Galanin-immunoreactive nerve terminals innervating the striated muscle fibers of the rat esophagus

Regional variations in the number distribution of intrinsic myenteric neurons and coinnervated motor endplates on the striated muscles in the rat esophagus

The roles of intrinsic neurons and the significance of the coinnervated striated muscles in the esophagus are unclear. We examined the number distribution of intrinsic neurons and coinnervated motor endplates on the striated muscles in the rat esophagus using immunohistochemistry to investigate whether these neurons and coinnervated striated muscles may be relevant to the local control of esophageal motility. The number of PGP9.5-positive neurons was higher in the cervical esophagus (segment 1) and gradually decreased toward the aboral, with a moderate increase in the abdominal (segment 5). This pattern was similar to that of NOS-positive neurons, while the number of ChAT-positive neurons decreased toward the aboral, but it was not significantly different among segments 3 to 5. The number of ChAT-positive motor endplates increased toward the aboral, with the highest number in segment 5. The proportion of coinnervated motor endplates was approximately 80% in segments 1 to 4, but approximately 66% in segment 5. NPY-IR was localized in some nerve terminals among the smooth muscles of the muscularis mucosa and some NOS- or ChAT-positive esophageal intrinsic neurons. ENK-8-IR was found in some NOS- or ChAT-positive intrinsic neurons, and nerve terminals surrounding intrinsic neurons in the esophagus, but not in motor neurons at the NA or DMV. This study suggests that regional variations in the number of intrinsic neurons and coinnervated striated muscles in the rat esophagus may be involved in local regulations of esophageal motility, and that the rat esophageal intrinsic neurons may contain, at least, motor neurons and interneurons.

Enteric co-innervation of striated muscle in the esophagus: still enigmatic?

The existence of a distinct ganglionated myenteric plexus between the two layers of the striated tunica muscularis of the mammalian esophagus has represented an enigma for quite a while. Although an enteric co-innervation of vagally innervated motor endplates in the esophagus has been suggested repeatedly, it was not possible until recently to demonstrate this dual innervation. Twenty-two years ago, we were able to demonstrate that motor endplates in the rat esophagus receive dual innervation from both vagal nerve fibers originating in the brain stem and from varicose enteric nerve fibers originating in the myenteric plexus. Meanwhile, a considerable amount of data has been gathered on enteric co-innervation and its occurrence in the esophagus of a variety of species including humans, its neurochemistry, spatial relationships on motor endplates, ontogeny and possible functional roles. These data underline the significance of this newly discovered innervation component, although its function in vivo is still largely unknown. The aim of this review, which is an update of our previous paper (Wörl and Neuhuber in Histochem Cell Biol 123(2):117-130. doi: 10.1007/s00418-005-0764-7 , 2005a), is to summarize the current knowledge about enteric co-innervation of esophageal striated muscle and to provide some hints as to its functional significance.

The neural regulation of the mammalian esophageal motility and its implication for esophageal diseases

In contrast to the tunica muscularis of the stomach, small intestine and large intestine, the external muscle layer of the mammalian esophagus contains not only smooth muscle but also striated muscle fibers. Although the swallowing pattern generator initiates the peristaltic movement via vagal preganglionic neurons that project to the myenteric ganglia in the smooth muscle esophagus, the progressing front of contraction is organized by a local reflex circuit composed by intrinsic neurons similarly to other gastrointestinal tracts. On the other hand, the peristalsis of the striated muscle esophagus is both initiated and organized by the swallowing pattern generator via vagal motor neurons that directly innervate the muscle fibers. The presence of a distinct ganglionated myenteric plexus in the striated muscle portion of the esophagus had been enigmatic and neglected in terms of peristaltic control for a long time. Recently, the regulatory roles of intrinsic neurons in the esophageal striated muscle have been clarified. It was reported that esophageal striated muscle receives dual innervation from both vagal motor fibers originating in the brainstem and varicose intrinsic nerve fibers originating in the myenteric plexus, which is called 'enteric co-innervation' of esophageal motor endplates. Moreover, a putative local neural reflex pathway that can control the motility of the striated muscle was identified in the rodent esophagus. This reflex circuit consists of primary afferent neurons and myenteric neurons, which can modulate the release of neurotransmitters from vagal motor neurons in the striated muscle esophagus. The pathogenesis of some esophageal disorders such as achalasia and gastroesophageal reflux disease might be involved in dysfunction of the neural networks including alterations of the myenteric neurons. These evidences indicate the physiological and pathological significance of intrinsic nervous system in the regulation of the esophageal motility. In addition, it is assumed that the components of intrinsic neurons might be therapeutic targets for several esophageal diseases.

