Skip to main content
SpringerLink
Log in

Immunohistochemical study of the colonic muscle and innervation in idiopathic chronic constipation

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: This study was designed to investigate neural and muscular features of the colonic wall in patients with severe idiopathic constipation. METHODS: By using quantitative immunohistochemistry, resected specimens from 14 patients with idiopathic chronic constipation and 17 nonobstructed cancer controls were studied. RESULTS: Routine histology revealed no significant histologic abnormality throughout the colon apart from four cases of melanosis coli. Ratio of the thickness of circular to longitudinal muscle was significantly lower in the left colon in constipated subjects. The myenteric plexus appeared morphologically normal in all subjects. S-100 protein, which stains neuronal supporting tissues, demonstrated an increase in the proportion of neural tissue in the myenteric plexus. There was an increased number of PGP-9.5 immunoreactive nerve fibers in the muscularis propria in constipated patients, and this was significantly higher in the ascending and descending colon. CONCLUSION: Intractably constipated patients have alterations in the neural composition of the colonic myenteric plexus and innervation of the circular muscle.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kamm MA, Hawley PR, Lennard-Jones JE. Outcome of colectomy for severe idiopathic constipation. Gut 1988;29:969–73.

    PubMed  Google Scholar 

  2. Krishnamurthy S, Schuffler MD, Rohrmann CA, Pope CE II. Severe idiopathic constipation is associated with a distinctive abnormality of the colonic myenteric plexus. Gastroenterology 1985;88:26–34.

    PubMed  Google Scholar 

  3. Krishnamurthy S, Schuffler MD. Pathology of neuromuscular disorders of the small intestine and colon. Gastroenterology 1987;93:610–39.

    PubMed  Google Scholar 

  4. Agnati LF, Fuxe K, Janson AM, Zoli M, Harfstrand A. Quantitative analysis: computer assisted morphometry and microdensitometry applied to immunostained neurons. In: Polak JM, Van Noorden S, eds. Immunocytochemistry—modern methods and applications. Bristol: Wright, 1986:206–24.

    Google Scholar 

  5. Preston DM, Lennard-Jones JE. Severe chronic constipation of young women: idiopathic slow transit constipation. Gut 1986;27:41–8.

    PubMed  Google Scholar 

  6. Hsu SM, Raine L, Fanger H. Use of avidin-biotinperoxidase complex (ABC) in immunoperoxidase techniques: a comparison between ABC and unlabelled antibody (PAP) procedures. J Histochem Cytochem 1981;29:577–80.

    PubMed  Google Scholar 

  7. Ambe K, Mori M, Enjoji M. S-100 protein-positive dendritic cells in colorectal adenocarcinomas: distribution and relation to the clinical prognosis. Cancer 1989;63:496–503.

    PubMed  Google Scholar 

  8. Sams VR, Bobrow LG, Happerfield L, Keeling J. Evaluation of PGP-9.5 in the diagnosis of Hirschsprung's disease. J Pathol 1992;168:55–8.

    Article  PubMed  Google Scholar 

  9. Curran RC, Gregory J. The unmasking of antigens in paraffin sections of tissue by trypsin. Experientia 1977;33:1400–1.

    Article  PubMed  Google Scholar 

  10. Wells TR, Landing BH, Ariel I. Normal anatomy of the myenteric plexus of infants and children: demonstration by flat mount (circuit diagram) preparations. Perspect Pediatr Pathol 1987;11:52–74.

    Google Scholar 

  11. Jackson GD, Thompson RJ. The demonstration of new human brain specific proteins by high-resolution two-dimensional polyacrylamide gel electrophoresis. J Neurol Sci 1981;49:429–38.

    Article  PubMed  Google Scholar 

  12. Gulbenkain S, Wharton J, PolakJM. The visualization of cardiovascular innervation in the guinea-pig using an antiserum to protein gene product 9.5 (PGP-9.5). J Auton Nerv Syst 1987;19:581–93.

    Google Scholar 

  13. Lundberg L-M, Alm P, Wharton J, Polak JM. Protein gene product 9.5 (PGP-9.5): a new neuronal marker visualizing the whole uterine innervation and pregnancy-induced and developmental changes in the guinea pig. Histochemistry 1988;90:9–17.

    Article  PubMed  Google Scholar 

  14. Wilkinson KD, Deshpande S, Larsen CN. Comparisons of neuronal (PGP 9.5) and non-neuronal ubiquitin C-terminal hydrolases. Biochem Soc Trans 1992;20:631–42.

    PubMed  Google Scholar 

  15. Moore BW. A soluble protein characteristic of the nervous system. Biochem Biophys Res Commum 1965;19:739–44.

    Article  Google Scholar 

  16. Taguchi T, Tanaka K, Ikeda K. Immunohistochemical study of neuron specific enolase and S-100 protein in Hirschsprung's disease. Virchows Arch A Pathol Anat Histopathol 1985;405:399–409.

    Article  PubMed  Google Scholar 

  17. Haimoto H, Hosoda S, Kato K. Differential distribution of immunoreactive S-100-alpha and S-100-beta proteins in normal nonnervous human tissues. Lab Invest 1987; 57:489–98.

    PubMed  Google Scholar 

  18. Kamm MA. Colonic motor activity in constipation. In: Kamm MA, Lennard-Jones JE, eds. Constipation. Peter-borough: Wrightson Biomedical Publishing, 1994:65–72.

    Google Scholar 

  19. Bassotti G, Gaburri M, Imbimbo BP. Colonic mass movements in idiopathic chronic constipation. Gut 1988;29:1173–9.

    PubMed  Google Scholar 

  20. Koch TR, Carney JA, Go L, Go VL. Idiopathic chronic constipation is associated with decreased colonic vasoactive intestinal peptide. Gastroenterology 1988;94:300–10.

    PubMed  Google Scholar 

  21. Milner PM, Crowe R, Kamm MA, Lennard-Jones JE, Burnstock G. Vasoactive intestinal polypeptide levels in sigmoid colon in idiopathic constipation and diverticular disease. Gastroenterology 1990;99:666–75.

    PubMed  Google Scholar 

  22. Benson MJ, Kumar D, Roberts J,et al. Colonic neural and smooth muscle abnormalities in slow transit constipation. Gastroenterology 1992;102:A424.

    Google Scholar 

  23. Smith B. Pathologic changes in the colon produced by anthraquinone purgatives. Dis Colon Rectum 1973;16: 455–8.

    PubMed  Google Scholar 

  24. Kluck P, ten Kate FJ, Schouten WR,et al. Efficacy of antibody NF2F11 staining in the investigation of severe long-standing constipation: a preliminary report. Gastroenterology 1987;93:872–5.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. St. Mark's Hospital, London, UK

    H. J. Park M.D., M. A. Kamm M.D., A. M. Abbasi M.D. & I. C. Talbot M.D.

  2. Department of Internal Medicine, Yonsei University Medical College, Seoul, Korea

    H. J. Park M.D.

Authors
  1. H. J. Park M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. A. Kamm M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. M. Abbasi M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. I. C. Talbot M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Supported by a grant from Yonsei University Research Foundation, Seoul, Korea. Dr. Talbot is supported in part by the Imperial Cancer Research Fund.

About this article

Cite this article

Park, H.J., Kamm, M.A., Abbasi, A.M. et al. Immunohistochemical study of the colonic muscle and innervation in idiopathic chronic constipation. Dis Colon Rectum 38, 509–513 (1995). https://doi.org/10.1007/BF02148851

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02148851

Keywords

Search

Navigation