title: Isolation and cultivation of neuronal precursor cells from the developing human enteric nervous system as a tool for cell therapy in dysganglionosis.
abstract: BACKGROUND
  The human enteric nervous system (ENS) descends from migrating neural crest cells (NCC) and is structured into different plexuses embedded in the gastrointestinal tract wall. The development of this entity strongly depends on the supply of an appropriate support with trophic factors during organogenesis. The lack of important factors, such as glial cell line-derived neurotrophic factor, leads to severe disturbances in the ENS and, thus, to motility disorders in children. The isolation of neuronal precursor cells as well as their transplantation after expansion in vitro is therefore a hopeful new approach concerning all forms of dysganglionosis in children.
  
  
  METHODS
  We therefore established a way to isolate and expand precursor cells from the developing and postnatal human ENS. Bowel samples were obtained from human fetuses and children (from the 9th week of gestation to 5 years postnatal). Myenteric plexus was isolated by enzymatical digestion and cultivated until spheroid aggregates, the so-called neurospheres, developed. These neurospheres could be differentiated and also be transplanted after dissociation into aganglionic bowel in vitro.
  
  
  RESULTS
  Enteric neurospheres could be grown from different gestational ages, including postmortem material. Undifferentiated proliferating precursor cells were kept in culture for up to 72 days and could be differentiated in neurons and glial cells in vitro.
  
  
  CONCLUSIONS
  The first results using isolated enteric neurospheres in aganglionic bowel are quite promising and are a basis to develop an appropriate cell therapy for all kinds of dysganglionosis, especially for cases where a surgical approach is not sufficient or not even possible.
authors.affiliation: Department of Pediatric Surgery, Clinical Hospital Mannheim, University Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Rauch
authors.forename: Andrea
authors.initials: A
authors.lastname: Hänsgen
authors.forename: Cornelia
authors.initials: C
authors.lastname: Hagl
authors.forename: Stefan
authors.initials: S
authors.lastname: Holland-Cunz
authors.forename: Karl-Herbert
authors.initials: KH
authors.lastname: Schäfer
mesh_terms: D064987:Cell- and Tissue-Based Therapy / Q000379:methods*; D002478:Cells, Cultured; D002675:Child, Preschool; D017615:Enteric Nervous System / Q000166:cytology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D007231:Infant, Newborn; D007410:Intestinal Diseases / Q000601:surgery*; D007422:Intestines / Q000166:cytology / Q000294:innervation*; D009422:Nervous System Diseases / Q000601:surgery*; D011247:Pregnancy; D033581:Stem Cell Transplantation / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods*