Down syndrome and the enteric nervous system

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dc.contributor.authorMoore S.W.
dc.date.accessioned2011-05-15T16:03:45Z
dc.date.available2011-05-15T16:03:45Z
dc.date.issued2008
dc.description.abstractDown syndrome (DS) is the most common chromosomal abnormality occurring in humans. Up to 77% of DS children have associated gastrointestinal (GI) abnormalities, which may be structural or functional in nature. Functional disturbances may, in turn, affect the outcome of corrective surgical procedures, prompting to caution. It is becoming clear that the processes affecting the enteric nervous system (ENS) in DS not only affect the micro-anatomy but also nerve function, and there is some histological evidence of ENS variations in both human and DS animal models. This suggests that developmental disorders of the ENS are probably fundamental to the functional GI disturbances encountered in patients with DS. The anomalous brain development, function and resulting intellectual impairment associated with DS appears to result from the genetic imbalance created by the trisomy of chromosome 21. The possible links between the brain, GI and ENS involvement are not as yet entirely clear. Neurotropic factors affecting brain development during embryogenesis are probably interlinked with ENS development, but the precise mechanism of how this occurs has yet to be established. This study explores what is known about the ENS dysfunction in DS and reviews the possible importance of chromosome 21 located and other genes in its etiology. Functional motor disturbances of the esophagus and colon are not uncommon and may be congenital or acquired in nature. The most prominent of these include esophageal dysmotility syndromes (e.g. achalasia, gastroesophageal reflux, dysphagia) as well as a higher incidence of chronic constipation and Hirschsprung's disease (HSCR) (2-15%) occurring in association with DS. Chromosome 21 itself is thought to be the site of a modifier gene for HSCR. Recently identified candidate genetic mechanisms provide unique insights into the genetic background of the neurological and cognitive disorders associated with DS. Although the role of the triplicated chromosome 21 and genetic dosage remain important, the additional role of other chromosome 21 genes in the etiology of ENS developmental anomalies remains undetermined and requires ongoing research. © 2008 Springer-Verlag.
dc.description.versionReview
dc.identifier.citationPediatric Surgery International
dc.identifier.citation24
dc.identifier.citation8
dc.identifier.issn1790358
dc.identifier.other10.1007/s00383-008-2188-7
dc.identifier.urihttp://hdl.handle.net/10019.1/12767
dc.subjectbrain development
dc.subjectbrain function
dc.subjectchromosome 21
dc.subjectcognitive defect
dc.subjectconstipation
dc.subjectdisease association
dc.subjectDown syndrome
dc.subjectdysphagia
dc.subjectembryo development
dc.subjectesophagus achalasia
dc.subjectgastroesophageal reflux
dc.subjectgenetics
dc.subjectHirschsprung disease
dc.subjecthuman
dc.subjectintestine innervation
dc.subjectpriority journal
dc.subjectreview
dc.subjecttrisomy 21
dc.subjectChild
dc.subjectDown Syndrome
dc.subjectEnteric Nervous System
dc.subjectGastrointestinal Diseases
dc.subjectGastrointestinal Motility
dc.subjectHumans
dc.titleDown syndrome and the enteric nervous system
dc.typeReview
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