Studies of the inhibitory non-adrenergic neuromuscular transmission in the smooth muscle of the normal human intestine and from a case of Hirschsprung's disease.

A modified sucrose-gap method was used to study both non-adrenergic inhibitory neuromuscular transmission and effects of adenosine 5'-triphosphate (ATP) on isolated smooth muscle preparations from the human intestine. It was found that non-adrenergic inhibition in the circular smooth muscle layer was of larger amplitude than in the longitudinal layer. Study of the ionic mechanisms underlying non-adrenergic inhibition indicated that an increase in K+ conductance was responsible for the generation of non-adrenergic inhibitory junction potentials (IJPs). The results suggest that the inhibitory actions of the endogenous neurotransmitter and exogenous ATP are due to increases in Ca2+-dependent K+ conductance. The K+-channel blockers tetraethylammonium and 4-aminopyridine had no effect on IJPs or ATP, while apamin slightly decreased both the amplitude of the IJP and the hyperpolarization of the circular smooth muscle caused by ATP. These results are consistent with the purinergic hypothesis of non-adrenergic inhibition. In addition to inhibitory purinoceptors, the existence of excitatory purinoceptors was identified in the longitudinal muscle, activation of which probably caused an increase in Na+-conductance. The excitatory purinoceptor-mediated contraction in the longitudinal muscle from the constricted region of large intestine from patients with Hirschsprung's disease was greater than that found in control specimens. It is possible that excitatory purinoceptors play a role in the pathophysiology of Hirschsprung's disease.