Enteric co-innervation of striated muscle fibres in human oesophagus

Oesophageal striated muscle of several mammalian species receives dual innervation from both vagal motor fibres originating in the brain stem and enteric nerve fibres originating in myenteric ganglia. The aim of this study was to investigate this so-called enteric co-innervation in the human oesophagus. Histochemical and immunohistochemical methods combined with confocal laser scanning microscopy were utilized to study innervation of 14 oesophagi obtained from body donors (age range 47-95 years). In addition, the distribution of striated and smooth muscle in longitudinal and circular layers of the tunica muscularis was studied semiquantitatively. The upper half of the oesophagus was built up of both muscle types with a predominance (>50-60%) of striated muscle, whereas the lower half consisted of smooth muscle only. The majority of motor endplates was compact and ovoid. Enteric nerve fibres on approximately 17% of motor endplates stained for neuronal nitric oxide synthase, vasoactive intestinal polypeptide, galanin and neuropeptide Y and were completely separated from vagal cholinergic nerve terminals. There was remarkable variability of co-innervation rates between striated muscle bundles with some reaching almost 50%. Myenteric neurons representing the putative source of enteric co-innervating nerve fibres, stained for all these markers, which were almost completely colocalized with NADPH-diaphorase. Our study provides evidence for enteric co-innervation of striated muscle in human oesophagus. From these and recent functional results in various rodent species, we suggest that this innervation component represents an integral part of an intramural reflex mechanism for local most likely inhibitory modulation of oesophageal motility.

Enteric co-innervation of motor endplates in the esophagus: state of the art ten years after

The existence of a distinct ganglionated myenteric plexus between the two layers of the striated tunica muscularis of the mammalian esophagus represented an enigma for quite a while. Although an enteric co-innervation of vagally innervated motor endplates in the esophagus has been repeatedly suggested, it was not possible until recently to demonstrate this dual innervation. Ten years ago, we were able to demonstrate that motor endplates in the rat esophagus receive a dual innervation from both vagal nerve fibers originating in the brain stem and from varicose enteric nerve fibers originating in the myenteric plexus. Since then, a considerable amount of data could be raised on enteric co-innervation and its occurrence in a variety of species, including humans, its neurochemistry, spatial relationships on motor endplates, ontogeny, and possible roles during esophageal peristalsis. These data underline the significance of this newly discovered innervation component, although its function is still largely unknown. The aim of this review is to summarize current knowledge about enteric co-innervation of esophageal striated muscle and to provide some hints as to its functional significance.

Development of neuromuscular junctions in the mouse esophagus: Morphology suggests a role for enteric coinnervation during maturation of vagal myoneural contacts

The time course of establishment of motor endplates and the subsequent developmental changes in their enteric and vagal innervation were examined in esophageal striated muscle of perinatal and adult C57/Bl6 mice by using immunocytochemistry and confocal laser scanning microscopy. Nicotinic acetylcholine receptors were visualized with alpha-bungarotoxin; vagal motor nerve terminals with antisera against vesicular acetylcholine transporter; and enteric nerve fibers with antisera against neuronal nitric oxide synthase, vasoactive intestinal peptide, and galanin. Because the various stages of esophageal striated myogenesis advance caudocranially, i.e., more mature stages are found cranial to immature stages, longitudinal cryosections through the esophagus were investigated. Synaptogenesis was divided into several distinct stages. 1) Mononucleated cells express acetylcholine receptors over their entire surface. 2) They start to cluster receptors without nerve fiber contacts. 3) The first nerve contact on a growing receptor cluster is made by a vagal nerve terminal, followed by an enteric terminal. 4) Vagal terminals grow until they match the size of endplate areas, and one to three enteric terminals intertwine with them on every receptor cluster. 5) After vagal terminals have covered the whole endplate area, enteric terminals are withdrawn from the majority of motor endplates. In a minority of endplates, enteric coinnervation persists through adulthood. The enteric innervation of all developing motor endplates, shortly after vagal terminals have contacted them, and the removal of enteric nerve fibers from the majority of mature motor endplates suggest a major role of enteric nerve fibers during maturation of esophageal neuromuscular junctions.

