Is the reduction of VIP the clue to the pathophysiology of Hirschsprung's disease?

The reduction of vasoactive intestinal peptide-(VIP) containing nerve fibres in the aganglionic segment in Hirschsprung's disease is thought to contribute to the sustained contraction of this intestinal segment. In order to study the significance of VIP in the pathogenesis of Hirschsprung's disease we used immunohistochemistry to evaluate the reduction of VIP-immunoreactive nerve fibres in aganglionic intestine compared to the ganglionic one. The VIP nerve fiber density was compared with the type of onset of disease (e.g. neonatal ileus or obstipation) and with the length of the aganglionic segment. No statistically significant correlation between these factors could be registered. This indicates a high complexity of the neuronal derangement in aganglionic intestine and that the degree of VIP deficiency alone does not correlate with the severity of the disease.