Cholinergic innervation and ganglion cell distribution in Hirschsprung's disease

Anne K. Braczynski, Stefan Gfroerer, Rudi Beschorner, Patrick N. Harter, Peter Baumgarten, Udo Rolle, Michel Mittelbronn*

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)


Background: The diagnostic gold standard of Hirschsprung's disease (HD) is based on the histopathological assessment of colorectal biopsies. Although data on cholinergic innervation and ganglion cell (GC) distribution exist, only few studies have examined these two key features together. We assessed the pattern of cholinergic innervation and the amount of GCs in colorectal specimens of 14 HD patients. Methods: We established a semi-quantitative score for cholinergic innervation using acetylcholinesterase (AChE) enzyme histochemistry and quantitatively analyzed the number of GCs via NADH tetrazolium reductase (NADH) enzyme histochemistry. We examined both the entire length of the resected specimens as well as defined areas of the transition zone of both pathological and healthy appearing segment. Results: High AChE score values were associated with absence of GCs, and AChE scores were inversely correlated with the number of GCs. Nevertheless, we observed several cases in which one of the two features revealed a normal distribution pattern, whereas the other still displayed pathological features. Conclusions: Our data support the need for transmural colon biopsies, to enable the best evaluation of both cholinergic innervation and GCs for a reliable assessment of HD.

Original languageEnglish
Article number399
JournalBMC Pediatrics
Issue number1
Publication statusPublished - 24 Aug 2020


  • AChE
  • Aganglionosis
  • Colon
  • Hirschsprung's disease
  • Recto-sigmoid


Dive into the research topics of 'Cholinergic innervation and ganglion cell distribution in Hirschsprung's disease'. Together they form a unique fingerprint.

Cite this