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Neuropeptides in the internal anal sphincter in neurogenic faecal incontinence

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Abstract

The internal anal sphincter has both an intrinsic and extrinsic innervation which modulates its activity. While the nature of the extrinsic innervation has been well characterised, the same is not true of the intrinsic innervation. Although a variety of neurotransmitters have been identified in the human internal anal sphincter, their physiological role in health, and possible involvement in disease processes, have received little attention. Using immunohistochemistry we have studied the distribution and nerve fibre densities of a range of neuropeptides in the internal anal sphincter from 12 cancer patients (controls) and from 16 patients with neurogenic faecal incontinence. We have also studied the in vitro effect of vasoactive intestinal peptide, neuropeptide tyrosine, and galanin on isolated preparations of the internal anal sphincter from 11 cancer controls and 5 patients with neurogenic faecal incontinence. There was no difference in either the distribution or density of the neuropeptides between the 2 groups of patients, and there was no qualitative difference in the in vitro responses of the sphincter to the neuropeptides. These findings suggest that these neuropeptide components of the intrinsic innervation of the internal anal sphincter are unaffected in patients with neurogenic faecal incontinence.

Résumé

Le sphincter anal interne a une innervation intrinsèque et extrinsèque qui règle son activité. Tandis que la nature de l'innervation extrinséque a été bien caractérisée il n'en est pas de même pour l'innervation intrinséque. Quoiqu'une variété de neurotransmetteurs a été identifiée dans le sphincter anal interne humain, le rôle physiologique chez l'adulte sain et leur possible participation dans les processus pathologiques ont été peu étudiés. Par immunohistochimie, nous avons étudié la distribution et la densité dans les fibres nerveuses d'une série de neuropeptides au niveau du sphincter anal interne de 12 patients atteints de cancer (contrôle) et de 16 patients avec une incontinence fécale neurogénique. Nous avons aussi étudié l'effet in vitro du VIP, neuropeptide tyrosine, et galanine sur des préparations isolées de sphincter anal interne de 11 cancers contrôles et de 5 patients avec incontinence neurogénique. Il n'y avait pas de différence dans la distribution ou la densité des neuropeptides entre les deux groupes de patients et il n'y avait pas de différence qualitative dans les réponses in vitro du sphincter aux neuropeptides. Ces résultats suggèrent que ces neuropeptides composant de l'innervation intrinséque du sphincter anal interne ne sont pas affectés chez les patients avec incontinence neurogénique.

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Authors and Affiliations

  1. The Sir Alan Parks Physiology Unit, St. Mark's Hospital, City Road, EC1V 2PS, London, UK

    C. T. M. Speakman, M. A. Kamm, M. M. Henry & R. J. Nicholls

  2. Department of Anatomy and Developmental Biology and Centre for Neuroscience, University College London, Gower Street, WC1E 6BT, London, UK

    C. H. V. Hoyle & G. Burnstock

  3. Physiology Department, St. Mark's Hospital, City Road, EC1V 2PS, London, UK

    C. T. M. Speakman

Authors
  1. C. T. M. Speakman
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  2. C. H. V. Hoyle
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  3. M. A. Kamm
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  4. M. M. Henry
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  5. R. J. Nicholls
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  6. G. Burnstock
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Speakman, C.T.M., Hoyle, C.H.V., Kamm, M.A. et al. Neuropeptides in the internal anal sphincter in neurogenic faecal incontinence. Int J Colorect Dis 8, 201–205 (1993). https://doi.org/10.1007/BF00290306

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  • DOI: https://doi.org/10.1007/BF00290306

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