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An assessment of enteric nervous system and estroprogestinic receptors in obstructed defecation associated with rectal intussusception
Author(s) -
Bassotti Gabrio,
Villanacci Vincenzo,
Bellomi Alberto,
Fante Rossella,
Cadei Moris,
Vicenzi Luca,
Tonelli Francesco,
Nesi Gabriella,
Asteria Corrado R
Publication year - 2012
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/j.1365-2982.2011.01850.x
Subject(s) - enteric nervous system , interstitial cell of cajal , myenteric plexus , receptor , medicine , estrogen receptor , estrogen , intussusception (medical disorder) , gastroenterology , endocrinology , pathology , immunohistochemistry , surgery , cancer , breast cancer
Background The pathophysiological basis of obstructed defecation (OD) is still incompletely understood. In particular, few or no data are available concerning the enteric nervous system (ENS) in this condition. We investigated ENS abnormalities in patients with OD, undergoing surgery, together with the presence of estrogen (α and β) and progesterone receptors, and compare the results with those obtained in controls. Methods Full‐thickness rectal samples were obtained from 17 patients undergoing stapled transanal rectal resection for OD associated with rectal intussusception. Samples were analyzed by immunohistochemistry for enteric neurons, enteric glial cells, interstitial cells of Cajal (ICC), and for estrogen and progesterone receptors. Data were compared with those obtained in 10 controls. Key Results No differences between patients and controls were found for enteric neurons, whereas (compared with controls) OD patients displayed a significant decrease of enteric glial cells in both the submucous ( P = 0.0006) and the myenteric ( P < 0.0001) plexus. ICC were significantly increased in patients in the submucosal surface ( P < 0.0001) and the myenteric area ( P < 0.0001). Concerning estroprogestinic receptors, both were present on ICC in patients and controls. Estrogen receptors α and progesterone receptors were absent on enteric neurons and enteric glial cells in patients and controls, whereas estrogen receptors β were present in all controls and in 69% of patients’ enteric neurons ( P = 0.18) and in 12% of patients’ glial cells ( P = 0.0001). Conclusions & Inferences Patients with OD associated to rectal intussusception display abnormalities of the ENS and of estrogen receptors β.