Neurochemical coding in the small intestine of patients with Crohn's disease.
BACKGROUND
There have been conflicting results regarding the effect of Crohn's disease on the neurochemical composition of the enteric nervous system.


OBJECTIVE
To examine the effect of Crohn's disease on the neurochemical composition of enteric nerve fibres and cell bodies using whole mount preparations of human ileum.


METHODS
Whole wall ileum from seven normal subjects and nine patients with Crohn's disease was used to investigate the neurochemical composition of neurones and nerve fibres in the myenteric plexus, circular muscle, and serosa layer of ileum using immunohistochemical techniques.


RESULTS
Increased tyrosine hydroxylase, 5-hydroxytryptamine, and neuropeptide Y immunoreactivity was exclusively seen in the myenteric plexus. There was increased neurofilament immunoreactivity in the myenteric plexus and nerve fibres of the circular muscle layer, and thick bundles of immunoreactive nerve fibres in the serosa layer. Increased vasoactive intestinal polypeptide, nitric oxide synthase, and pituitary adenylate cyclase activating peptide immunoreactivity was seen in the myenteric plexus and nerve fibres of the circular muscle layer, and aggregates of inflammatory cells in the serosa layer of the afflicted segment of Crohn's ileum. In addition, there was a chaotic display of nerve fibres containing some of the neuroactive substances with a high frequency of enlarged varicosities in the myenteric ganglia and/or nerve fibres of the circular muscle layer of Crohn's ileum.


CONCLUSIONS
Results show quantitative as well as qualitative changes in the neurochemical composition of enteric nerve fibres and nerve cell bodies of Crohn's ileum. These changes and the presence of nitric oxide synthase and peptides immunoreactive inflammatory cells in the serosa layer suggest that nerve-immune interactions may have a significant role in the process of the inflammatory changes seen in Crohn's ileitis.
Belai
A
A
Department of Anatomy and Developmental Biology, University College London Medical School.
Boulos
P B
PB
Robson
T
T
Burnstock
G
G
D000328:Adult; D000368:Aged; D003424:Crohn Disease; D017615:Enteric Nervous System / Q000737:chemistry*; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007079:Ileitis; D007082:Ileum / Q000294:innervation*; D007091:Image Processing, Computer-Assisted; D008875:Middle Aged; D009478:Neuropeptide Y / Q000032:analysis; D009479:Neuropeptides / Q000032:analysis; D018377:Neurotransmitter Agents / Q000032:analysis; D019001:Nitric Oxide Synthase / Q000032:analysis; D051219:Pituitary Adenylate Cyclase-Activating Polypeptide; D012701:Serotonin / Q000032:analysis; D014446:Tyrosine 3-Monooxygenase / Q000032:analysis; D014660:Vasoactive Intestinal Peptide / Q000032:analysis
C495401:ADCYAP1 protein, human; D009478:Neuropeptide Y; D009479:Neuropeptides; D018377:Neurotransmitter Agents; D051219:Pituitary Adenylate Cyclase-Activating Polypeptide; D012701:Serotonin; D014660:Vasoactive Intestinal Peptide; D019001:Nitric Oxide Synthase; D014446:Tyrosine 3-Monooxygenase