Myenteric Denervation of the Gut with Benzalkonium Chloride: A Review of Forty Years of an Experimental Model

Abstract

Experimental denervation of organs plays a key role in understanding the functional aspects of the normal innervation as well as the diseases related to them. In 1978 the experimental model of myenteric denervation of the rat gut by serosal application of benzalkonium chloride (BAC) was proposed. BAC is a positively charged surface-active alkylamine and is a powerful cationic detergent, which destroys bacteria after ionic attraction and for this reason is largely used as a surgical antiseptic. Since its initial report, the BAC-induced myenteric denervation model has been used to study many functional and pathological aspects of the enteric nervous system. So far this is the only pure method of myenteric denervation available for research in this area. Promising reports in the literature have shed light on the possibilities for the development of new uses of the BAC-denervation experimental model as a therapeutic tool in some pathological situations. This review aims to shed light on the main historical and recent findings provided by this experimental model.

Hirschsprung-Associated Enterocolitis: Transformative Research from Bench to Bedside

“…BAC ablates the myenteric neurons and glia of the intestine leading to the development of aganglionosis. 38 39 40 41…”

Animal Models of Hirschsprung's Disease: State of the Art in Translating Experimental Research to the Bedside

“…The benzalkonium chloride (BAC) rat model of HSCR is a wellestablished model, 11 which has provided a unique opportunity to investigate the mechanisms behind the origins of this congenital anomaly. This procedure was first described by Sato et al in 1978 and corroborated the following year via histological analysis.…”

Botulinum toxin as a treatment for short bowel syndrome in rats

“…Nevertheless, despite the encouraging preliminary results and the usefulness of the BAC experimental model for the comprehension of the role of the enteric nervous system in intestinal adaptations after extensive resections, translating these promising findings from bench to bedside is not yet a feasible task. In fact, it would be reckless to perform such experiments in humans because BAC promotes peritonitis with further risk of pseudo-obstruction, as well as irreversible denervation followed by uncontrolled dilatation of the viscera 6 . In this aspect the use of botulinum toxin (BT) instead of BAC as a way of achieving the denervation of the remaining small intestine in SBS could be an interesting option because it leads to a mild and transient denervation of the intestine 7 .…”