CURE, Digestive Diseases Research Center and Center for Neurobiology of Stress; Digestive Diseases Division, Department of Medicine, David Geffen School of Medicine UCLA and VA Greater Los Angeles Healthcare System, Angeles, California, USA.
J Physiol Pharmacol. 2009 Dec;60 Suppl 7(Suppl 7):33-46.
It is well established that central corticotropin releasing factor (CRF) signaling mediates the gastrointestinal responses to stress. However, as shown in the brain, both CRF receptors and ligands are also widely expressed in the colon and the ileum of humans and rodents, and stress modulates their expression. Several functional studies documented that peripheral injection of CRF or urocortin stimulates colonic transit, motility, Fos expression in myenteric neurons, and defecation through activation of CRF(1) receptors, whereas it decreases ileal contractility via CRF(2) receptors. Additionally, intraperitoneal administration of CRF induces colonic mast cells degranulation via both CRF(1) and CRF(2) receptors and increases ion secretion and mucosal permeability to macromolecules, which can in turn promote intestinal inflammation and alter visceral sensitivity. Most peripheral CRF-induced alterations of colonic and ileal functions mimic effects which are observed after stress exposure, and CRF receptor antagonists given peripherally prevent stress-induced GI dysfunction. Furthermore, CRF peptides can reproduce secretomotor and mucosal alterations in vitro. Therefore, accumulated clinical and preclinical evidence supports in addition to the brain, a role for peripheral CRF signaling in mediating stress-induced effects on gastrointestinal sensorimotor, mucosal and immune functions, that may be components of underlying mechanisms involved in stress-related impact on inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS).
已有充分证据表明,中枢促肾上腺皮质释放因子(CRF)信号转导介导了应激对胃肠道的反应。然而,正如在大脑中所显示的那样,CRF 受体和配体在人类和啮齿动物的结肠和回肠中也广泛表达,并且应激会调节它们的表达。几项功能研究记录表明,外周注射 CRF 或孤啡肽通过激活 CRF(1)受体刺激结肠转运、运动、肌间神经元中的 Fos 表达和排便,而通过 CRF(2)受体降低回肠收缩性。此外,CRF 腹腔内给药通过 CRF(1)和 CRF(2)受体诱导结肠肥大细胞脱颗粒,并增加离子分泌和大分子对黏膜的通透性,这反过来又可促进肠道炎症并改变内脏敏感性。大多数外周 CRF 诱导的结肠和回肠功能改变类似于应激暴露后观察到的效应,并且外周给予 CRF 受体拮抗剂可预防应激引起的胃肠道功能障碍。此外,CRF 肽可在体外再现分泌运动和黏膜改变。因此,积累的临床前和临床证据支持除了大脑之外,外周 CRF 信号转导在介导应激对胃肠道感觉运动、黏膜和免疫功能的影响方面也发挥作用,这可能是应激对炎症性肠病(IBD)和肠易激综合征(IBS)影响的潜在机制的组成部分。