Anne-Marie O’Donnell

Skip segment Hirschsprung’s disease: a rare phenomenon

AbstractSkip segment Hirschsprungs disease (SSHD) involves a skip area of normally ganglionated intestine, surrounded proximally and distally by aganglionosis. We report a case of SSHD in infant with total colonic aganglionosis (TCA). Although SSHD is a rare and controversial condition, it should be considered a definite entity in the evaluation of Hirschsprungs disease.

Vagal neural crest contribution to the chick embryo cloaca.

Intrinsic innervation of the developing chick cloaca is provided by the enteric nervous system, a network of neurons and glia that lies within its walls. The enteric nervous system originates from neural crest cells that migrate from the vagal and sacral regions of the neural tube during the early stages of development. Abnormal cloacal development can cause a number of anorectal anomalies including persistent cloaca. Our study aimed to investigate the contribution of vagal neural crest cells to the total population of enteric neurons and glia within the chick embryo cloaca, using quail-chick chimeras. Chicken embryos were incubated until the 10–12 somite stage (ss). The vagal neural tube, corresponding to somites 1–7, was then microsurgically ablated in ovo and isochronic and isotopic quail grafts were performed. The eggs were then reincubated until embryos were harvested at E12. Whole embryos were fixed in Bouin’s fluid, embedded in paraffin wax and sectioned. Immunohistochemistry was carried out using the HNK-1 antibody to label all neural crest cells, and the quail-specific antibody, QCPN, to label quail cells. QCPN-immunoreactive cells were seen to make up a large proportion of enteric neurons and glia within the walls of the embryonic cloaca. HNK-1 labelled all neural crest cells in the myenteric and submucosal plexuses as well as the sacral crest-derived nerve of Remak, while QCPN-positive cells were evident in both plexuses but mostly in the submucosal plexus, where they appeared to make up the majority of neurons. Results show that the chick embryo cloaca is primarily innervated by vagal neural crest cells. Further studies to investigate the contribution of sacral neural crest cells to the same region will give further insight into the development of the enteric nervous system within the embryonic cloaca.

The effect of vagal neural crest ablation on the chick embryo cloaca.

The cloaca, the caudal limit of the avian gastrointestinal tract, acts as a collecting chamber into which the gastrointestinal, urinary, and genital tracts discharge. It is intrinsically innervated by the enteric nervous system, which is derived from neural crest émigrés that migrate from the vagal and sacral regions of the neural tube. Abnormal cloacal development can cause a number of anorectal anomalies, including persistent cloaca. Ablation of the vagal neural crest has previously been shown to result in an aganglionic hindgut to the extent of the colorectum. The aim of our study was to investigate the effect of vagal neural crest ablation on the cloaca, the limit of the hindgut in the developing chick embryo. Chick embryos were incubated until the 10–12 somite stage. The vagal neural tube corresponding to the level of somites 3–6 was then ablated, and eggs were incubated until harvested on embryonic day 11 (E11). Whole chick embryos were fixed, embedded in paraffin, and sectioned. Immunohistochemistry was then carried out using the HNK-1 monoclonal antibody to label neural crest cells, and results were assessed by light microscopy. Vagal neural crest ablation resulted in a dramatic decrease in the number of neural crest cells colonizing the chick embryo cloaca compared with control embryos. Ablated embryos contained only a small number of HNK-1-positive neural crest cells, which were scattered within the myenteric plexus in a disorganised pattern. Hypoganglionosis was also evident in other regions of the hindgut in ablated embryos. Ablation of the vagal neural crest results in a hypoganglionic cloaca in addition to hypoganglionosis of the hindgut. These results suggest that the cloaca is largely innervated by vagal neural crest émigrés. Further studies involving quail-chick chimeras to investigate the exact contribution provided by both vagal and sacral neural crest cells to the cloaca should increase our understanding of the pathophysiology of conditions like persistent cloaca.

