Alimentary TractDecreased interstitial cell of Cajal volume in patients with slow-transit constipation☆,☆☆
Section snippets
Materials and methods
Procurement of human tissue was approved by the Institutional Review Board of the Mayo Clinic. All tissues were immediately snap-frozen after procurement and stored at −70°C until use. The investigator performing the data analysis was blinded to the clinical diagnosis (control vs. slow-transit constipation).
Demographics
The demographics of the patients with slow-transit constipation are shown in Table 1, and the demographics of the controls are shown in Table 2.
Patient Age (yr) Sex Colonic transit (GC at 24 h; n = 1.6-3.8) Duration of constipation (yr) Pathology report 1 71 F 1.1 Lifelong Colon mildly dilated, more so proximally; no microscopic abnormality 2 37 F 1.6 >20 Histologically unremarkable colon, ileum, and appendix 3 42 F 1.3 >15 Colon, ileum, and appendix without diagnostic abnormality 4 23 F 1.3 10
Discussion
The cause of constipation, even in patients with severe slow-transit constipation requiring surgery, is often elusive. The data presented in this report suggest that in addition to a previously described defect in innervation,5–9 which the present study confirms, there is also a decrease in ICC volume. It is now established that ICC are required for generation of the smooth muscle electrical slow wave.11, 12 The electrical slow wave determines smooth muscle contractile activity. In the absence
Acknowledgements
The authors thank Gary Stoltz and Adrian Holm for technical assistance and Kristy Zodrow for secretarial assistance.
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Address request for reprint to: Gianrico Farrugia, M.D., Mayo Clinic, Guggenheim 8, 200 First Street Southwest, Rochester, Minnesota 55905. e-mail: [email protected]; fax: (507) 284-0266.
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Supported by National Institutes of Health grants DK 52766 and 17238.