The Expression of Enteric Nerve Markers and Nerve Innervation in Total Colonic Aganglionosis

Abstract

Objective. To study differences in the expression of various nerve markers between total colonic aganglionosis (TCA) and common-segment-type Hirschsprung’s disease (HD) using immunohistochemistry. Methods. All-layer colon and ileum specimens were extracted from 18 patients diagnosed with TCA and treated at the Children’s Hospital of Fudan University between January 1996 and December 2005. The reference group consisted of 10 cases each of common-segment-type HD and anorectal malformations (ARMs). Immunohistochemical comparison was conducted on the expression levels of the enteric nerve markers protein gene product 9.5 (PGP9.5), S-100 protein, neuron-specific enolase (NSE), and peripherin. Results. There were no statistically significant differences in expression of PGP9.5, S-100 protein, NSE, and peripherin in ganglionic intestinal sections from the TCA group, HD group, or ARM group ( P > .05). A few mature and immature ganglion cells were observed in the transitional sections from the TCA group, and expression levels of the nerve markers were lower than in the HD group ( P < .01). Ganglion cells were found in the far-end intestinal section in none of the 18 cases of TCA, where thick nerve trunks were fewer and nerve marker expression levels were lower than in the HD group ( P < .01), most evidently in the cases of PGP9.5. Conclusions . The study revealed evident differences in the positive expression of nerve markers in the enteric sections when TCA and common-segment HD were compared, indicating differences in enteric nerve innervation in these conditions.