Skip to main content
Log in

Hirschsprung's disease as a neurochristopathy

  • Main Topic
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Recent molecular-genetic and histochemical studies of intestinal aganglionosis have confirmed the initial classification established by Bolande, who considered Hirschsprung's disease (HD) a neurocristopathy.

This paper is a critical review of the results of molecular-genetic studies carried out from 1992 to date. In particular, the author focuses on the possible clinical impact of the identification ofRET as a causative gene for HD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Angrist M, Kauffman E, Slaugenhaupt SA, Matise TC, Puffenberger EG, Washington SS, Lipton A, Cass DT, Reyna T, Weeks DE, Sieber W Chakravarti A (1993) A gene for Hirschsprung disease (megacolon) in the pericentromeric region of human chromosome 10. Nat Genet 4: 351–356

    Article  PubMed  CAS  Google Scholar 

  2. Angrist M, Bolk S, Thiel B, Puffenberger EG, Hofstra RM, Buys HCM, Cass DT, Chakravarti A (1995) Mutation analysis of the RET receptor tyrosine kinase in Hirschsprung disease. Hum Mol Genet 4: 821–830

    Article  PubMed  CAS  Google Scholar 

  3. Attié T, Pelet A, Sarda P, Eng C, Edery P, Mulligan LM, Ponder BAJ, Munnich A, Lyonnet S (1994) A 7 by deletion of the RET proto-oncogene in familial Hirschsprung's disease. Hum Mol Genet 3: 1439–1440

    Article  PubMed  Google Scholar 

  4. Attié T, Pelet A, Edery P, Eng C, Mulligan LM, Amiel J, Boutrand J, Beldijord C, Nihoul-Fèkètè C, Munich A, Ponder BAJ, Lyonnet S (1995) Diversity of RET proto-oncogene mutations in familial and sporadic Hirschprung disease. Hum Mol Genet 4: 1381–1386

    Article  PubMed  Google Scholar 

  5. Badner JA, Chakravarti A (1990) Waardenburg syndrome and Hirschsprung disease: evidence for pleiotropic effects of a single dominant gene. Am J Med Genet 35: 100–104

    Article  PubMed  CAS  Google Scholar 

  6. Badner JA, Sieber WK, Garver KL, Chakravarti A (1990) A genetic study of Hirschsprung disease. Am J Hum Genet 46: 568–580

    PubMed  CAS  Google Scholar 

  7. Bard LA (1978) Heterogeneity in Waardenburg's syndrome. Arch Ophthalmol 96: 1193–1198

    Article  PubMed  CAS  Google Scholar 

  8. Bolande RP (1974) The neurocristopathies. A unifying concept of disease arising in neural crest maldevelopment. Hum Pathol 5: 409–429

    Article  Google Scholar 

  9. Bolande RP (1981) Neurofibromatosis. The quintessential neurocristopathy: pathogenetic concepts and relationships. In: Riccardi VM, Mulvihill JJ (eds) Advances in neurology: neurofibromatosis (von Recklinghausen disease). Raven Press, New York, pp 67–75

    Google Scholar 

  10. Bolino A, Schuffenecker I, Yin L, Seri M, Silengo M, Tocco T, Chabrier G, Houdent C, Murat A, Schlumberger M, Tourniaire J, Lenoir GM, Romeo G (1995) RET mutations in exons 13 and 14 of FMTC patients. Oncogene 10: 2415–2419

    PubMed  CAS  Google Scholar 

  11. Borst MJ, VanCamp JM, Peacock ML, Decker RA (1995) Mutational analysis of multiple endocrine neoplasia type 2A associated with Hirschsprung's disease. Surgery 117: 386–391

    Article  PubMed  CAS  Google Scholar 

  12. Bower RJ, Adkins JC (1980) Ondine's curse and neurocristopathy. Clin Pediatr 19: 665–668

    Article  CAS  Google Scholar 

  13. Branski D, Dennis NR, Neale JM, Brooks LJ (1979) Hirschsprung's disease and Waardenburg's syndrome. Pediatrics 63: 803–804

