Immunohistochemical study of the sympathetic innervation of the colon in chronic slow-transit constipation

Abstract

The purpose of this study is to determine the distribution and features of sympathetic innervation of the tissues of the human colon wall in chronic slow-transit constipation using immunohistochemical methods. Materials and methods. Immunohistochemical study of large intestine segments (colon and sigmoid colon) obtained as a result of surgical treatment of patients with chronic slow-transit constipation was carried out using neural markers (PGP 9.5 protein, tyrosine hydroxylase, synaptophysin). Results. It has been shown that the majority of postganglionic sympathetic nerve fibers are localized in the Auerbach and Meissner plexuses. Their terminal axons form pericellular synaptic apparatuses around cholinergic neurons. Another part of the sympathetic fibers is involved in the innervation of the muscular plate of the mucous membrane and the walls of the venous vessels of the submucosa; their terminal varicose axons can be seen on smooth muscle cells as distant synapses en passant. Significant features of sympathetic innervation disorders of the large intestine of the studied patients were established; morphological evidence for the reactive, dystrophic and degenerative changes in the sympathetic apparatuses in the ganglionic plexuses were found. The regularities of the absence of sympathetic innervation in two muscle layers (longitudinal and circular), as well as in the mucous membrane, were revealed. Sympathetic neurons were not found in the studied sections of the large intestine. Conclusion. It is assumed that the identified pathological changes in sympathetic innervation in chronic slow-transit constipation can serve as one of the main causes of disruption of normal bowel functions.