Grundy D
Department of Biomedical Science, University of Sheffield, Western Bank, UK.
Gut. 2004 Mar;53 Suppl 2(Suppl 2):ii5-8. doi: 10.1136/gut.2003.033415.
Vagal and spinal afferents represent the information superhighways that convey sensory information from the gut to the central nervous system. These afferents are sensitive to both mechanical and chemical stimuli. Vagal afferents terminate in the muscle layers and in the mucosa. Muscle afferents are activated at physiological levels of distension and during peristalsis. In contrast, spinal afferents encode supraphysiological levels of intestinal pressure. Vagal and spinal afferents also express a wide range of membrane receptors to a variety of chemical mediators generated from both within and outside the gut wall. Some of these receptors are part of a modality specific transduction pathway involved in sensory signalling from the gut lumen to vagal afferent endings in the mucosa. Others, which are activated by substances derived from multiple cellular sources during ischaemia, injury, or inflammation act in a synergistic way to cause acute or chronic sensitisation of the afferent nerves to mechanical and chemical stimuli. Understanding the mechanisms that underlie hypersensitivity may have implications for the pharmaceutical approach to the treatment of functional bowel disorders like irritable bowel syndrome.
迷走神经和脊髓传入神经是将肠道感觉信息传递至中枢神经系统的信息高速公路。这些传入神经对机械刺激和化学刺激均敏感。迷走神经传入神经终止于肌层和黏膜。肌层传入神经在生理扩张水平和蠕动过程中被激活。相比之下,脊髓传入神经编码肠道超生理水平的压力。迷走神经和脊髓传入神经还表达多种膜受体,以应对肠壁内外产生的各种化学介质。其中一些受体是特定模式转导途径的一部分,参与从肠腔到黏膜中迷走神经传入神经末梢的感觉信号传递。其他受体在缺血、损伤或炎症期间被多种细胞来源产生的物质激活,以协同方式导致传入神经对机械和化学刺激产生急性或慢性致敏。了解超敏反应的潜在机制可能对治疗诸如肠易激综合征等功能性肠病的药物治疗方法具有启示意义。