Identification of interstitial cells of Cajal. Significance for studies of human small intestine and colon

Interstitial cells of Cajal (ICC) were described a century ago by Ramón y Cajal a.o. as primitive neurons in the intestines. In the period 1900-1960 a large number of light microscopical studies of ICC were published, in which ICC were identified by heir characteristic morphology. After 1960 electron microscopical studies emphasized similarities between ICC and fibroblasts. In our early studies of ICC in the external musculature of mouse small intestine, we identified ICC by their characteristic morphology and topography, and we analyzed the relation between ICC, autonomic nerves and smooth muscle. These studies strongly suggested that ICC were fundamental regulators of external muscle function. These hypotheses have since been supported by independent morphological and electrophysiological evidence, strongly suggesting a pacemaker role of some ICC populations as well as other regulatory functions (mechanoreceptive, mediating inhibitory nervous input). In spite of this possible fundamental importance for G-I motility, ICC have not been adequately described or even identified in human intestine, and hence, never included in ultrastructural studies of G-I neuropathology. This survey presents the concepts of ultrastructure necessary for identification and morphological studies of ICC in human intestine.