Farthing M J
St Bartholomew's and the Royal London School of Medicine and Dentistry, United Kingdom.
Int J Med Microbiol. 2000 Oct;290(4-5):491-6. doi: 10.1016/S1438-4221(00)80073-9.
Although there has been extensive investigation of the biochemical consequences of the interactions between bacterial enterotoxins and intestinal epithelial cells and the mechanisms by which they induce intestinal secretion, relatively little attention has been given to other aspects of the host response to these enterotoxins. There is now compelling evidence that the enteric nervous system has a major role in enhancing the secretory state induced by cholera toxin, the E. coli enterotoxins and possibly C. difficile toxin A. Cholera toxin for example is thought to activate a neural reflex via the release of 5-hydroxytryptamine from enterochromaffin cells. Neurotransmitters involved in the reflex include substance P and vasoactive intestinal polypeptide. Delineation of these neural pathways may offer new possibilities for the pharmacological control of enterotoxin-mediated secretion.
尽管已经对细菌肠毒素与肠上皮细胞相互作用的生化后果以及它们诱导肠道分泌的机制进行了广泛研究，但宿主对这些肠毒素反应的其他方面却相对较少受到关注。现在有令人信服的证据表明，肠神经系统在增强霍乱毒素、大肠杆菌肠毒素以及可能还有艰难梭菌毒素A所诱导的分泌状态方面起着主要作用。例如，霍乱毒素被认为是通过肠嗜铬细胞释放5-羟色胺来激活神经反射。参与该反射的神经递质包括P物质和血管活性肠肽。对这些神经通路的描述可能为肠毒素介导的分泌的药理控制提供新的可能性。
