title: Quantitation of cellular components of the enteric nervous system in the normal human gastrointestinal tract--report on behalf of the Gastro 2009 International Working Group.
abstract: BACKGROUND
  Patients with gastrointestinal neuromuscular diseases may undergo operative procedures that yield tissue appropriate to diagnosis of underlying neuromuscular pathology. Critical to accurate diagnosis is the determination of limits of normality based on the study of control human tissues. Although robust diagnostic criteria exist for many qualitative alterations in the neuromuscular apparatus, these do not include quantitative values due to lack of adequate control data.
  
  
  OBJECTIVE
  The aim of this report was to summarize all relevant available published quantitative data for elements of the human enteric nervous system (neuronal cell bodies, glial cells, and nerve fibers) from the perspective of the practicing pathologist. Forty studies meeting inclusion criteria were systematically reviewed with data tabulated in detail and discussed in the context of methodological variations and limitations. The results reveal a lack of concordance between observations of different investigators resulting in data insufficient to produce robust normal ranges. This diversity highlights the need to standardize the way pathologists collect, process, and quantitate neuronal and glial elements in enteric neuropathologic samples, as suggested by recent international guidelines on gastrointestinal neuromuscular pathology.
authors.affiliation: Neurogastroenterology Group, Blizard Institute of Cell and Molecular Science, Barts, Queen Mary University of London, London, UK. c.h.knowles@qmul.ac.uk
authors.forename: C H
authors.initials: CH
authors.lastname: Knowles
authors.forename: B
authors.initials: B
authors.lastname: Veress
authors.forename: R P
authors.initials: RP
authors.lastname: Kapur
authors.forename: T
authors.initials: T
authors.lastname: Wedel
authors.forename: G
authors.initials: G
authors.lastname: Farrugia
authors.forename: J-M
authors.initials: JM
authors.lastname: Vanderwinden
authors.forename: K
authors.initials: K
authors.lastname: Geboes
authors.forename: V V
authors.initials: VV
authors.lastname: Smith
authors.forename: J E
authors.initials: JE
authors.lastname: Martin
authors.forename: G
authors.initials: G
authors.lastname: Lindberg
authors.forename: P J
authors.initials: PJ
authors.lastname: Milla
authors.forename: R
authors.initials: R
authors.lastname: De Giorgio
mesh_terms: D017615:Enteric Nervous System / Q000166:cytology*; D045888:Ganglion Cysts; D041981:Gastrointestinal Tract / Q000166:cytology*; D006801:Humans; D007391:International Cooperation; D009412:Nerve Fibers; D009457:Neuroglia / Q000166:cytology; D009474:Neurons / Q000166:cytology