Functional Neuro-organization of the Peripheral Abdominopelvic Autonomic Plexuses in Humans; an Immunohistochemical and Radiologic Approach

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BACKGROUND & RELEVANT WORK BY THE APPLICANT The abdominal aortic plexus (AP) is a network of nerves deep in the abdomen that control the abdominal and pelvic organs. However, our understanding of the functional pathways within (i.e., those nerves specifically involved with controlling the different organs) remain uncharacterized. In fact, our lab only recently detailed the anatomy of the upper portion in humans (Beveridge et al., 2015; Beveridge et al., 2016, Beveridge et al., 2018; Nair et al., 2019). Given the structural consistency we observed, questions arose whether the constituent neurons were further organized by function, and how these distributions vary between males and females. OBJECTIVE OF OUR RESEARCH PROGRAM Our lab (Groh et al., 2018; Groh et al. 2021) and others (Botti et al., 2014; Lepiarczyk et al., 2018; Pidsudko et al., 2019) have shown a functional organization indeed exists in animals; however, little work has been done to examine the human form. Therefore, the long-term goal of our research program is to elucidate the peripheral pathways of autonomic innervation to the pelvic organs in humans. To this end, the present proposal is aimed at our lab's short-term goal of tracing the pathways of innervation to the bladder in males and females using state-of-the-art immunohistochemical and radiologic imaging techniques in human cadavers so that we can elucidate these pathways at gross and microscopic scales. Importantly, this will be completed in collaboration with leading magnetic resonance imaging and microscopy core facilities to offer our trainees the opportunity to develop translatable skillsets as junior scientists.   IMPACT & SIGNIFICANCE For centuries, the ability for scientists to examine the functional pathways within the AP has been limited to animal models due to the invasiveness or toxicity of existing research methods. Now, unpublished work from our lab provides compelling evidence to demonstrate that the novel application of these state-of-the-art immunohistochemical and radiologic methods are capable of uncovering this information in human cadavers. Beyond advancing the field of human anatomy, this work will have a tremendous impact for surgeons who require this anatomical knowledge to inform research into nerve-sparing surgical approaches to prevent postoperative urogenital complications common to abdominopelvic surgeries such as cancer resection of the large intestines (Keating, 2004), testis cancer surgery (Pettus et al. 2009; Afferi et al., 2021), lumbar spine surgery (Carragee et al., 2011), or bladder reconstruction surgery (Dangle et al., 2013).