Human enteric glia diversity in health and disease: new avenues for the treatment of Hirschsprung disease

Hirschsprung disease (HSCR) is caused by an absence of the enteric nervous system (ENS), which is crucial for intestinal function. The ENS is composed of enteric neurons and glia, and is mostly derived from migrating vagal neural crest cells. Trunk-derived Schwann cells also play a significant role in postnatal maintenance of the ENS. However, the diversity of the ENS in health and disease remains largely unknown. Here, we performed single cell RNA sequencing on pediatric controls and HSCR individuals, and identified two major classes of enteric glia, being canonical and Schwann-like enteric glia. We show that the latter are the main contributors of enteric glia heterogeneity after birth and importantly, that they are preserved in aganglionic segments of HSCR individuals. In a zebrafish model of HSCR, which also shows preservation of Schwann-like enteric glia, enteric neurogenesis could be stimulated, demonstrating a potential novel therapy for HSCR.