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Gender differences in reduced substance P (SP) in children with slow-transit constipation

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Abstract

Purpose

Adult slow-transit constipation (STC) occurs predominantly in females and is associated with low numbers of substance P (SP)-containing nerves in colonic circular muscle.

Aim

To determine if reduced SP nerves is female predominant in paediatric STC.

Methods

Children with STC were identified from records of more than 600 nuclear transit studies (NTS) and intestinal biopsies done for intractable chronic constipation between November 1998 and March 2009. Colonic seromuscular biopsies collected from hepatic and splenic flexures, and sigmoid colon were processed for immunohistochemistry. Nerve fibre density in circular muscle containing SP was measured qualitatively by a pathologist.

Results

Eighty-eight children with chronic constipation had both NTS and intestinal biopsies. Seventy-eight children (52 M; age 2–15.5 years; mean 7.7 years) had STC diagnosed by NTS. SP was reduced in 10/26 girls, but only 11/52 boys.

Conclusion

In this sample, STC was more common in boys than girls. However, in girls with STC, SP deficiency occurred in 40%, when compared with 20% of boys. During puberty, the percentage of girls with reduced SP decreased, whilst the percentage of boys increased. These results suggest that STC is heterogeneous and that there are some gender differences, the implication of which requires further investigation.

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References

  1. Sutcliffe JR, King SK, Hutson JM, Cook DJ, Southwell BR (2009) Gastrointestinal transit in children with chronic idiopathic constipation. Pediatr Surg Int 25:465–472

    Article  PubMed  Google Scholar 

  2. Stanton MP, Hutson JM, Simpson D et al (2005) Colonic manometry via appendicostomy shows reduced frequency, amplitude, and length of propagating sequences in children with slow-transit constipation. J Pediatr Surg 40:1138–1145

    Article  PubMed  Google Scholar 

  3. King SK, Catto-Smith AG, Stanton MP et al (2008) 24-Hour colonic manometry in pediatric slow transit constipation shows significant reductions in antegrade propagation. Am J Gastroenterol 103:2083–2091

    Article  PubMed  Google Scholar 

  4. Holzer P, Holzer-Petsche U (1997) Tachykinins in the gut. Part I. Expression, release and motor function. Pharmacol Ther 73:173–217

    Article  PubMed  CAS  Google Scholar 

  5. Maggi CA, Catalioto RM, Criscuoli M et al (1997) Tachykinin receptors and intestinal motility. Can J Physiol Pharmacol 75:696–703

    Article  PubMed  CAS  Google Scholar 

  6. Southwell BR, Furness JB (2001) Immunohistochemical demonstration of the NK(1) tachykinin receptor on muscle and epithelia in guinea pig intestine. Gastroenterology 120:1140–1151

    Article  PubMed  CAS  Google Scholar 

  7. Southwell BR, Woodman HL, Murphy R, Royal SJ, Furness JB (1996) Characterisation of substance P-induced endocytosis of NK1 receptors on enteric neurons. Histochem Cell Biol 106:563–571

    Article  PubMed  CAS  Google Scholar 

  8. Harrington AM, Hutson JM, Southwell BR (2005) Immunohistochemical localization of substance P NK1 receptor in guinea pig distal colon. Neurogastroenterol Motil 17:727–737

    Article  PubMed  CAS  Google Scholar 

  9. Lavin ST, Southwell BR, Murphy R, Jenkinson KM, Furness JB (1998) Activation of neurokinin 1 receptors on interstitial cells of Cajal of the guinea-pig small intestine by substance P. Histochem Cell Biol 110:263–271

    Article  PubMed  CAS  Google Scholar 

  10. Vannucchi MG, Corsani L, Faussone-Pellegrini MS (1999) Substance P immunoreactive nerves and interstitial cells of Cajal in the rat and guinea-pig ileum. A histochemical and quantitative study. Neurosci Lett 268:49–52

    Article  PubMed  CAS  Google Scholar 

  11. Porter AJ, Wattchow DA, Hunter A, Costa M (1998) Abnormalities of nerve fibers in the circular muscle of patients with slow transit constipation. Int J Colorectal Dis 13:208–216

