Human gut neuroanatomy: methodology for a quantitative analysis of nerve elements and neurotransmitter diversity in the human "enteric nervous system"

After a few decad of neglect, the "enteric nervous system" has recently regained the attention of investigators. Indeed, various studies, such as those which led to the isolation from the gut of a number of neuropeptides, subsequently demonstrated throughout the nervous system, have prompted major advancements of modern neuroscience. In spite of a wealth of animal investigations and a number of human studies, however, available information concerning the human "enteric nervous system" is comparatively sparse. In the opinion that such lack of information was largely due to unavailability of appropriate techniques, we have initiated and developed a new comprehensive methodology. This way, a quantitative analysis was made possible of both nerve structure and transmitter status, point-to-point along the gut, as well as within the various, functionally heterogeneous components of the gastrointestinal wall itself. After a general introduction, the present review is intended to summarize such methodology, with the addition of a few illustrative examples of application and a practically-oriented guideline to its use, in the form of technical appendix.