Peptidergic innervation irregularities in Hirschsprung's disease. Immunohistochemistry--radioimmunoassay.

The distribution of vasoactive intestinal polypeptide (VIP)-containing nerves and the contents of both VIP and substance P (S-P) in the intestines from 12 children with Hirschsprung's disease were examined using immunohistochemical methods and radioimmunoassay. VIP-containing nerve fibers were markedly decreased in number in the true muscle coats of aganglionic segments, while extrinsic hypertrophic nerve bundles in these segments showed positive VIP-immunoreactivities. This finding suggests the existence of extrinsic origins of VIP-containing nerves in the human gut. The contents of VIP were 44.5 +/- 8.2 in aganglionic segments and 130 +/- 17.1 pg/mg wet tissue weight in normoganglionic segments. The contents of S-P were 0.42 +/- 0.18 in aganglionic segments and 6.38 +/- 2.3 pg/mg wet tissue weight in normoganglionic segments. Both VIP and S-P contents in aganglionic segments were significantly reduced as assessed by the use of radioimmunoassay (p less than 0.001 and p less than 0.05). These abnormal peptidergic patterns of innervation might relate to the non-peristaltic state in Hirschsprung's disease.