Blood Vessels in Ganglia in Human Esophagus Might Explain the Higher Frequency of Megaesophagus Compared With Megacolon

Abstract

This study aimed to determine the existence of blood vessels within ganglia of the myenteric plexus of the human esophagus and colon. At necropsy, 15 stillborns, newborns and children up to two years of age, with no gastrointestinal disorders, were examined. Rings of the esophagus and colon were analyzed and then fixed in formalin and processed for paraffin. Histological sections were stained by hematoxylin-eosin, Giemsa and immunohistochemistry for the characterization of endothelial cells, using antibodies for anti-factor VIII and CD31. Blood vessels were identified within the ganglia of the myenteric plexus of the esophagus, and no blood vessels were found in any ganglia of the colon. It was concluded that the ganglia of the myenteric plexus of the esophagus are vascularized, while the ganglia of the colon are avascular. Vascularization within the esophageal ganglia could facilitate the entrance of infectious agents, as well as the development of inflammatory responses (ganglionitis) and denervation, as found in Chagas disease and idiopathic achalasia. This could explain the higher frequency of megaesophagus compared with megacolon.

Treatment with low doses of aspirin during chronic phase of experimental Chagas’ disease increases oesophageal nitrergic neuronal subpopulation in mice

“…; Adad et al . ), the present study demonstrated that T. cruzi infection did not lead to a reduction in the nitrergic neuron population, similar to our findings in an earlier study, in which we found a greater number of neurons compared with the present results (Massocatto et al . ).…”

“…Despite the consensus in the literature that CD leads to oesophageal denervation (Nascimento et al 2013;Adad et al 2014), the present study demonstrated that T. cruzi infection did not lead to a reduction in the nitrergic neuron population, similar to our findings in an earlier study, in which we found a greater number of neurons compared with the present results (Massocatto et al 2016). We attribute the atrophy of the oesophageal wall found in those animals to be reflected in a greater concentration of nitrergic neurons (Massocatto et al 2016).…”

Physiotherapy in the surgical treatment of Chagasic Megaesophagus

“…Gastrointestinal involvement includes morphologic and functional alterations in the esophagus and large intestine, called Chagasic Megaesophagus (CME) and Chagasic Megacolon (CMC). There is a larger prevalence of CME due to greater vascular support in the myenteric plexus, in the esophagus, in comparison to the large intestine 4,5 . CME is characterized by luminal enlargement alongside muscular hypotrophy and inflammatory processes in nervous and muscular layers, with a loss of Cajal cellsresponsible for the organ's peristalsis.…”

El cuarto número del 2017 en NeuroGastroLATAM Reviews

“…Estudios histopatológicos de los plexos mientéricos del esófago y del colon han demostrado que en el primero estos están vascularizados, mientras que en el colon son avasculares. Esta diferencia podría explicar la mayor entrada del agente infeccioso, con el desarrollo de ganglionitis y denervación que llevaría al desarrollo de megaesófago y cambios de acalasia o pseudoacalasia, haciendo que el megaesófago sea mucho más frecuente que el megacolon 4 . Bilder y Goin refieren que en el caso de megaesófago se debe discriminar de acalasia verdadera mediante la detección de anticuerpos contra el T. cruzi 3 .…”