von Boyen G B T, Krammer H-J, Süss A, Dembowski C, Ehrenreich H, Wedel T
Department of Medicine II (Gastroenterology), University Hospital of Heidelberg at Mannheim, Germany.
Gut. 2002 Sep;51(3):414-9. doi: 10.1136/gut.51.3.414.
A homozygous mutation of the endothelin B receptor (EDNRB) gene in spotting lethal (sl/sl) rats leads to Hirschsprung's disease (HSCR) with long segmented aganglionosis. However, the effects on the development of the enteric nervous system (ENS) promoted by a heterozygous mutation of the EDNRB gene are not known. The present study aimed to describe and morphometrically assess the phenotypic abnormalities of the ENS in heterozygous (+/sl) EDNRB deficient rats in comparison with homozygous (sl/sl) EDNRB deficient and wild-type (+/+) rats.
The distal small intestine, caecum, and colon were obtained from sl/sl, +/sl, and +/+ rats. To demonstrate the three dimensional organisation of the ENS, the intestinal wall was microdissected into wholemounts and incubated against the pan-neuronal marker protein gene product 9.5. Assessment of the ENS included morphometric quantification of ganglionic size and density, the number of nerve cells per ganglia, and the diameter of nerve fibre strands within both the myenteric and submucous plexus.
Sl/sl rats were characterised by complete aganglionosis resembling the same histopathological features observed in patients with HSCR. +/sl rats revealed more subtle abnormalities of the ENS: the submucous plexus was characterised by a significantly increased ganglionic size and density, and the presence of hypertrophied nerve fibre strands. Morphometric evaluation of the myenteric plexus did not show statistically significant differences between +/sl and +/+ rats.
In contrast with sl/sl rats, +/sl rats display non-aganglionated malformations of the ENS. Interestingly, these innervational abnormalities resemble the histopathological criteria for intestinal neuronal dysplasia (IND). Although IND has been described in several intestinal motility disorders, the concept of a clearly defined clinical-histopathological entity is still controversially discussed. The present findings support the concept of IND based on clearly defined morphological criteria suggesting a genetic link, and thus may provide a model for human IND. Furthermore, the data underline the critical role of the "gene dose" for the phenotypic effects promoted by the EDNRB/EDN3 system and confirm that the development of the ENS is not an "all or none" phenomenon.
斑点致死(sl/sl)大鼠内皮素B受体(EDNRB)基因的纯合突变导致先天性巨结肠(HSCR)伴长节段无神经节症。然而,EDNRB基因杂合突变对肠神经系统(ENS)发育的影响尚不清楚。本研究旨在描述并通过形态计量学评估杂合(+/sl)EDNRB缺陷大鼠与纯合(sl/sl)EDNRB缺陷大鼠及野生型(+/+)大鼠相比ENS的表型异常。
从sl/sl、+/sl和+/+大鼠获取远端小肠、盲肠和结肠。为展示ENS的三维组织结构,将肠壁显微解剖成整装片,并用泛神经元标记物蛋白基因产物9.5进行孵育。对ENS的评估包括神经节大小和密度的形态计量学量化、每个神经节的神经细胞数量以及肌间神经丛和黏膜下神经丛内神经纤维束的直径。
sl/sl大鼠的特征是完全无神经节症,类似于HSCR患者中观察到的相同组织病理学特征。+/sl大鼠显示出ENS更细微的异常:黏膜下神经丛的特征是神经节大小和密度显著增加,以及存在肥大的神经纤维束。肌间神经丛的形态计量学评估在+/sl和+/+大鼠之间未显示出统计学上的显著差异。
与sl/sl大鼠不同,+/sl大鼠表现出ENS的无神经节畸形。有趣的是,这些神经支配异常类似于肠道神经元发育异常(IND)的组织病理学标准。尽管IND已在几种肠道动力障碍中被描述,但一个明确定义的临床 - 组织病理学实体的概念仍存在争议。本研究结果支持基于明确定义的形态学标准的IND概念,提示存在遗传联系,因此可能为人类IND提供一个模型。此外,数据强调了“基因剂量”对EDNRB/EDN3系统促进的表型效应的关键作用,并证实ENS的发育不是一种“全或无”现象。