Colonic neurotransmitters following spinal cord injury

: Aim of the study was to determine if the colonic motility dysfunction in spinal injured patients is reflected in changes in the neurotransmitters substance P (SP), vasoactiv intestinal peptide (VIP), and neuron-specific enolase (NSE) in the enteric nervous system. A controlled prospective analysis of full-thickness colonic biopsies was carried out. The study population consisted of spinal cord injured (SCI) patients coming forward for colonic surgery; controls were patients having colonic resections. Full-thickness colonic specimens were obtained from SCI and control patients having colorectal procedures. The specimens were examined for histological differences and immunohistochemically stained for SP, VIP and NSE. The ratio of SP and VIP to NSE was then qualitatively compared between SCI patients and controls. SP and VIP were chosen for their role in excitatory and inhibitory neurotransmission. NSE is an isoenzyme of the glycolytic enzyme enolase, which is contained in all enteric nervous system. Specimens of colon were obtained from 4 SCI and 7 control patients. No histological differences were found between colonic specimens from SCI and control patients. The ratio of SP and VIP to NSE was qualitatively similar for both SCI patients and controls. In conclusion, colonic dysmotility was not reflected by qualitative changes in intrinsic enteric neurotransmitters.