    Article  PubMed  CAS  Google Scholar 

  12. King SK, Sutcliffe JR, Ong SY et al (2010) Substance P and vasoactive intestinal peptide are reduced in right transverse colon in pediatric slow-transit constipation. Neurogastroenterol Motil 22:883–892, e234

    Google Scholar 

  13. Southwell BR, Clarke MC, Sutcliffe J, Hutson JM (2009) Colonic transit studies: normal values for adults and children with comparison of radiological and scintigraphic methods. Pediatr Surg Int 25:559–572

    Article  PubMed  Google Scholar 

  14. Cook BJ, Lim E, Cook D et al (2005) Radionuclear transit to assess sites of delay in large bowel transit in children with chronic idiopathic constipation. J Pediatr Surg 40:478–483

    Article  PubMed  Google Scholar 

  15. King SK, Sutcliffe JR, Hutson JM (2005) Laparoscopic seromuscular colonic biopsies: a surgeon’s experience. J Pediatr Surg 40:381–384

    Article  PubMed  Google Scholar 

  16. Southwell BR, Koh TL, Wong SQ et al Decrease in nerve fibre density in human sigmoid colon circular muscle occurs with growth but not aging. Neurogastroenterol Motil 22:439–445, e106

  17. Hutson JM, Chow CW, Borg J (1996) Intractable constipation with a decrease in substance P-immunoreactive fibres: is it a variant of intestinal neuronal dysplasia? J Pediatr Surg 31:580–583

    Article  PubMed  CAS  Google Scholar 

  18. Giardiello FM, Brensinger JD, Petersen GM (2001) AGA technical review on hereditary colorectal cancer and genetic testing. Gastroenterology 121:198–213

    Article  PubMed  CAS  Google Scholar 

  19. Wheatley JM, Hutson JM, Chow CW, Oliver M, Hurley MR (1999) Slow-transit constipation in childhood. J Pediatr Surg 34:829–832 (discussion 823–832)

    Article  PubMed  CAS  Google Scholar 

  20. Stanton MP, Hengel PT, Southwell BR et al (2003) Cholinergic transmission to colonic circular muscle of children with slow-transit constipation is unimpaired, but transmission via NK2 receptors is lacking. Neurogastroenterol Motil 15:669–678

    Article  PubMed  CAS  Google Scholar 

  21. Hutson JM, McNamara J, Gibb S, Shin YM (2001) Slow transit constipation in children. J Paediatr Child Health 37:426–430

    Article  PubMed  CAS  Google Scholar 

  22. King SK, Sutcliffe JR, Southwell BR, Chait PG, Hutson JM (2005) The antegrade continence enema successfully treats idiopathic slow-transit constipation. J Pediatr Surg 40:1935–1940

    Article  PubMed  Google Scholar 

  23. Hutson JM, Chase JW, Clarke MC et al (2009) Slow-transit constipation in children: our experience. Pediatr Surg Int 25:403–406

    Article  PubMed  Google Scholar 

  24. King SK, Sutcliffe JR, Ong SY et al (2010) Substance P and vasoactive intestinal peptide are reduced in right transverse colon in pediatric slow-transit constipation. Neurogastroenterol Motil 22(8):883–892

    Article  PubMed  CAS  Google Scholar 

  25. Hutson JM, Chow CW, Hurley MR, Uemura S, Wheatley JM, Catto-Smith AG (1997) Deficiency of substance P-immunoreactive nerve fibres in children with intractable constipation: a form of intestinal neuronal dysplasia. J Paediatr Child Health 33:187–189

    Article  PubMed  CAS  Google Scholar 

  26. Watier A, Devroede G, Duranceau A et al (1983) Constipation with colonic inertia. A manifestation of systemic disease? Dig Dis Sci 28:1025–1033

    Article  PubMed  CAS  Google Scholar 

  27. Preston DM, Lennard-Jones JE (1986) Severe chronic constipation of young women: ‘idiopathic slow transit constipation’. Gut 27:41–48

