A deficiency of interstitial cells of Cajal in Chagasic megacolon

Disordered gut motor activity is a feature of patients with Chagas' disease : colonic involvement leads to the development of megacolon and symptoms of constipation. Interstitial cells of Cajal are thought to modulate gut moti lity. The aim of this study was to test the hypothesis that there is an abn ormality of the density of distribution of interstitial cells of Cajal in C hagasic megacolon. Interstitial cells of Cajal were identified by immunohis tochemistry using an anti-c-kit antibody. Six patients with Chagasic megaco lon were compared with normal controls. The density of distribution of inte rstitial cells of Cajal was assessed in the longitudinal and circular muscl e layers, and in the intermuscular plane of the Chagasic and normal colon. Statistical analysis was performed using Fisher's exact test. The interstit ial cells of Cajal density in Chagasic megacolon was much reduced in compar ison to normal colonic tissue in the longitudinal muscle layer (P=0.0084), intramuscular plane (P<0.0001), and circular muscle layer (P=0.0051). The l ack of interstitial cells of Cajal may play a role in the pathophysiology o f the disease, leading to the development of megacolon and symptoms of cons tipation (C) 2000 Elsevier Science B.V. All rights reserved.