    PubMed  CAS  Google Scholar 

  14. Bronner-Fraser M (1993) Segregation of cell lineage in the neural crest. Curr Opin Genet Dev 3: 641–647

    Article  PubMed  CAS  Google Scholar 

  15. Carlson KM, Don S, Chi D, Scavarda N, Toshima K, Jackson CE, Wells SA Jr, Goodfellow PJ, Donis-Keller H (1994) Single missense mutation in the tyrosine kinase catalytic domain of the RET proto-oncogene is associated with multiple endocrine neoplasia type 2B. Proc Natl Acad Sci U S A 91: 1579–1583

    Article  PubMed  CAS  Google Scholar 

  16. Carter C, Easton DF, Mathew CG (1987) Exclusion of linkage loci on chromosome 19 with multiple endocrine neoplasia type 2. Cytogenet Cell Genet 45: 33–37

    Article  PubMed  CAS  Google Scholar 

  17. Ceccherini I, Bocciardi R, Yin L, Pasini B, Hofstra R, Takahashi M, Romeo G (1993) Exon structure and flanking intronic sequences of the human RET proto-oncogene. Biochem Biophys Res Commun 196: 1288–1295

    Article  PubMed  CAS  Google Scholar 

  18. Chatten J, Voorhess ML (1967) Familial neuroblastoma. N Engl J Med 277: 1230

    Article  PubMed  CAS  Google Scholar 

  19. Clausen N, Andersson P, Tommerup N (1989) Familial occurrence of neuroblastoma, Von Recklinghausen's neurofibromatosis, Hirschsprung's agangliosis and Jaw-winking syndrome. Acta Paediatr Scand 78: 736–741

    Article  PubMed  CAS  Google Scholar 

  20. Currie ABM, Haddad M, Honeyman M, Boddy SAM (1986) Associated developmental abnormalities of the anterior end of the neural crest: Hirschsprung's disease — Waardenburg's syndrome. J Pediatr Surg 21: 240–250

    Article  Google Scholar 

  21. Decker RA (1992) Long-term follow-up of a large North American kindred with multiple endocrine neoplasia type 2A. Surgery 112: 1066–1073

    PubMed  CAS  Google Scholar 

  22. Donis-Keller H, Don S, Chi D, Carlson KM, Toshima K, Lairmore TC, Howe JR, Moley J, Goodfellow P, Wells SA Jr (1993) Mutations in the RET proto-oncogene are associated with MEN 2A and FMTC. Hum Mol Genet 2: 851–856

    Article  PubMed  CAS  Google Scholar 

  23. Edery P, Lyonnet S, Mulligan LM, Pelet A, Dow E, Abel L, Holder S, Nihoul-Fékété C, Ponder BAJ, Munnich A (1994) Mutations of the RET proto-oncogene in Hirschsprung's disease. Nature 367: 378–379

    Article  PubMed  CAS  Google Scholar 

  24. Edery P, Pelet A, Mulligan LM, Abel L, Atti T, Dow E, Bonneau D, David A, Flintoff W Jan D, Journel H, Lacombe D, Le Merrer M, Meijers C, Parent P, Philip N, Plauchu H, Sarda P, Verloes A, Nihoul-Fékété C, Williamson R, Ponder BAJ, Munnich A, Lyonnet S (1994) Long segment and short segment familial Hirschsprung's disease: variable clinical expression at the RET locus. J Med Genet 31: 602–606

    Article  PubMed  CAS  Google Scholar 

  25. Eng C, Smith DP, Mulligan LM, Nagai MA, Healey CS, Ponder MA, Gardner E, Scheumann GFW Jackson CE, Tunnacliffe A, Ponder BAJ (1994) Point mutation within the tyrosine kinase domain of the RET proto-oncogene in multiple endocrine neoplasia type 2B and related sporadic tumours. Hum Mol Genet 3: 237–241

