Absence of NADPH-diaphorase activity in internal anal sphincter (IAS) achalasia.
We studied the internal anal sphincter (IAS) muscle from 10 patients with achalasia and five normal controls using histochemical staining for NADPH-diaphorase and acetylcholinesterase (AChE). Normal control IAS muscle contained occasional AChE-positive nerve fibers, whereas IAS achalasia specimens demonstrated prominent AChE-positive nerve fibers in muscle layers. NADPH-diaphorase activity was strongly expressed in nerves in the normal IAS muscle but was absent or scanty in the muscle of patients with IAS achalasia. Our findings of increased AChE-positive nerves and the absence of NADPH-diaphorase activity taken in conjunction with reports of abnormal peptidergic innervation indicate that complex neural abnormalities occur in IAS achalasia. The primary event remains obscure, but it is possible that a single defect, such as nitrergic nerve depletion, may lead to compensatory changes in the other nerve fibers.
Hirakawa
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Children's Research Centre, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland.
Kobayashi
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O'Briain
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DS
Puri
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P
D000110:Acetylcholinesterase / Q000032:analysis; D001003:Anal Canal / Q000294:innervation; D001004:Anus Diseases / Q000201:enzymology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D007223:Infant; D008297:Male; D009130:Muscle, Smooth / Q000201:enzymology / Q000294:innervation; D009252:NADPH Dehydrogenase / Q000032:analysis / Q000172:deficiency*; D009412:Nerve Fibers / Q000201:enzymology; D012018:Reflex; D013194:Staining and Labeling
D009252:NADPH Dehydrogenase; D000110:Acetylcholinesterase