Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.
Department of Pediatrics, Children's Hospital of Philadelphia Research Institute and Perelman School of Medicine at the University of Pennsylvania, Abramson Research Center, Philadelphia, Pennsylvania, USA.
JCI Insight. 2019 Apr 18;5(11):124510. doi: 10.1172/jci.insight.124510.
Children with trisomy 21 (Down syndrome [DS]) have a 130-fold increased incidence of Hirschsprung Disease (HSCR), a developmental defect where the enteric nervous system (ENS) is missing from distal bowel (i.e., distal bowel is aganglionic). Treatment for HSCR is surgical resection of aganglionic bowel, but many children have bowel problems after surgery. Post-surgical problems like enterocolitis and soiling are especially common in children with DS. To determine how trisomy 21 affects ENS development, we evaluated the ENS in two DS mouse models, Ts65Dn and Tc1. These mice are trisomic for many chromosome 21 homologous genes, including Dscam and Dyrk1a, which are hypothesized to contribute to HSCR risk. Ts65Dn and Tc1 mice have normal ENS precursor migration at E12.5 and almost normal myenteric plexus structure as adults. However, Ts65Dn and Tc1 mice have markedly reduced submucosal plexus neuron density throughout the bowel. Surprisingly, the submucosal neuron defect in Ts65Dn mice is not due to excess Dscam or Dyrk1a, since normalizing copy number for these genes does not rescue the defect. These findings suggest the possibility that the high frequency of bowel problems in children with DS and HSCR may occur because of additional unrecognized problems with ENS structure.
患有三体 21 型(唐氏综合征 [DS])的儿童患先天性巨结肠(HSCR)的发病率增加了 130 倍,HSCR 是一种发育缺陷,肠神经系统(ENS)缺失于远端肠道(即,远端肠道无神经节)。HSCR 的治疗方法是切除无神经节的肠道,但许多儿童在手术后仍存在肠道问题。手术后出现的问题,如肠炎和粪便污染,在 DS 儿童中尤其常见。为了确定三体 21 如何影响 ENS 的发育,我们在两种 DS 小鼠模型(Ts65Dn 和 Tc1)中评估了 ENS。这些小鼠的许多 21 号染色体同源基因都存在三体现象,包括 Dscam 和 Dyrk1a,它们被认为与 HSCR 风险有关。Ts65Dn 和 Tc1 小鼠在 E12.5 时 ENS 前体细胞迁移正常,成年时其肌间神经丛结构几乎正常。然而,Ts65Dn 和 Tc1 小鼠的整个肠道的黏膜下神经丛神经元密度明显降低。令人惊讶的是,Ts65Dn 小鼠的黏膜下神经元缺陷不是由于 Dscam 或 Dyrk1a 过量引起的,因为这些基因的拷贝数正常化并不能挽救缺陷。这些发现表明,DS 和 HSCR 儿童中肠道问题高发的可能性是由于 ENS 结构的其他未被识别的问题。