, Volume 462, Issue 1, p 125

The pathophysiology of chagasic megacolon: beyond ICC…

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To the editor:

Dear Sir,

We read with interest the recent article by Adad et al. [1] in which they reported a reduction of the number of interstitial cells of Cajal (ICC) in the colonic myenteric plexus and circular muscle areas of chagasic patients with or without megacolon. This reduction was much more pronounced in patients with megacolon, where it was also accompanied by a significant decrease of enteric neurons [1]. The strength of this study relies in the fact that the authors took into consideration patients without overt megacolon and the cell count was carried out in complete intestinal rings that allowed them to correct the neuron and ICC dispersion due to intestinal dilation and muscular hypertrophy of the megacolon. The findings of ICC decrease were consistent with previous studies in chagasic patients with megacolon [24]. However, in our study, we found an increase of one of the three colonic populations of ICC, the intramuscular, and we disagree with the interpretation of