    Article  PubMed  CAS  Google Scholar 

  26. Eng C, Smith DP, Mulligan LM, Healey CS, Zvelebil MJ, Stonehouse TJ, Ponder MA, Jackson CE, Waterfield MD, Ponder BAJ (1995) A novel point mutation in the tyrosine kinase domain of the RET proto-oncogene in sporadic medullary thyroid carcinoma and in a family with FMTC. Oncogene 10: 509–513

    PubMed  CAS  Google Scholar 

  27. Gaisie G, Sang K, Young LW (1979) Coexistent neuroblastoma and Hirschsprung's disease — another manifestation of the neurocristopathy? Pediatr Radiol 8: 161–163

    Article  PubMed  CAS  Google Scholar 

  28. Goldberg MF (1966) Waardenburg's syndrome with fundus and other anomalies. Arch Ophthalmol 76: 797–810

    Article  PubMed  CAS  Google Scholar 

  29. Guilleminault C, McQuitty J, Ariagno RL, Challamel MJ, Korobkin R, McClead RE (1982) Congenital central alveolar hypoventilation syndrome in six infants. Pediatrics 70: 684–694

    PubMed  CAS  Google Scholar 

  30. Haddad GG, Mazza NM, Defeudini R, Blanc WA, Driscoll JM, Epstein MAF, Eppstein RA, Mellins RB (1978) Congenital failure of automatic control of ventilation, gastrointestinal motility and heart rate. Medicine 57: 517–526

    Article  PubMed  CAS  Google Scholar 

  31. Hamilton J, Bodurtha JN (1989) Congenital central hypoventilation syndrome and Hirschsprung's disease in half sibs. J Med Genet 26: 272–274

    Article  PubMed  CAS  Google Scholar 

  32. Hofstra RMW Landsvater RM, Ceccherini I, Stulp RP, Stelwagen T, Yin L, Pasini B, Hoppener JWM, Van Amstel HKP, Romeo G, Lips CJM, Buys CHCM (1994) A mutation in the RET proto-oncogene associated with multiple endocrine neoplasia type 2B and sporadic medullary thyroid carcinoma. Nature 367: 375–376

    Article  PubMed  CAS  Google Scholar 

  33. Hörstadius S (1950) The neural crest. Its properties and derivatives in the light of experimental methods. Oxford University Press, London, pp 1–12

    Google Scholar 

  34. Hosoda K, Hammer RE, Richardson JA, Baynash AG, Cherung JC, Giaid A, Yanagisawa M (1994) Targeted and natural (piebaldlethal) mutations of endothelin-B receptor gene produce megacolon associated with spotted coat color in mice. Cell 79: 1267–1276

    Article  PubMed  CAS  Google Scholar 

  35. Kelley RI, Zackai EH (I981) Congenital deafness, Hirschsprung's and Waardenburg's syndrome (abstract). Am J Hum Genet 33: 65A

    Google Scholar 

  36. Keynes R and Lunsden A (1990) Segmentation and the origin of regional diversity in the vertebrate central nervous system. Neuron 4: 1–9

    Article  PubMed  CAS  Google Scholar 

  37. Kusafuka T, Wang Y, Puri P (I995) Novel mutations of the endothelin-B receptor gene in sporadically occurring Hirschsprung's disease (abstract). Eighth International Symposium on Paediatric Surgical Research, Dublin, July 1995

  38. Landsvater RM, Rombouts AGM, Meerman GJ, Schillhorn-van Veen JMJ, Berendes MJH, Geerdink RA, Struyvenberg A, Buys CHCM, Lips CJM (1993) The clinical implications of a positive calcitonin test for C-cell hyperplasia in genetically unaffected members of an MEN2A kindred. Am J Hum Genet 52: 335–342

    PubMed  CAS  Google Scholar 

  39. Lumsden A, Sprawson N, Graham A (1991) Segmental origin and migration of neural crest cells in the hindbrain region of the chick embryo. Development 113: 1281–1291

