Lechin Fuad, van der Dijs Bertha
Department of Neurophysiology, Instituto de Medicina Experimental, Faculty of Medicine, Universidad Central de Venezuela, Apartado 80.983, Caracas, 1080, Venezuela.
Dig Dis Sci. 2009 Mar;54(3):458-70. doi: 10.1007/s10620-008-0369-9. Epub 2008 Jul 16.
Clinical digestive disorders depend on the non-adequate coupling of functioning of the gastrointestinal tract with that of its affluent systems, namely, the pancreatic exocrine and the hepato-biliary secretions. The secretion of gastrointestinal hormones is monitored by the peripheral autonomic nervous system. However, the latter is regulated by the central nervous system (CNS) circuitry localized at the medullary pontine segment of the CNS. In turn, both parasympathetic and adrenergic medullary circuitries are regulated by the pontine A5 noradrenergic (NA) and the dorsal raphe serotonergic nuclei, respectively. DR-5HT is positively correlated with the C1-Ad medullary nuclei (responsible for adrenal gland secretion), whereas the MR-5HT nucleus is positively correlated with the A5-NA pontomedullary nucleus. The latter is responsible for neural sympathetic activity (sympathetic nerves). Both types of sympathetic activities maintain an alternation with the peripheral parasympathetic branch, which is positively correlated with the enterochromaffin cells that secrete serotonin. Serotonin displays hormonal antagonism to the circulating catecholamines.
临床消化系统疾病取决于胃肠道与其相关系统（即胰腺外分泌和肝胆分泌）功能的不适当耦合。胃肠激素的分泌受外周自主神经系统监测。然而，后者受中枢神经系统（CNS）位于延髓脑桥段的神经回路调节。反过来，副交感神经和肾上腺素能髓质回路分别受脑桥A5去甲肾上腺素能（NA）和中缝背核5-羟色胺能核调节。中缝背核5-羟色胺能（DR-5HT）与负责肾上腺分泌的C1-肾上腺素能髓质核呈正相关，而中缝大核5-羟色胺能（MR-5HT）核与脑桥中脑A5-NA核呈正相关。后者负责神经交感活动（交感神经）。两种交感神经活动都与外周副交感神经分支交替，外周副交感神经分支与分泌5-羟色胺的肠嗜铬细胞呈正相关。5-羟色胺对循环中的儿茶酚胺具有激素拮抗作用。
