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Effect of chagas' disease on nitric oxide-containing neurons in severely affected and unaffected intestine

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

Abstract

PURPOSE: The pathophysiology of Chagas' disease is incompletely understood. Neuronal nitric oxide has been cited as a candidate neurotransmitter responsible for relaxation of the internal anal sphincter. Neuronal nicotinamide adenine dinucleotide phosphate diaphorase can be used as a marker for neuronal nitric oxide synthase. This study was designed to examine the alterations of the nitric oxidecontaining neurons in the enteric nervous system of the colon of patients who underwent resections for advanced megacolon and to compare these specimens with small-bowel specimens from the same patients and with specimens from control subjects. METHODS: Specimens from resected rectum and extramucosal small-bowel biopsy specimens from 11 patients with Chagas megacolon but no apparent small-bowel clinical involvement were compared with the uninvolved colon and jejunum of 10 control patients with colon cancer. Tissues were fixed in Zamboni solution and evaluated by histochemistry for nicotinamide adenine dinucleotide phosphate diaphorase-containing neurons. Reactivity was evaluated on a 0 to 4 scale in the longitudinal muscle, myenteric plexus, circular muscle, submucosal plexus, and mucosa. RESULTS: Specimens from control patients showed well-stained myenteric and submucosal neurons and an abundant network of terminal nerve fibers in the muscle layers. Chagasic specimens had decreased staining in all layers of the gut. Overall there was a statistically significant decrease in nicotinamide adenine dinucleotide phosphate diaphorase-containing neurons. Biopsy specimens from clinically uninvolved small bowel of patients with Chagas' disease also showed decreased reactivity, but to a lesser degree. CONCLUSIONS: Nicotinamide adenine dinucleotide phosphate diaphorase activity is decreased in patients with advanced megacolon. The alterations are more relevant in the myenteric plexus and the circular muscle. Reactivity is also diminished in the clinically uninvolved small bowel, but to a lesser extent.

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Authors and Affiliations

  1. From the Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

    Adriana Vaz Safatle-Ribeiro M.D.

  2. Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania

    Ulysses Ribeiro Jr M.D.

  3. Department of Gastroenterology, University of São Paulo, São Paulo, Brazil

    Ulysses Ribeiro Jr M.D., Adriana Vaz Safatle-Ribeiro M.D., Angelita Habr-Gama M.D. & Joaquim J. Gama-Rodrigues M.D.

  4. Division of Gastroenterology and Hepatology, Allegheny University of the Health Sciences, Broad and Vine, Mail Stop 131, 191021192, Philadelphia, Pennsylvania

    Jackie Sohn D.D.S. &  James C. Reynolds M.D.

Authors
  1. Ulysses Ribeiro Jr M.D.
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  2. Adriana Vaz Safatle-Ribeiro M.D.
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  3. Angelita Habr-Gama M.D.
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  4. Joaquim J. Gama-Rodrigues M.D.
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  5. Jackie Sohn D.D.S.
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  6. James C. Reynolds M.D.
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Additional information

Read at the meeting of the Society for Surgery of the Alimentary Tract, Washington, D.C., May 10 to 15, 1997.

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Ribeiro, U., Safatle-Ribeiro, A.V., Habr-Gama, A. et al. Effect of chagas' disease on nitric oxide-containing neurons in severely affected and unaffected intestine. Dis Colon Rectum 41, 1411–1417 (1998). https://doi.org/10.1007/BF02237058

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  • DOI: https://doi.org/10.1007/BF02237058

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