Communication between interstitial cells of Cajal and gastrointestinal muscle

Interstitial cells of Cajal (ICC) pace gastrointestinal muscle by initiating slow waves in both muscle layers and appear to be preferred sites for reception of neurotransmitters. ICC of the myenteric plexus (ICC-MP) pace stomach and small intestine, while intramuscular ICC (ICC-IM) receive nerve messages. Recently, ICC-IM have been found to provide regenerative responses to and amplification of pacing messages from ICC-MP, at least in some systems. This review will examine the assumption that gap junctions provide low-resistance contacts for pacing. Structural and functional evidence will be evaluated. Structural, theoretical and experimental difficulties with the gap junctions hypothesis for pacing will be considered. So far little direct evidence about the role of gap junctions in neurotransmission exists, although a structural basis exists. Alternate possibilities for transmission of ICC pacing and neural messages will be examined and suggestions for future research made.