Visceral Pain Group, Centre for Nutrition and Gastrointestinal Diseases, Discipline of Medicine, University of Adelaide, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA 5000, Australia.
Department of Physiology and Biomedical Engineering and Enteric NeuroScience Program, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Nat Rev Gastroenterol Hepatol. 2014 Oct;11(10):611-27. doi: 10.1038/nrgastro.2014.103. Epub 2014 Jul 8.
The gastrointestinal tract is innervated by several distinct populations of neurons, whose cell bodies either reside within (intrinsic) or outside (extrinsic) the gastrointestinal wall. Normally, most individuals are unaware of the continuous, complicated functions of these neurons. However, for patients with gastrointestinal disorders, such as IBD and IBS, altered gastrointestinal motility, discomfort and pain are common, debilitating symptoms. Although bouts of intestinal inflammation underlie the symptoms associated with IBD, increasing preclinical and clinical evidence indicates that infection and inflammation are also key risk factors for the development of other gastrointestinal disorders. Notably, a strong correlation exists between prior exposure to gut infection and symptom occurrence in IBS. This Review discusses the evidence for neuroplasticity (structural, synaptic or intrinsic changes that alter neuronal function) affecting gastrointestinal function. Such changes are evident during inflammation and, in many cases, long after healing of the damaged tissues, when the nervous system fails to reset back to normal. Neuroplasticity within distinct populations of neurons has a fundamental role in the aberrant motility, secretion and sensation associated with common clinical gastrointestinal disorders. To find appropriate therapeutic treatments for these disorders, the extent and time course of neuroplasticity must be fully appreciated.
胃肠道受多种不同神经元群体支配，其神经元胞体位于胃肠道壁内（内在）或壁外（外在）。通常，大多数人都没有意识到这些神经元的持续、复杂的功能。然而，对于患有胃肠道疾病（如 IBD 和 IBS）的患者来说，胃肠道运动改变、不适和疼痛是常见的、使人虚弱的症状。虽然肠道炎症发作是 IBD 相关症状的基础，但越来越多的临床前和临床证据表明，感染和炎症也是其他胃肠道疾病发展的关键危险因素。值得注意的是，先前肠道感染与 IBS 症状发生之间存在很强的相关性。这篇综述讨论了影响胃肠道功能的神经可塑性（改变神经元功能的结构性、突触或内在变化）的证据。这种变化在炎症期间很明显，而且在许多情况下，在受损组织愈合很久之后仍然存在，此时神经系统无法恢复正常。在常见的临床胃肠道疾病中，特定神经元群体的神经可塑性在异常运动、分泌和感觉中起着根本性的作用。为了找到这些疾病的适当治疗方法，必须充分了解神经可塑性的程度和时间过程。