    PubMed  CAS  Google Scholar 

  40. Lyonnet S, Bolino A, Pelet A, Abel L, Nihoul-Fékété C, Briard ML, Mok-Siu V, Kriinen H, Martucciello G, Lerone M, Puliti A, Yin L, Weissenbach J, Devoto M, Munnich A, Romeo G (1993) A gene for Hirschsprung disease maps to the proximal long arm of chromosome 10. Nat Genet 4: 346–350

    Article  PubMed  CAS  Google Scholar 

  41. Mahakrishnan A, Srinivasan MS (1980) Piebaldism with Hirschsprung's disease. Arch Dermatol 116: 1102

    Article  PubMed  CAS  Google Scholar 

  42. Martucciello G, Bicocchi MP, Dodero P, Lerone M, Cirillo M, Puliti A, Gimelli G, Romeo G, Jasonni V (1992) Total colonic aganglionosis associated with interstitial deletion of the long arm of chromosome 10. Pediatr Surg Int 7: 308–310

    Article  Google Scholar 

  43. Martucciello G, Favre A, Takahashi M, Jasonni V (1995) Immu-nohistochemical localization of ret protein in Hirschsprung's disease. J Pediatr Surg 30: 433–436

    Article  PubMed  CAS  Google Scholar 

  44. McMahon R, Mulligan LM, Healey CS, Payne SJ, Ponder M, Ferguson-Smith MA, Barton DE, Ponder BAJ (1994) Direct, nonradioactive detection of mutations in multiple endocrine neoplasia type 2A families. Hum Mol Genet 3: 643–646

    Article  PubMed  CAS  Google Scholar 

  45. Meire F, Standaert L, De Laey JJ, Zeng LH (1987) Waardenburg syndrome, Hirschsprung disease and Marcus Gunn ptosis. Am J Med Genet 27: 683–686

    Article  PubMed  CAS  Google Scholar 

  46. Meijers JHC, Mulder M (1995) Antero-posterior differences within caudal hindbrain neural crest cell populations and the development of the enteric nervous system (personal communication). Second International Meeting: Hirschsprung's disease and related neurocristopathies, Cleveland, October 1995

  47. Meijers JHC, Peters-van der Sanden MJH, Tibboel D, Arthur van der Kampè WM, Luider TM, Molenaar JC (1992) Colonization characteristics of enteric neural crest cells: embryological aspects of Hirschsprung's disease. J Pediatr Surg 27: 811–814

    Article  PubMed  CAS  Google Scholar 

  48. Minutillo C, Pemberton PJ, Goldblatt J (1989) Hirschsprung's disease and Ondine's curse: further evidence for a distinct syndrome. Clin Genet 36: 200–203

    Article  PubMed  CAS  Google Scholar 

  49. Mukohopadhyay S, Wilkinson PW (1990) Cerebral arteriovenous malformation, Ondine's curse and Hirschsprung's disease. Dev Med Child Neurol 32: 1087–1089

    Article  Google Scholar 

  50. Mulligan LM, Kwok JBJ, Healey CS, Elsdon MJ, Eng C, Gardner E, Love DR, Mole SE, Moore JK, Papi L, Ponder MA, Telenius H, Tunnacliffe A, Ponder BAJ (1993) Germ-line muta tions of the RET proto-oncogene in multiple endocrine neoplasia type 2A. Nature 363: 458–460

    Article  PubMed  CAS  Google Scholar 

  51. Mulligan LM, Eng C, Healey CS, Clayton D, Kwok JBJ, Gardner E, Ponder MA, Frilling A, Jackson CE, Lehnert H, Neumann HPH, Thibodeau SN, Ponder BAJ (1994) Specific mutations of the RET proto-oncogene are related to disease phenotype in MEN 2A and FMTC. Nat Genet 6: 70–74

