Peptidergic innervation in Hirschsprung's disease.

An increasing amount of evidence concerning the existence of non-adrenergic, non-cholinergic autonomous nerves has been presented during the past decade. These nerves contain different peptides which may act as neurotransmitters. The pathophysiology in Hirschsprung's disease is not yet fully explained. To throw further light upon it, the distribution and occurrence of different peptide-containing (peptidergic) nerves was studied. A semiquantitative immuno-histochemical method was used to assess the distribution and occurrence of nerves containing encephalin, GRP (gastrin-releasing peptide), VIP (vasoactive intestinal peptide) or substance P in four patients operated by Duhamel's procedure. The results indicate a total absence of encephalin and GRP containing nerves in the aganglionic segment. Such nerves could, however, be found in the normally ganglionated part of colon. The nerves containing VIP and substance P were fewer in the aganglionic segment than in the rest of the colon. The result is related to what is hitherto known about the specific effects of the different peptides.