Unraveling the molecular basis of clinical heterogeneity in Hirschsprung disease through gene expression analysis

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Muntadhar M. Isa, Maimun Syukri, Z.A. Muchlisin, Gunadi, Dian Adi Syahputra, Teuku Yusriadi, Yumna Muzakkir, Reno Keumalazia Kamarlis, Zulham Effendy, Ahmad Setyadi, Siti Maghfirah, Tristia Rinanda

2026 Pediatric Surgery International Vol. 42 Issue 1 Article Cited by 0 SDG 3SDG 17 Quartile

Abstract

Purpose: To assess the association of RET, NRG1, SEMA3, and RARB gene variants with clinical phenotypes of Hirschsprung disease (HSCR) in a population with limited genetic data (Aceh, Indonesia). Methods: This study employed an observational analytical design with a cross-sectional approach. A total of 57 patients who underwent HSCR surgery were included. Demographic, clinical, and histopathological data were collected. Both a-ganglionic and ganglionic tissues from the colon or rectum were sampled from HSCR patients, along with control samples from each patient with anorectal malformation. mRNA expression of RET, NRG1, SEMA3, and RARB genes was measured using real-time PCR. Results: Among the 57 patients, most were male (70.2%) and had short-segment HSCR (98.2%). NRG1 expression was significantly reduced in aganglionic colon tissue compared with controls (2.84-fold; p = 0.02). RET expression was markedly decreased in both aganglionic (3.23-fold; p = 0.02) and ganglionic tissues (3.89-fold; p = 0.02). Similarly, SEMA3 expression was significantly lower in aganglionic (3.05-fold; p = 0.03) and ganglionic tissues (2.94-fold; p = 0.04) relative to control colon. Conclusions: Reduced expression of NRG1, RET, and SEMA3 was observed in HSCR colon tissues, suggesting their involvement in disease pathogenesis among Acehnese patients. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2026.

Affiliations

Pediatric Surgery Division, Surgery Department Faculty of Medicine, Universitas Syiah Kuala/ Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia; Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Syiah Kuala/ Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia; Faculty of Marine and Fisheries, Universitas Syiah Kuala, Banda Aceh, Indonesia; Pediatric Surgery Division, Department of Surgery, Universitas Gajah Mada/dr. Sardjito Hospital, Yogyakarta, Indonesia; Department of Pathology Anatomy, Faculty of Medicine, Universitas Syiah Kuala/ Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia; Department of Surgery, Universitas Syiah Kuala/Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia; Microbiology Department, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia

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