Rectoanal incontinence (RI) is one of the most debilitating gastrointestinal motility disorders affecting the elderly. A decrease in tone or stiffess of the smooth muscle of the internal anal sphincter (IAS) occurs with age and contributes to RI. Studies to date from our lab have provided insight into the regulatory control of IAS. In this competitive renewal application we propose to delineate novel control mechanisms of IAS muscle tone that can be targeted therapeutically. We will test the central hypothesis that miRNA regulation of RhoA/ROCK and SM22 is mechanistically linked to the age-dependent decrease in IAS tone and to RI, and that therapeutic targeting of miRNAs can increase IAS tone in vivo. We will establish differences in the signaling and contractile properties among multiple smooth muscle types of the lower GI tract;and in IAS as a function of age. Using both human and rat IAS, we propose studies to (Aim: 1) identify those intracellular signaling molecules that regulate IAS tone, and (Aim 2) identify miRNAs that regulate these intracellular signaling molecules, and develop strategies to reverse the miRNA-regulated decrease in IAS tone with age. We will establish multiple layers of control, focusing on the role of miRNAs as critical regulators of RhoA, RhoA-associated kinase (ROCK) and SM22. Preliminary biochemical and functional data support our hypothesis asserting the roles of RhoA, ROCK, and SM22 in determining SM tone among different SM types and age groups, while miRNA microarray analyses identify miR-139-5p and miR-1 as important regulators of ROCK and SM22 expression, respectively. Our robust approach includes cell, tissue, and in vivo models, enabling coordinated analysis of the miRNA-dependent proteome and signaling changes with functional effects. Beyond the unquestionable significance of the theme, the strengths of this proposal include: 1) exploration of novel mechanisms that explain the decrease in the IAS tone with age;2) a comprehensive and coordinated """"""""omic"""""""", signaling and functional analysis that spans the reductionist- integrative spectrum;and 3) the development of a feasible therapeutic strategy for a disease that is currently untreatable.

Public Health Relevance

Rectoanal incontinence (RI), one of the most debilitating gastrointestinal motility disorders affecting the elderly, is characterized with decrease in tone o stiffness of the smooth muscle of the internal anal sphincter (IAS). Using model systems in the animals and humans, we will identify intracellular signaling molecules and novel regulatory microRNAs in the pathophysiology and therapeutic targeting for RI in the elderly.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project (R01)
Project #
Application #
Study Section
Clinical, Integrative and Molecular Gastroenterology Study Section (CIMG)
Program Officer
Hamilton, Frank A
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Thomas Jefferson University
Internal Medicine/Medicine
Schools of Medicine
United States
Zip Code
Singh, Jagmohan; Mohanty, Ipsita; Rattan, Satish (2018) In vivo magnetofection: a novel approach for targeted topical delivery of nucleic acids for rectoanal motility disorders. Am J Physiol Gastrointest Liver Physiol 314:G109-G118
Mohanty, Ipsita; Parija, Subas Chandra; Suklabaidya, Sujit et al. (2018) Acidosis potentiates endothelium-dependent vasorelaxation and gap junction communication in the superior mesenteric artery. Eur J Pharmacol 827:22-31
Kumar, S; Singh, J; Rattan, S et al. (2017) Review article: pathogenesis and clinical manifestations of gastrointestinal involvement in systemic sclerosis. Aliment Pharmacol Ther 45:883-898
Rattan, Satish (2017) Ca2+/calmodulin/MLCK pathway initiates, and RhoA/ROCK maintains, the internal anal sphincter smooth muscle tone. Am J Physiol Gastrointest Liver Physiol 312:G63-G66
Singh, Jagmohan; Mohanty, Ipsita; Addya, Sankar et al. (2017) Role of differentially expressed microRNA-139-5p in the regulation of phenotypic internal anal sphincter smooth muscle tone. Sci Rep 7:1477
Kumar, Sumit; Singh, Jagmohan; Kedika, Ramalinga et al. (2016) Role of muscarinic-3 receptor antibody in systemic sclerosis: correlation with disease duration and effects of IVIG. Am J Physiol Gastrointest Liver Physiol 310:G1052-60
Krishna, Chadalavada Vijay; Singh, Jagmohan; Thangavel, Chellappagounder et al. (2016) Role of microRNAs in gastrointestinal smooth muscle fibrosis and dysfunction: novel molecular perspectives on the pathophysiology and therapeutic targeting. Am J Physiol Gastrointest Liver Physiol 310:G449-59
Singh, Jagmohan; Boopathi, Ettickan; Addya, Sankar et al. (2016) Aging-associated changes in microRNA expression profile of internal anal sphincter smooth muscle: Role of microRNA-133a. Am J Physiol Gastrointest Liver Physiol 311:G964-G973
Mandaliya, Rohan; Burkart, Ashlie L; DiMarino, Anthony J et al. (2016) Association between common variable immunodeficiency and collagenous infiltrative disorders of the gastrointestinal tract: A series of four patients. Indian J Gastroenterol 35:133-8
Mandaliya, Rohan; DiMarino, Anthony J; Moleski, Stephanie et al. (2015) Survey of anal sphincter dysfunction using anal manometry in patients with fecal incontinence: a possible guide to therapy. Ann Gastroenterol 28:469-74

Showing the most recent 10 out of 111 publications