Deficiency of platelet-derived growth factor receptor-α-positive cells in Hirschsprung's disease colon

AIM To investigate whether the expression of platelet-derived growth factor receptor-α-positive (PDGFRα(+))-cells is altered in Hirschsprungs disease (HD). METHODS HD tissue specimens (n = 10) were collected at the time of pull-through surgery, while colonic control samples were obtained at the time of colostomy closure in patients with imperforate anus (n = 10). Immunolabelling of PDGFRα(+)-cells was visualized using confocal microscopy to assess the distribution of these cells, while Western blot analysis was undertaken to quantify PDGFRα protein expression. RESULTS Confocal microscopy revealed PDGFRα(+)-cells within the mucosa, myenteric plexus and smooth muscle in normal controls, with a marked reduction in PDGFRα(+)-cells in the HD specimens. Western blotting revealed high levels of PDGFRα protein expression in normal controls, while there was a striking decrease in PDGFRα protein expression in the HD colon. CONCLUSION These findings suggest that the altered distribution of PDGFRα(+)-cells in both the aganglionic and ganglionic HD bowel may contribute to the motility dysfunction in HD.

Differences in nitrergic innervation of the developing chick cloaca and colorectum

The intrinsic innervation of the developing gut has long been a subject of investigation, but little is known regarding that of the embryonic cloaca. The cloaca, like the rest of the gastrointestinal tract, is intrinsically innervated by the enteric nervous system. Nitrergic neurons and fibres make up a large part of this system, thus, their distribution provides us with a useful insight into its development. Cloacal and colorectal tissue specimens were removed from chick embryos at embryonic days 11 (E11), E15 and E19. NADPH-diaphorase (NADPH-d) histochemistry was carried out using whole mount tissue preparations. Ganglia density, the number of NADPH-d-positive cells per ganglia in the myenteric plexus and cell size were calculated and statistical analysis was performed to compare both regions of the gut (P<0.001). There were significant differences in the ganglia density in the cloaca compared to the colorectum at E11 (P<0.05) and E15 (P<0.01), with the colorectum having a much denser network. In both the cloaca and the colorectum, ganglia density significantly decreased with age (P<0.001), while significant differences were observed in the number of NADPH-d-positive cells per ganglia in both regions through development. Total cell size was similar in both the cloaca and colorectum at each stage and increased in both regions through development, predominantly due to an increase in the cytoplasm. Results reveal striking differences in innervation between the chick embryo cloaca and colorectum. The sparse network of innervation evident within the cloaca in contrast to the dense network within the colorectum emphasizes the individuality of both regions. These results highlight the need for a further in-depth analysis of the enteric nervous system’s development within the embryonic cloaca.

The development of excitatory neurons in the chick cloaca.

IntroductionThe enteric nervous system of the chick embryo hindgut is derived from the vagal and sacral neural tube. Nerve cells from these regions produce various neuronal phenotypes, including inhibitory and excitatory nerve cells, providing intrinsic innervation to the chick embryo cloaca. We hypothesised that the vagal and sacral neural tubes provide the cloaca, with phenotypically similar nerve cells. The aim of our study was to investigate the origin of excitatory neurotransmission in the developing cloaca.Materials and methodsChicken embryos were incubated until the 10–12 somite stage (ss). To study the vagal neural tube contribution to the cloaca, this region was microsurgically ablated in ovo and replaced with the corresponding region from age-matched quail embryos. To study the sacral neural tube contribution to the cloaca, the vagal neural tube was ablated at the 10–12 ss, but not replaced with quail neural tube, thus, only the sacral neural crest cells remained. All embryos were harvested at E12 and E14, embedded in paraffin wax and serially sectioned. Immunohistochemistry was carried out on all embryos using human natural killer-1, quail non-chick perinuclear, choline acetyltransferase (ChAT) and substance P (SubP) antibodies.ResultsCholine acetyltransferase- and SubP-positive neurons were seen to originate in both the vagal and the sacral neural tube. The vagal neural tube provided the majority of the nerve cells to the chick embryo cloaca and expressed both ChAT and SubP in both the myenteric and submucosal plexus. The sacral neural tube contributed a lesser amount of nerve cells to the chick embryo cloaca, but was also seen to produce both ChAT- and SubP-positive nerve cells in both ganglionated plexus.ConclusionThis study shows, for the first time, that the excitatory ChAT- and SubP-expressing neurons in the developing cloaca originate in both the vagal and the sacral neural tube. These results highlight the origin of phenotypically similar nerve cells in both regions of the neural tube, providing new insights into the developmental origin of the intrinsic innervation of the persistent cloaca.

