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Enteric neurons of the esophagus: an immunohistochemical study using donated elderly cadavers

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Abstract

Purpose

To describe and discuss the normal anatomy and function of enteric neurons in the esophagus of aged individuals.

Method

We examined ganglion cells in esophagus specimens obtained from 15 elderly cadavers without any macroscopic pathology in the mediastinum and abdomen. Neuronal nitric oxide synthase and vasoactive intestinal polypeptide were used as parasympathetic nerve markers, and tyrosine hydroxylase as a sympathetic nerve marker.

Results

The thoracic and abdominal esophagus contained a well-developed myenteric nerve plexus (S100 protein-positive area) in the intermuscular layer: 0.02–0.03 mm2 per 1-mm length of the circular esophageal wall. The cervical esophagus usually contained no ganglion cells. The number of parasympathetic ganglion cells was maximal in the upper or middle thoracic esophagus (mean 18–23 cells per section), whereas sympathetic cells were considerably less numerous at any sites (mean 1–3 cells).

Conclusion

In comparison with previous data from elderly cadavers, the esophagus carried much fewer ganglion cells than the intestine and colon; sympathetic cells were particular less numerous. Esophageal smooth muscle exhibits a unique mode of peristalsis characterized by a rebound contraction with a long latency after stimulation. This type of peristalsis appears to be regulated by inhibitory, nNOS-positive nerves with a sparse distribution, which seems to account for the long-span peristalsis unique to the esophagus. The extreme sparsity of ganglion cells in the cervical esophagus suggests that enteric neuron-integrated peristalsis, like that in the intestine and colon, is unlikely. Surgical treatment of the esophagus is likely to change or impair these unique features.

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Acknowledgements

We are grateful to the individuals who donated their bodies after death to Tokyo Dental College for Research and Education on human anatomy without any economic benefit. We also thank their families for agreeing to the donation as well as their patience in waiting for the return of their remains after study.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan

    Ai Hirano-Kawamoto, Yohei Honkura, Yuta Kobayashi & Yukio Katori

  2. Department of Anatomy, Tokyo Dental College, 2-9-18 Misaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan

    Gen Murakami & Shin-ichi Abe

  3. Division of Internal Medicine, Iwamizawa Asuka Hospital, 297-13 Shibun-cho, Iwamizawa, Hokkaido, 068-0833, Japan

    Gen Murakami

Authors
  1. Ai Hirano-Kawamoto
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  2. Yohei Honkura
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  3. Yuta Kobayashi
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  4. Gen Murakami
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  5. Shin-ichi Abe
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  6. Yukio Katori
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Correspondence to Yohei Honkura.

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Hirano-Kawamoto, A., Honkura, Y., Kobayashi, Y. et al. Enteric neurons of the esophagus: an immunohistochemical study using donated elderly cadavers. Surg Radiol Anat 39, 477–484 (2017). https://doi.org/10.1007/s00276-016-1799-2

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  • DOI: https://doi.org/10.1007/s00276-016-1799-2

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