Johnson Michaela E, Humenick Adam, Peterson Rochelle A, Costa Marcello, Wattchow David A, Sia Tiong Cheng, Dinning Phil G, Brookes Simon J H
College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
Colorectal Surgical Unit, Division of Surgery, Flinders Medical Centre, Bedford Park, SA, Australia.
Front Neurosci. 2022 Dec 1;16:1072002. doi: 10.3389/fnins.2022.1072002. eCollection 2022.
In the human large bowel, sacral parasympathetic nerves arise from S2 to S4, project to the pelvic plexus ("hypogastric plexus") and have post-ganglionic axons entering the large bowel near the rectosigmoid junction. They then run long distances orally or aborally within the bowel wall forming "ascending nerves" or "shunt fascicles" running in the plane of the myenteric plexus. They form bundles of nerve fibres that can be distinguished from the myenteric plexus by their straight orientation, tendency not to merge with myenteric ganglia and greater width.
To identify reliable marker(s) to distinguish these bundles of ascending nerves from other extrinsic and intrinsic nerves in human colon.
Human colonic segments were obtained with informed consent, from adult patients undergoing elective surgery ( = 21). Multi-layer immunohistochemical labelling with neurofilament-H (NF200), myelin basic protein (MBP), von Willebrand factor (vWF), and glucose transporter 1 (GLUT1), and rapid anterograde tracing with biotinamide, were used to compare ascending nerves and lumbar colonic nerves.
The rectosigmoid and rectal specimens had 6-11 ascending nerves spaced around their circumference. Distal colon specimens typically had 1-3 ascending nerves, with one located near the mesenteric taenia coli. No ascending nerves were observed in ascending colon specimens. GLUT1 antisera labelled both sympathetic lumbar colonic nerves and ascending nerves in the gut wall. Lumbar colonic nerves joined the myenteric plexus and quickly lost GLUT1 labelling, whereas GLUT1 staining labelled parasympathetic ascending nerves over many centimetres.
Ascending nerves can be distinguished in the colorectum of humans using GLUT1 labelling combined with NF200.
在人类大肠中，骶副交感神经起源于S2至S4，投射至盆腔丛（“腹下丛”），其节后轴突在直肠乙状结肠交界处附近进入大肠。然后，它们在肠壁内沿口侧或肛侧长距离延伸，形成在肌间神经丛平面内走行的“升神经”或“分流束”。它们形成神经纤维束，其直的走行方向、不与肌间神经节融合的倾向以及较宽的宽度使其有别于肌间神经丛。
确定可靠的标志物，以将这些升神经束与人类结肠中的其他外在神经和内在神经区分开来。
在获得知情同意后，从接受择期手术的成年患者（n = 21）获取人类结肠段。使用神经丝-H（NF200）、髓磷脂碱性蛋白（MBP）、血管性血友病因子（vWF）和葡萄糖转运蛋白1（GLUT1）进行多层免疫组织化学标记，并用生物素酰胺进行快速顺行追踪，以比较升神经和腰结肠神经。
直肠乙状结肠和直肠标本在其周围有6 - 11条升神经。远端结肠标本通常有1 - 3条升神经，其中一条位于肠系膜结肠带附近。升结肠标本中未观察到升神经。GLUT1抗血清标记了肠壁中的交感腰结肠神经和升神经。腰结肠神经加入肌间神经丛并迅速失去GLUT1标记，而GLUT1染色在数厘米的范围内标记了副交感升神经。
使用GLUT1标记结合NF200可在人类结直肠中区分升神经。
