Summary. The aim of this work was to study the cellular organization of the intestinal mucosa in humans with chronic slow-transit constipation, as well as the relationship of mucosal cells with neural and glial structures. Materials and methods. An immunohistochemical study of fragments of the colon mucosa obtained as a result of surgical treatment of patients with chronic slow-transit constipation was carried out. To identify immune-inflammatory cells, antibodies to CD68, to the Iba-1 protein for macrophages, tryptase for mast cells, and histochemical staining with toluidine blue were used. To identify nerve structures, antibodies to the PGP 9.5 protein and tyrosine hydroxylase were used. S100β protein served as an immunohistochemical marker for glia, and serotonin and chromogranin A for enterochromaffin cells. Results. In all cases, pathological changes of lymphoid tissue, hypertrophy of the connective tissue plate of the crypts and the formation of leukocyte infiltrates were detected in the colon mucosa. The cellular elements of infiltrates are lymphocytes, monocyte-macrophage elements (Iba-1+, CD68+), mast cells are less represented. A concentration of enterochromaffin cells was detected in the epithelium of the mucous membrane. It has been established that postganglionic cholinergic fibers of microganglion neurons of the submucosal plexus participate in the innervation of mucosal tissues. They form terminal synaptic networks (en passant). Nerve structures are found among leukocyte infiltrates. Intercellular relationships have been established between parasympathetic nerve endings and their glial elements on the one hand and immuno-inflammatory cells on the other. It was found that there is no sympathetic innervation of the mucosal tissues. Conclusions. Intense innervation and leukocyte infiltrates in the colon mucosa during chronic slow-transit constipation indicate the development of neurogenic inflammation, which, according to the authors, plays a decisive role in changing the permeability of the enteral epithelium, the development of immune reactions aimed at maintaining tissue homeostasis and restoring barrier functions colon mucosal.
Ei et al. (Sun,) studied this question.