    Article  PubMed  CAS  Google Scholar 

  52. Mulligan LM, Eng C, Attié T, Lyonnet S, Marsh DJ, Hyland V, Robinson BG, Frilling A, Verellen-Dumoulin C, Safar A, Venter DJ, Munnich A, Ponder BAJ (1994) Diverse phenotypes associated with exon 10 mutations of the RET proto-oncogene. Hum Mol Genet 3: 2163–2167

    Article  PubMed  CAS  Google Scholar 

  53. O'Dell K, Staren SE, Bassuk A (1987) Total colonic aganglionosis (Zuelzer-Wilson syndrome) and congenital failure of automatic control of ventilation (Ondine's curse). J Pediatr Surg 22: 1019–1020

    Article  PubMed  Google Scholar 

  54. Omen GS, McKusick VA (1979) The association of Waardenburg syndrome and Hirschsprung megacolon. Am J Med Genet 3: 217–223

    Article  Google Scholar 

  55. Pasini B, Borrello MG, Greco A, Bongarzone I, Yin L, Mondellini P, Alberti L, Miranda C, Arighi E, Bocciardi R, SeriM, Barone V, Radice MT, Romeo G, PierottiMA (1995) Loss of function effect of RET mutations causing Hirschsprung disease. Nat Genet 10: 35–40

    Article  PubMed  CAS  Google Scholar 

  56. Pelet A, Atti T, Goulet O, Eng C, Ponder BAJ, Munnich A, Lyonnet S (1994) De-novo mutations of RET proto-oncogene in Hirschsprung's disease. Lancet 344: 1769–1770

    Article  PubMed  CAS  Google Scholar 

  57. Peters-van der Sanden MJH, Kirby ML, Gittenberger-de Groot A, Tibboel D, Mulder MP, Meijers C (1993) Ablation of various regions within the avian neural crest has differential effects on ganglion formation in the fore-, mid-, and hind gut. Dev Dyn 196: 183–194

    Article  PubMed  CAS  Google Scholar 

  58. Puffenberger EG, Kauffman ER, Bolk S, Matise TC, Washington SS, Angrist M, Weissenbach J, Garver KL, Mascari M, Ladda R, Slaugenhaupt SA, Chakravarti A (1994) Identity-by descent and association mapping of a recessive gene for Hirschsprung disease on human chromosome 13822. Hum Mol Genet 3: 1217–1225

    Article  PubMed  CAS  Google Scholar 

  59. Puffenberger EG, Hosoda K, Washington SS, Nakao K, de Wit D, Yanagisawa M, Chakravarti A (1994b) A missense mutation of the endothelin-B receptor gene in multigenic Hirschsprung disease. Cell 79: 1257–1266

    Article  PubMed  CAS  Google Scholar 

  60. Puliti A (1995) Molecular genetic mapping of the dominant megacolon mutation (Dom) in the mouse (personal communication). Second International Meeting: Hirschsprung's disease and related neurocristopathies, Cleveland, October 1995

  61. Reed WB, Stone VM, Boder E, Ziprowski L (1967) Pigmentary disorders in association with congenital deafness. Arch Dermatol 95: 176–186

    Article  PubMed  CAS  Google Scholar 

  62. Romeo G, Ronchetto P, Yin L, Barone V, Seri M, Ceccherini I, Pasini B, Bocciardi R, Lerone M, Käriäinen H, Martucciello G (1994) Point mutations affecting the tyrosine kinase domain of the RET proto-oncogene in Hirschsprung's disease. Nature 367: 377–378

    Article  PubMed  CAS  Google Scholar 

  63. Santoro M, Rosati R, Grieco M, Berlingieri MT, Colucci D'Amato GL, De Franciscis V (1990) The RET proto-oncogene is consistently expressed in human pheochromocytoma and thyroid medullary carcinomas. Oncogene 5: 1595–1598