    Article  PubMed  CAS  Google Scholar 

  28. King SK, Southwell BR, Hutson JM (2006) An association of multiple endocrine neoplasia 2B, a RET mutation; constipation; and low substance P-nerve fiber density in colonic circular muscle. J Pediatr Surg 41:437–442

    Article  PubMed  Google Scholar 

  29. Slater BJ, Varma JS, Gillespie JI (1997) Abnormalities in the contractile properties of colonic smooth muscle in idiopathic slow transit constipation. Br J Surg 84:181–184

    Article  PubMed  CAS  Google Scholar 

  30. Wedel T, Van Eys GJ, Waltregny D, Glenisson W, Castronovo V, Vanderwinden JM (2006) Novel smooth muscle markers reveal abnormalities of the intestinal musculature in severe colorectal motility disorders. Neurogastroenterol Motil 18:526–538

    Article  PubMed  CAS  Google Scholar 

  31. Vanderwinden JM, Rumessen JJ (1999) Interstitial cells of Cajal in human gut and gastrointestinal disease. Microsc Res Tech 47:344–360

    Article  PubMed  CAS  Google Scholar 

  32. Lyford GL, He CL, Soffer E et al (2002) Pan-colonic decrease in interstitial cells of Cajal in patients with slow transit constipation. Gut 51:496–501

    Article  PubMed  CAS  Google Scholar 

  33. Tong WD, Liu BH, Zhang LY, Zhang SB, Lei Y (2004) Decreased interstitial cells of Cajal in the sigmoid colon of patients with slow transit constipation. Int J Colorectal Dis 19:467–473

    Article  PubMed  Google Scholar 

  34. Chelimsky G, Boyle JT, Tusing L, Chelimsky TC (2001) Autonomic abnormalities in children with functional abdominal pain: coincidence or etiology? J Pediatr Gastroenterol Nutr 33:47–53

    Article  PubMed  CAS  Google Scholar 

  35. Raethjen J, Pilot MA, Knowles C, Warner G, Anand P, Williams N (1997) Selective autonomic and sensory deficits in slow transit constipation. J Auton Nerv Syst 66:46–52

    Article  PubMed  CAS  Google Scholar 

  36. Altomare DF, Portincasa P, Rinaldi M et al (1999) Slow-transit constipation: solitary symptom of a systemic gastrointestinal disease. Dis Colon Rectum 42:231–240

    Article  PubMed  CAS  Google Scholar 

  37. Knowles CH, Scott SM, Lunniss PJ (2001) Slow transit constipation: a disorder of pelvic autonomic nerves? Dig Dis Sci 46:389–401

    Article  PubMed  CAS  Google Scholar 

  38. Sutcliffe J, King SK, Clarke MC, Farmer P, Hutson JM, Southwell BR (2007) Reduced distribution of pacemaking cells in dilated colon. Pediatr Surg Int 23:1179–1182

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. F Douglas Stephens Surgical Research Laboratory, Murdoch Childrens Research Institute, Melbourne, Australia

    Yee Ian Yik, Pamela J. Farmer, Sebastian K. King, John M. Hutson & Bridget R. Southwell

  2. Anatomical Pathology, Royal Children’s Hospital, Melbourne, Australia

    C. W. Chow & John M. Hutson

  3. Department of Paediatrics, University of Melbourne, Melbourne, Australia

    Yee Ian Yik, Sebastian K. King & John M. Hutson

  4. Gut Motility Laboratory, Surgical Research Group, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, VIC, 3052, Australia

    Bridget R. Southwell

  5. Department of General Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

    Yee Ian Yik

Authors
  1. Yee Ian Yik
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  2. Pamela J. Farmer
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  3. Sebastian K. King
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  4. C. W. Chow
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  5. John M. Hutson
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  6. Bridget R. Southwell
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Correspondence to Bridget R. Southwell.

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Yik, Y.I., Farmer, P.J., King, S.K. et al. Gender differences in reduced substance P (SP) in children with slow-transit constipation. Pediatr Surg Int 27, 699–704 (2011). https://doi.org/10.1007/s00383-011-2852-1

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  • DOI: https://doi.org/10.1007/s00383-011-2852-1

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