Acetylcholinesterase-activity in rectal mucosa of children with obstipation

Toorman, Jan; Gt, Bots; Pm, Vio

doi:10.1007/bf00432586

Cited by 11 publications

(3 citation statements)

References 4 publications

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“…20 In conclusion, the histochemical demonstration of AChE activity in suction rectal biopsies is an accurate technique, provided that one is aware of the pitfalls outlined, and we recommend that it replace full thickness biopsy in the screening for and diagnosis of Hirschsprung's disease. Equivocal, atypical, or negative results when contradicting clinical features are an indication for repeat biopsy or full thickness biopsy.…”

Section: Discussionmentioning

confidence: 91%

Clinical evaluation of the histochemical diagnosis of Hirschsprung's disease.

Barr¹,

Booth²,

Filipe³

et al. 1985

Gut

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Section: Discussionmentioning

confidence: 91%

Clinical evaluation of the histochemical diagnosis of Hirschsprung's disease.

Barr¹,

Booth²,

Filipe³

et al. 1985

Gut

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“…To further complicate matters, abnormal AChE staining patterns have been described in patients with structural or anatomical gastrointestinal abnormalities (e.g. anorectal malformations) [84] and chronic inflammatory disease of the gastrointestinal tract [92] as well as in obstipation [96]. This raises the question of whether they may be acquired.…”

Section: Problems In Interpreting Ache Histochemistrymentioning

confidence: 99%

Acetylcholinesterase in Hirschsprung?s disease

Moore

Johnson

2005

Ped Surgery Int

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The association between the congenital absence of colonic ganglion cells and an increased acetylcholinesterase (AChE) expression in the affected tissue is of diagnostic importance in Hirschsprung's disease (HSCR). Investigation of AChE's function in development may also help unravel some of the complex pathophysiology in HSCR. Normal nerves do not stain for AChE, but increased AChE expression is associated with the hypertrophied extrinsic nerve fibres of the aganglionic segment in HSCR. Although a high degree of histochemical diagnostic accuracy exists, results are not always uniform, and false positives and false negatives are reported. False negative results are primarily related to age, and an absence of AChE reaction does not exclude HSCR in neonates within the first 3 weeks after birth. AChE staining results may lack uniformity, resulting in a number of technical modifications that have been made to improve standardization of AChE staining. At least two distinct histological patterns are described, types A and B. The interpretation of increased AChE staining patterns in ganglionated bowel at the time of surgical pull-through remains a problem in patients with HSCR. The development of rapid staining techniques has helped to identify normal ganglionated bowel with greater certainty. The presence of fine AChE neurofibrils in the ganglionated segment has contributed to the debate surrounding intestinal neuronal dysplasia. Quantitative assay of cholinesterase activity confirms the pattern of histochemical staining. AChE is particularly increased in relation to butrylcholinesterase, with one molecular form, the G4 tetrameric form, predominating. It is likely that the raised levels of AChE in aganglionic tissue are the transcriptional consequence of the abnormalities in signalling molecules that characterize HSCR. Evidence suggests that this AChE is functioning in a nonenzymatic capacity to promote cell adhesion and differentiation and that the hypertrophied nerves and neurofibrils may be the result of this increased AChE expression.

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“…The discovery of an increased acetylcholinesterase activity in rectal tissue contributed a great deal more precision to the diagnosis. Initially, histochernical detection was employed (1,2,3), the results being somewhat subjective and, at best, semiquantitative (4). A more accurate biochemical method, measured in homogenate, was introduced by Boston et al in 1975 (5) and was improved by the use of a selective inhibitor of non-specific cholinesterases (6).…”

Section: Constipationmentioning

confidence: 99%