The role of the human enteric nervous system (ENS) in the control of the intestinal epithelium organization and proliferation is unknown. To address this issue, we developed a novel co-culture model, consisting of human submucosa containing the submucosal plexus and a human colonic epithelial monolayer. After 3 days in basal conditions (i.e. in absence of neuronal activation) epithelium disorganization and proliferation occurred. In contrast, electrical activation of submucosal neurones maintained monolayer organization and decreased cell proliferation. These effects were blocked by tetrodotoxin and a vasoactive intestinal peptide (VIP) receptor antagonist, and reproduced by VIP. In conclusion, our study suggests that the human ENS is involved in the control of epithelial cell proliferation.
Endoscopic ultrasonography and magnetic resonance pancreatography are the most useful investigations for the diagnosis of CDHP. Pancreaticoduodenectomy is justified after failure of medical treatment or endoscopic drainage. Late results after PD are dependent on alcoholic consumption when CDHP is associated with chronic pancreatitis.
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