Localization of neurokinin 1 receptor (NK1R) immunoreactivity in rat esophagus

The aim of the present immunohistochemical study was to investigate the localization of neurokinin 1 receptor (NK1R) in rat esophagus and examine the relationship between NK1Rs and intrinsic cholinergic, nitrergic, or substance P (SP) neurons. NK1R immunoreactivity (IR) was observed on the nerve cell bodies in the myenteric ganglia throughout the esophagus, but not on striated muscles and smooth muscle cells of the muscularis mucosae. The frequency of occurrence of NK1R neurons was highest in the cervical esophagus and lowest in the lower thoracic esophagus. Considerable immunoreactivity was seen on the nerve cell surfaces and was also present in the cytoplasm of cell somas and in the initial part of the axons, but not in any other nerve fibers or terminals. Dogiel type I-like morphology was observed in some of the NK1R neurons; however, the majority exhibited polymorphic morphology. Double immunolabeling indicated that a majority (77%) of the NK1R neurons were immunoreactive for choline acetyltransferase (ChAT), while a minority (23%) were immunoreactive for nitric oxide synthase (NOS)-IR. Most of the NK1R neurons (92%) were innervated by the SP nerve fibers. Triple immunolabeling indicated that 70% of the NK1R neurons were associated with intrinsic SP nerve fibers (without CGRP-IR), 59% were associated with extrinsic SP nerve fibers (with CGRP-IR), and 35% were associated with both intrinsic and extrinsic SP nerve fibers. These results suggest that SP/tachykinin released from the SP nerve fibers of intrinsic and/or extrinsic origin activates the predominantly intrinsic cholinergic neurons via NK1Rs to influence neuronal transmission or motility in rat esophagus.

Anatomical and neurochemical features of the extrinsic and intrinsic innervation of the striated muscle in the porcine esophagus: evidence for regional and species differences

Studies of the intrinsic and extrinsic innervation patterns of esophageal motor endplates (MEPs) are mainly confined to small rodents. Therefore, an immunocytochemical, denervation and tracing study was conducted on the pig, an experimental model in which the distribution of the striated esophageal muscle portion more closely resembles the human situation. The purpose of this study was to analyze the origin and neurochemical content of the nerve fibers participating in the myoneural synapse. Fifteen 6-week-old domestic pigs were studied by immunohistochemistry combined with alpha-bungarotoxin labeling to define the co-innervation patterns of nitrergic and peptidergic nerve terminals in MEPs. Some animals were subjected to unilateral infra- or supranodose vagotomy to determine the origin of the nerve terminals in MEPs. Special attention was paid to the interregional differences in terms of co-innervation rates, and these findings were compared with literature data on small mammals. Double stainings revealed that most of the nNOS-immunoreactive (ir) terminals in MEPs co-stained for VIP, GAL and NPY, but not for PACAP and L-ENK. PACAP- and L-ENK-ir terminals were coarser than nNOS-ir terminals, and largely co-localized VAChT. High percentages of MEPs at the cervical level were contacted by PACAP- (approximately 94%) and L-ENK-ir (approximately 78%) terminals, but the proportion of both decreased in the rostrocaudal direction. Vagotomy significantly reduced their presence in MEPs at the thoracic and abdominal levels, while nNOS-ir terminals observed in approximately 30% of the MEPs were unaffected by vagotomy. Immunostainings on brainstem cryosections after retrograde tracing from the cervical esophagus showed that a large number of FB-positive cells in the nucleus ambiguus were PACAP-ir (approximately 72%). C-kit-positive interstitial cells of Cajal were seen adjacent to the striated muscle fibers, apparently without direct relationship to MEPs. Similar to mouse esophagus, intrinsic nitrergic fibers were found to run close to, or even spiral around, these interstitial cells, an association that might point to a role as specialized spindle proprioceptors. In conclusion, the cholinergic terminals-part of which coexpress PACAP and/or L-ENK-that innervate MEPs in the porcine esophagus have a vagal origin, whereas the nNOS/VIP/GAL/NPY-ir fibers co-innervating these MEPs are intrinsic in nature. The regional differences observed along the esophageal length pertain to the neurochemical content of the vagal motor innervation of the MEPs.

Enteric co-innervation of striated muscle fibers in the esophagus: just a "hangover"?

