ArticleWorld journal of pediatric surgery2026
NAD+ metabolic collapse and arrest of epithelial development in Hirschsprung disease.
Article in World journal of pediatric surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Background: Hirschsprung disease (HSCR) is characterized by distal aganglionosis. Persistent postoperative dysmotility and enterocolitis suggest that intrinsic epithelial vulnerabilities may remain within the ganglionic bowel. We here aimed to define both the state of the epithelium and its metabolism in HSCR. Methods: Distal colonic tissues from patients with HSCR and non-HSCR controls (HSCR allied disorders) were examined by single-cell RNA sequencing. Particular attention was given to nicotinamide adenine dinucleotide (NAD Results: Compared with control, HSCR epithelium showed marked transcriptional remodeling, with accumulation of stem and transit-amplifying cells, and depletion of differentiated epithelial lineages, indicating impaired epithelial maturation. These changes were most pronounced in the distal ganglionic colon with a reduced epithelial KRT20 signal, where oxidative phosphorylation, ATP synthesis, and lipid and steroid metabolic pathways were broadly suppressed. Key NAD Conclusion: HSCR epithelium displays metabolic fragility characterized by NAD
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