Department of Physiology II, Nara Medical University School of Medicine, Shijo-cho, Kashihara, Japan.
Neurogastroenterol Motil. 2010 Jul;22(7):806-13, e226. doi: 10.1111/j.1365-2982.2010.01474.x. Epub 2010 Feb 8.
It was recently reported that some 5-HT(4)-receptor agonists increased neuronal numbers and length of neurites in enteric neurons developing in vitro from immunoselected neural crest-derived precursors. We aimed to explore a novel approach in vivo to reconstruct the enteric neural circuitry that mediates a fundamental distal gut reflex.
The neural circuit insult was performed in guinea pigs by rectal transection and subsequent end-to-end one layer anastomosis. A 5-HT(4)-receptor agonist, mosapride citrate (10-100 micromol L(-1)) (applied for a patent) was applied locally at the anastomotic site.
Mosapride promoted the regeneration of the neural circuit in the impaired myenteric plexus and the recovery of the defecation reflex in the distal gut. Furthermore, mosapride generated neurofilament (NF)-, 5-HT(4)-receptor- and 5-bromo-2'-deoxyuridine (BrdU)-positive cells and surprisingly formed neural network in the newly formed granulation tissue at the anastomotic site 2 weeks after enteric nerve circuit insult. Possible neural stem cell markers, anti-distal less homeobox 2 (DLX2)- and p75-positive and NF-positive cells increased during the same time period. All actions by mosapride were inhibited by the specific 5-HT(4)-receptor antagonist, GR113808 (10 micromol L(-1)).
CONCLUSIONS & INFERENCES: These results indicate that activation of enteric neural 5-HT(4)-receptors promotes reconstruction of an enteric neural circuit leading to the recovery of the defecation reflex in the distal gut, and that this reconstruction involves possibly neural stem cells. These findings indicate that treatment with 5-HT(4) agonists could be a novel therapy for generating new enteric neurons to rescue aganglionic gut disorders.
最近有报道称,一些 5-HT(4)-受体激动剂可增加体外免疫选择神经嵴衍生前体细胞发育的肠神经元的数量和突起长度。我们旨在探索一种新的体内方法来重建介导基本远肠反射的肠神经回路。
通过直肠横断和随后的端对端单层吻合,在豚鼠中进行神经回路损伤。局部应用 5-HT(4)-受体激动剂莫沙必利柠檬酸盐(10-100 μmol L(-1))(申请专利)于吻合部位。
莫沙必利促进受损肌间神经丛中的神经回路再生和远肠排便反射的恢复。此外,莫沙必利在肠神经回路损伤后 2 周在吻合部位的新形成肉芽组织中产生神经丝(NF)、5-HT(4)-受体和 5-溴-2'-脱氧尿苷(BrdU)阳性细胞,并令人惊讶地形成神经网络。在同一时期,神经干细胞标志物抗远端少同源盒 2(DLX2)和 p75 阳性和 NF 阳性细胞增加。莫沙必利的所有作用均被特异性 5-HT(4)-受体拮抗剂 GR113808(10 μmol L(-1)) 抑制。
这些结果表明,激活肠神经 5-HT(4)-受体可促进肠神经回路的重建,导致远肠排便反射的恢复,并且这种重建涉及可能的神经干细胞。这些发现表明,5-HT(4)激动剂的治疗可能是一种产生新的肠神经元以挽救无神经节肠道疾病的新疗法。