Mechanism of Rho-kinase-mediated Ca2+-independent contraction in aganglionic smooth muscle in a rat model of Hirschsprung's disease.

Purpose: Lack of ganglion cells is the main cause of bowel movement disorder in Hirschsprung's disease. Because smooth muscle is the primary organ, the properties of intestinal smooth muscle need to be investigated. We therefore investigated the reactivity of the contractile system and the mechanism of contraction in aganglionic intestinal smooth muscle.

Methods: Colonic smooth muscle strips from endothelin-B receptor gene-deficient [EDNRB(-/-)] rats were loaded with the Ca(2+) indicator dye fura-PE3/AM and changes in fluorescence intensity were monitored. The intracellular calcium concentration ([Ca(2+)]i) and force development in the strips were measured simultaneously.

Results: The force induced by 10 microM substance P (SP) was higher than that induced by 60 mM K(+) depolarization (control), whereas [Ca(2+)]i elevation induced by 10 microM SP was less than that induced by 60 mM K(+) in all segments. Pretreatment with the Rho-kinase inhibitor Y-27632 inhibited force development more strongly in EDNRB(-/-) aganglionic segments than in EDNRB(+/+) ganglionic segments. However, [Ca(2+)]i was higher in EDNRB(-/-) aganglionic segments than in EDNRB(+/+) ganglionic segments.

Conclusions: The Ca(2+)-independent pathway involving Rho-kinase was hyperactivated in EDNRB(-/-) aganglionic segments. This phenomenon is assumed to compensate for Ca(2+) channel downregulation and Ca(2+)-dependent contraction. From a clinical point of view, the motility of aganglionic intestine would be controllable with the control of Ca(2+)-independent contraction before definitive operations in Hirschsprung's disease.