Hypoganglionic colorectum in the chick embryo: a model of human hypoganglionosis

IntroductionThe enteric nervous system is an intrinsic network of nerve cells and glia within the gastrointestinal wall, which originates in the vagal and sacral neural tube. The vagal neural tube is known to supply the colorectum with the majority of its nerve cells, and its ablation during early development produces a hypoganglionic colorectum. We hypothesized that the cholinergic nerve activity in the chick embryo hypoganglionic colorectum is decreased similar to the human situation and, therefore, this study is designed to investigate cholinergic innervations in the chick embryo hypoganglionic colorectum.Materials and methodsChicken eggs were incubated until embryos reached the 10–12 somite stage. The vagal neural tube was microsurgically ablated and eggs were returned to the incubator until embryos reached E12 and E14. Whole embryos were fixed and embedded in paraffin wax. Transverse sections were cut and immunohistochemistry was performed using a neural crest cell antibody, human natural killer-1 (HNK-1), and a choline acetyltransferase antibody (ChAT).ResultsThe results showed that in normal embryos, the colorectum contained many nerve cells (HNK-1) and ChAT-positive nerve cells and fibres, while in embryos with a hypoganglionic colorectum, the number of nerve cells (HNK-1) and ChAT-positive nerve cells and fibres was decreased.ConclusionCholinergic nerve activity is decreased as a result of a reduction in nerve cell numbers in the chick embryo colorectum. These results suggest that the cholinergic activity in the hypoganglionic chick model resembles that of human hypoganglionosis.

The timing of enteric neural crest cell colonisation of the chick embryo cloaca

Neural crest cell (NCC) migration and formation of the enteric nervous system (ENS) is an essential process in the development of the normal human gut. Abnormalities of the ENS lead to a number of neurochristopathies. In avian embryos, the cloaca acts as a common chamber into which gastrointestinal, urinary and genital tracts emerge. Previous studies have elucidated the specific timeframes at which NCCs reach the various regions of the developing chick gut but, to date, none have looked at NCC colonisation of the cloaca. The aim of our study was to investigate the exact timing of the appearance of NCCs in the cloaca of chick embryos. Chicken embryos were harvested on embryonic days (E) 8–12. Whole embryos were fixed, embedded in paraffin and sectioned. Fluorescent immunohistochemistry, using an anti-HNK-1/N-CAM monoclonal antibody, was performed and images were obtained by confocal microscopy. There was no evidence of NCCs in the cloaca of embryos from E8 to E11. Intense immunoreactivity to HNK-1 first appeared in the cloaca of E12 embryos, demonstrating a profuse circumferential colonisation by NCCs at this time. Our study is the first to show the exact timing of enteric NCC colonisation of the chick embryo cloaca. Further studies, involving quail-chick chimeras, are required to establish the true origin of cloacal NCCs and to establish the relationship between NCCs and persistent cloaca.

Platelet-derived growth factor receptor alpha-positive (PDGFR[alpha]+) cells: A new cell type in the human ureteropelvic junction

Background:Ureteropelvic junction (UPJ) obstruction is the most common cause of congenital hydronephrosis. Normal ureteral motility requires coordinated interaction between neurons, smooth muscle cells (SMCs), and interstitial Cajal-like cells (IC-LCs). Recently, a new type of interstitial cell, platelet-derived growth factor receptor α-positive (PDGFRα+) cells, was discovered in the gastrointestinal tract and bladder.MethodsWe used immunohistochemistry to study PDGFRα protein distribution in normal human UPJ and congenital UPJ obstruction. Western blot and real-time PCR (RT-PCR) were used to study PDGFRα protein and gene expression levels. In addition, closely associated cells and small conductance Ca2+-activated K+ (SK) channels were investigated.ResultsPDGFRα+ cells were distinct from IC-LCs and SMCs and were in close proximity to nerve fibers. PDGFRα+ cells expressed SK3 channels, which are thought to mediate purinergic inhibitory neurotransmission in SMCs. The distribution of PDGFRα+ cells was similar in UPJ obstruction vs. controls. However, the expression of SK3 channels in PDGFRα+ cells was decreased in UPJ obstruction vs. controls.ConclusionThis study shows, for the first time, the PDGFRα+ cell expression in the human UPJ. Altered SK3 channel expression observed in PDGFRα+ cells in UPJ obstruction suggests that the impairment of SK3 activity across the UPJ may perturb upper urinary tract peristalsis in this urological condition.