEDLINE    
Patients suffering from idiopathic slow-transit chronic constipation have a delayed colonic transit referable to a decrease or loss of propagating contractions. Myogenic and/or neural mechanisms have been implicated in the pathophysiology of this dysfunction and neuronal abnormalities have been described at the ascending, descending and sigmoid colon. The morphology and motile behaviour of the ileocecocolonic region, which in healthy subjects regulates cecum filling and emptying, have never been investigated in such disease. Therefore, we endoscopically ascertained whether a motility impairment was present at these junctional areas and neither spontaneous nor provoked occlusive contractions were found at the cecocolonic junction. Light and electron microscope examination of the entire colon revealed apparently normal features of neurons, smooth muscle cells and interstitial cells of Cajal, while immunohistochemistry and quantitative analysis demonstrated neuronal anomalies at the junctional areas. These anomalies consisted of low total neuron density and significantly few VIP-immunoreactive neurons at the two enteric plexuses, significantly few NOS-immunoreactive neurons at the myenteric plexus and significantly more NOS-immunoreactive neurons at the submucous plexus. These findings exclude a myopathy and demonstrate the existence of a neuropathy. In particular, the presence at the ileocecocolonic region of few VIP- and NO-producing neurons suggests that there might be a reduced VIP and NO production which may result in a compromised relaxation and/or onset of propagating contractions, slowing down bolus transit. The presence at the proximal colon of such an abnormality might explain why left colectomy and/or cecorectal anastomosis are unsuccessful in patients with this disease.
M S Faussone-Pellegrini; A Infantino; P Matini; A Masin; B Mayer; M Lise
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Histology and histopathology     Volume:  14     ISSN:  0213-3911     ISO Abbreviation:  Histol. Histopathol.     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-11-26     Completed Date:  1999-11-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8609357     Medline TA:  Histol Histopathol     Country:  SPAIN    
Other Details:
Languages:  eng     Pagination:  1119-34     Citation Subset:  IM    
Department of Human Anatomy and Histology, University of Florence, Italy.
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MeSH Terms
Chronic Disease
Colon / metabolism,  pathology*,  ultrastructure
Constipation / metabolism,  pathology*
Endoscopy, Gastrointestinal
Gastrointestinal Motility
Ileum / metabolism,  pathology*,  ultrastructure
Mathematical Computing
Middle Aged
Muscle, Smooth / metabolism,  pathology,  ultrastructure
Neurons / cytology*,  metabolism
Nitric Oxide Synthase / metabolism
Nitric Oxide Synthase Type I
Vasoactive Intestinal Peptide / metabolism
Reg. No./Substance:
37221-79-7/Vasoactive Intestinal Peptide; EC protein, human; EC Oxide Synthase; EC Oxide Synthase Type I

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