Membrane properties and innervation of smooth muscle cells in Hirschsprung's disease.

Mechanical and membrane properties of smooth muscle cells and/or neuroeffector transmission in the aganglionic segment of the large intestine (Hirschsprung's disease) were compared with findings in the ganglionic segment. Tension-recording, microelectrode, and double sucrose gap methods were used. There was no difference in resting membrane potential of the longitudinal or circular muscle cell in these two segments, which were obtained at biopsy in Japanese children. In the ganglionic preparations, generations of regular prepotentials, with or without the spike, correlated well to the rhythmic contractions. However, in the aganglionic segment, irregular spike and contraction only were observed. In the circular or longitudinal muscle of the ganglionic segments, field stimulations evoked inhibitory junction potentials, excitatory junction potentials, or both and triggered initial relaxation and then a contraction of the tissue. In the aganglionic segment, however, field stimulation evoked only excitatory junction potentials followed by contraction. These results indicate that, in cases of Hirschsprung's disease, there may be a deficiency in the nonadrenergic inhibitory pathways. This is the first evidence for a lack of spasticity in muscle from the aganglionic segment of the large intestine obtained from children with Hirschsprung's disease.