2021 Fiscal Year Final Research Report

Enteric Nervous System in Congenital Intestinal Disease

Research Project

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Project/Area Number	18K08537
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 55010:General surgery and pediatric surgery-related
Research Institution	Shiga University of Medical Science
Principal Investigator	Sakai Sachiko 滋賀医科大学, 医学部, 助教 (10710478)
Co-Investigator(Kenkyū-buntansha)	久保田良浩滋賀医科大学, 医学部, 非常勤講師 (30305601) 加藤久尚滋賀医科大学, 医学部, 医員 (40756756) 谷眞至滋賀医科大学, 医学部, 教授 (60236677) 清水智治滋賀医科大学, 医学部, 教授 (70402708) 田尻達郎京都府立医科大学, 医学(系)研究科(研究院), 教授 (80304806)
Project Period (FY)	2018-04-01 – 2022-03-31
Keywords	Hirschsprung病診断 / calretinin免疫染色 / choline transporter免疫染色
Outline of Final Research Achievements	Calretinin(CR) immunostaining and Choline transporter(ChT) immunostaining were performed on intestinal specimens from neonates to 3 months of age in cases of Hirschsprung's disease(HD) and non-HD, respectively. CR immunostaining was positive in all cases of non-HD and negative in all cases of HD, even in the early neonatal period and in preterm infants, with a sensitivity and specificity of 100%; ChT immunostaining was negative in all cases of non-HD intestinal tracts, but the positive findings were difficult to recognize, with a sensitivity of 50% and specificity of 100%. Thus, CR immunostaining is useful in the diagnosis of HD, even in the early neonatal period, but the usefulness of ChT immunostaining is negative.
Free Research Field	小児外科学
Academic Significance and Societal Importance of the Research Achievements	H病診断のための直腸粘膜生検に対するAcetylcholinesterase染色（AChE染色）は、正診率が高いが、新生児早期では、粘膜固有層にAChE陽性である外来神経線維の代償性の増生がまだみられず、偽陰性になりうることが問題であった。今回の研究結果から、新生児期早期であっても、非H病腸管ではCR染色が陽性となり、H病ではCR染色陰性となることが確認できた。従来のAChE染色単独では不十分であった新生児期早期においても、AChE染色の補助診断としてCR染色を併用することで、より正確にH病診断を行えることが期待できる。