    PubMed  CAS  Google Scholar 

  64. Seri M, Yin L, Barone V, Bolino A, Celli J, Bocciardi R, Pasini B, Ceccherini I, Lerone M, Kristoffersson U, Larsson LT, Casasa JM, Cass DT, Abramowicz MJ, Vanderwinden JM, Kraveenkiené I, Baric I, Silengo M, Martucciello G, Romeo G (in press) Detection of RET mutations is higher among long segment than short segment Hirschsprung patients. Hum Murat

  65. Shah KN, Dalal SJ, Desai MP (1981) White forelock, pigmentary disorder of irides, and long segment Hirschsprung's disease: possible variant of Waardenburg syndrome. J Pediatr 99: 432–435

    Article  PubMed  CAS  Google Scholar 

  66. Shocker E, Teloh HA (1957) Case reports: aganglionic megacolon, pheochromocytoma, megaloureter and neurofibroma: concurrence of several abnormalities. Am J Dis Child 94: 185

    Google Scholar 

  67. Sobol H, Narod SA, Nakamura Y, Boneu A, Calmettes C, Chadenas D, Charpentier G, Chatal JF, Delepine N, Delisle MJ, Dupond JL, Garder P, Godefroy H, Gnillausseau PJ, GuillausseauScholer C, Houdent C, Lalau JD, Mace G, Parmentier C, Soubrier F, Tourniaire J, Lenoir GT (1989) Screening for multiple endocrine neoplasia type 2 a with DNA-polymorphism analysis. N Engl J Med 12: 996–1001

    Article  Google Scholar 

  68. Stern M, Erttmann R, Hellwege HH, Kuhn N (1980) Total aganglionosis of the colon and Ondine's curse (letter to editor). Lancet 1: 877–878

    Article  PubMed  CAS  Google Scholar 

  69. Takahashi M, Buma Y, Taniguchi M (1991) Identification of the RET proto-oncogene products in neuroblastoma and leukemia cells. Oncogene 6: 297–301

    PubMed  CAS  Google Scholar 

  70. Verdy M, Weber AM, Roy CC, MorinCL, Cadotte M, Brochu P (1982) Case report: Hirschsprung's disease in a family with multiple endocrine neoplasia type 2. J Pediatr Gastroenterol Nutr 1: 603–607

    Article  PubMed  CAS  Google Scholar 

  71. Verloes A, Elmer C, Lacombe D, Heinrichs C, Rebuffat E, Demarquez JL, Moncla A, Adam E (1993) Ondine-Hirschsprung syndrome (Haddad syndrome). Further delineation in two cases and review of the literature. Eur J Pediatr 152: 75–77

    Article  PubMed  CAS  Google Scholar 

  72. Weese-Mayer DE, Silvestri JM, Menzies LJ, Morrow-Kenny AS, Hunt CE, Hauptman SA (1992) Congenital central hypoventilation syndrome: diagnosis, management, and long-term outcome in thirty-two children. J Pediatr 120: 381–387

    Article  PubMed  CAS  Google Scholar 

  73. Xue F, Yu H, Maurer LH, Memoli VA, Nutile-McMenemy N, Schuster M, Bowden DW, Mao J-I, Noll WW (1994) Germline RET mutations in MEN 2A and FMTC and their detection by simple DNA diagnostic tests. Hum Mol Genet 3: 635–638

    Article  PubMed  CAS  Google Scholar 

  74. Yin L, Barone V, Seri M, BolinoA, Ceccherinie I, Pasini B, Tocco T, Lerone M, Cywes S, Moore S, Vanderwinden JM, Abramowicz MJ, Kristeffersson U, Lasrsson LT, Hael BCJ, Silengo M, Martucciello G, Romeo G (1944) Heterogeneity and low detection rate of RET mutations in Hirschsprung's disease. Eur J Hum Genet 2: 272–280

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Martucciello, G. Hirschsprung's disease as a neurochristopathy. Pediatr Surg Int 12, 2–10 (1997). https://doi.org/10.1007/BF01194793

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01194793

Key words

Navigation