title: The enteric nervous system in chagasic and idiopathic megacolon.
abstract: Chagas disease frequently causes megacolon. We investigated the enteric nervous systems in patients with chagasic megacolon compared to idiopathic megacolon and controls. Surgical specimens were obtained from 12 patients with chagasic megacolon (1 woman, 11 men, age range 41 to 72 y) and 9 patients with idiopathic megacolon (3 women, 6 men, age range 39 to 68 y), undergoing surgery for intractable constipation. A control group of 10 patients (9 women, 1 man, age range 43 to 75 y) undergoing left hemicolectomy for nonobstructing colorectal cancer was also studied. Colonic sections were investigated by conventional and immunohistochemical methods, also taking into consideration the presence of lymphocytes. Compared to controls, the 2 megacolon groups showed a decrease of enteric neurons (not due to increased apoptosis) and of enteric glial cells (all more important in chagasic patients). The interstitial cells of Cajal subtypes were decreased but not absent in megacolons, although an increase of the intramuscular subtype was found, suggesting a possible compensative mechanism. An increased amount of fibrosis was found in the smooth muscle and the myenteric plexus of chagasic patients compared to the idiopathic megacolon and the control group. A mild lymphocytic infiltration of the enteric plexuses (more evident in Chagas disease) was also found in megacolons but not in controls. Patients with chagasic megacolon display important abnormalities of several components of the enteric nervous system. Similar alterations, although of lesser severity, may be found in patients with idiopathic megacolon.
authors.affiliation: Digestive Motility Section, Dr C B Udaondo Hospital, Buenos Aires, Argentina.
authors.forename: Guido
authors.initials: G
authors.lastname: Iantorno
authors.forename: Gabrio
authors.initials: G
authors.lastname: Bassotti
authors.forename: Zulema
authors.initials: Z
authors.lastname: Kogan
authors.forename: Carlos Miguel
authors.initials: CM
authors.lastname: Lumi
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Cabanne
authors.forename: Simona
authors.initials: S
authors.lastname: Fisogni
authors.forename: Liliana Monastra
authors.initials: LM
authors.lastname: Varrica
authors.forename: Claudio R
authors.initials: CR
authors.lastname: Bilder
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Munoz
authors.forename: Barbara
authors.initials: B
authors.lastname: Liserre
authors.forename: Antonio
authors.initials: A
authors.lastname: Morelli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Villanacci
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D017209:Apoptosis; D015415:Biomarkers / Q000378:metabolism; D014355:Chagas Disease / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D003106:Colon / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008531:Megacolon / Q000378:metabolism / Q000469:parasitology / Q000473:pathology*; D008875:Middle Aged; D009197:Myenteric Plexus / Q000378:metabolism / Q000473:pathology*; D014349:Trypanosoma cruzi / Q000276:immunology / Q000302:isolation & purification
chemical_list: D015415:Biomarkers