Striated muscle of the esophagus was until recently considered to consist of "classical" skeletal muscle fibers innervated by cholinergic vagal motoneurons. The recently described co-innervation originating from enteric neurons expressing nNOS, VIP, NPY, and galanin added a new dimension of complexity. The aim of this study was to summarize current knowledge about, and to get further hints as to the possible function of enteric co-innervation of striated esophageal muscle fibers. Aldehyde fixed rat esophagi were processed for immunocytochemistry for CGRP or VAChT (to demonstrate vagal motor terminals), nNOS/NADPH-d, VIP, NPY, and galanin (to demonstrate enteric terminals), met-enkephalin, mu opiate receptor, muscarinic receptors m1-3, soluble guanylyl cyclase, and cGMP dependent kinase type I and II. Motor endplates were visualized using fluorochrome tagged alpha-bungarotoxin to label nicotinic receptors, or with AChE histochemistry. Besides light and confocal laser scanning microscopy, immuno electron microscopy was also employed. Up to 80% of motor endplates were co-innervated. In addition to nNOS, VIP, NPY, and galanin, many enteric terminals in esophageal motor endplates expressed met-enkephalin. Some appeared to stain for the muscarinic m(2) receptor. There was prominent immunostaining for the micro opioid receptor in the sarcolemma at both junctional and extrajunctional sites. Immunostaining for soluble guanylyl cyclase was prominent immediately beneath the clusters of nicotinic receptors. Enteric varicosities and vagal terminals intermingled in motor endplates often without intervening teloglial processes. During ontogeny, initially high co-innervation rates were reduced to adult levels in a cranio-caudally progressing manner. We conclude that, in addition to a possible nitrergic, VIP-, NPY-, and galaninergic modulation of neuromuscular transmission by enteric neurons, opioidergic mechanisms could play a role. On the other hand, cholinergic influence on enteric neurons may be exerted also by the nucleus ambiguus via motor endplates, in addition to the input from the dorsal motor nucleus. The observations that enteric nerve fibers contact striated muscle fibers at specialized sites, i.e., motor endplates, and that these contacts appear in an ordered cranio-caudal sequence after cholinergic motor endplates have been established point to a specific function in neuronal control of esophageal muscle rather than to be an unspecific "hangover" from the smooth muscle past of this organ.

Ultrastructure of intramural ganglia in the striated muscle portions of the guinea pig oesophagus

The ultrastructure of the myenteric plexus located in the striated muscle portion of the guinea pig oesophagus was examined and compared with that of the plexus associated with the smooth muscle portion of the rest of the digestive tract. The oesophageal ganglia had essentially the same architecture as those of the smooth muscle portion, such as a compact neuropil without the intervention of connective tissue and blood vessels. Some features, however, were particular to the striated muscle part of the oesophagus. It was clearly demonstrated that myelinated fibres, probably sensory terminals of vagal origin, join the myenteric ganglia. Synapses and terminal varicosities are sparsely distributed within the ganglia and fewer morphological types of axon varicosities could be distinguished compared with other regions. Glial cells are well developed in the oesophageal myenteric ganglia. These cells outnumber the ganglion cells, having a higher ratio than in the lower digestive tract, and form numerous cytoplasmic lamellar processes. The lamellar processes, located at the surface of the ganglia, considerably reduce the area of neuronal membrane which directly contacts the basal lamina. The role of these lamellar processes in the oesophageal ganglia is discussed.

Role of galanin in the gastrointestinal sphincters

Galanin was present and exerted potent effects in all the gastrointestinal sphincters examined. Galanin-immunoreactive nerve fibers and neurons are present in both the myenteric and submucosal plexuses of sphincters. The neuropeptide exerts diverse effects in different sphincteric smooth muscles that may be species specific. For example, in the lower esophageal sphincter, it may cause an increase in basal tone and suppression of nonadrenergic noncholinergic (NANC) nerve-mediated relaxation. On the contrary, in the internal anal sphincter (IAS), the predominant effect of galanin is to cause smooth muscle relaxation and augmentation of NANC nerve-mediated relaxation. In other sphincters, galanin may either have no effect or cause either an increase or a decrease in basal tone. Most of the actions of galanin on basal smooth muscle sphincteric tone are due to its actions directly on smooth muscle cells. However, some of the relaxant actions of the peptide may also be due to activation of NANC inhibitory neurons. The basic mechanism/s responsible for sphincteric smooth muscle contraction or relaxation in response to galanin have not been investigated. The suppressive as well as the augmentatory effects of galanin on NANC nerve-mediated sphincteric smooth muscle relaxation may be due to inhibition or facilitation, respectively, of the release of NANC inhibitory neurotransmitters such as nitric oxide and vasoactive intestinal polypeptide. Diverse effects in different gastrointestinal sphincters suggest a neuromodulatory rather than a neurotransmitter role of galanin and a significant role of the neuropeptide and putative antagonists in the pathophysiology and potential therapy of gastrointestinal motility disorders especially those affecting sphincteric function.