Müller, Michaela, Colcuc, Sebastian, Drescher, Daniel G., Eckardt, Alexander J., Pein, Harald, Taube, Christian, Schumacher, Johannes, Gockel, Henning R., Schimanski, Carl C., Lang, Hauke, and Gockel, Ines
Background and Aim Nitric oxide ( NO) is an important inhibitory mediator of esophageal function, and its lack leads to typical features of achalasia. In contrast, the role of intramuscular interstitial cells of Cajal ( ICC-IM) and vasoactive intestinal peptide ( VIP) in lower esophageal sphincter ( LES) function is still controversial. Therefore, we examined the function and morphology of the LES in vivo in NO-deficient ( nNOS-/-), ICC-IM-deficient ( W/ Wv)-, and wild-type ( WT) mice. Methods Esophageal manometry was performed with a micro-sized transducer catheter to quantify LES pressure, swallow evoked LES relaxation, and esophageal body motility. The LES morphology was examined by semiquantitative analysis of the immunoreactivity (reduction grade I- IV) of neuronal NOS ( nNOS), ICC-IM, and VIP and their correlation with esophageal function. Results nNOS-/- in comparison to WT mice showed a significantly higher LES mean resting pressure with an impaired swallow induced relaxation, whereas W/ Wv mice had a hypotensive LES with decreased relaxation. W/ Wv and nNOS-/- mice demonstrated differing degrees of tubular esophageal dysfunction. The reduced immunoreactivity of nNOS correlated with an increased LES pressure and decreased LES relaxation, respectively. Cajal-cell reduction correlated with impaired LES relaxation, whereas VIP reduction revealed no correlation with esophageal function. Conclusions The reduction of ICC-IM and nNOS can cause dysfunction of the LES and esophageal peristalsis, whereas VIP reduction seems to have no effect. ICC-IM and nNOS deficiency might be independent relevant causes of esophageal dysfunction similar to that seen in human achalasia. [ABSTRACT FROM AUTHOR]