Chalazonitis Alcmène, Rao Meenakshi
Department of Pathology and Cell Biology, Columbia University, 630 West 168th Street, P&S 11-511, New York, NY, USA.
Department of Pediatrics, Columbia University, 622 West 168th Street, PH 17, New York, NY, USA.
Brain Res. 2018 Aug 15;1693(Pt B):207-213. doi: 10.1016/j.brainres.2018.01.011. Epub 2018 Jan 31.
Neurological disorders cause gastrointestinal (GI) symptoms that are debilitating and markedly diminish quality of life in patients. The enteric nervous system (ENS), the intrinsic nervous system of the GI tract that is often referred to as "the second brain", shares many features with the central nervous system. The ENS plays an essential role in regulating many GI functions including motility and fluid secretion. Enteric neuronal degeneration could therefore be responsible for the GI symptoms commonly observed in neurological conditions. Here we describe the organization and functions of the ENS and then review the evidence for ENS involvement in two common neurodegenerative disorders, Parkinson's disease (PD) and Alzheimer's disease (AD). Data from patients as well as animal models suggest that PD affects distinct subsets of neurons and glia in the ENS, and that the ENS may participate in the pathogenesis of this disorder. While there has been great enthusiasm for the possibility of sampling the ENS for diagnosis or therapeutic monitoring of PD, further work is needed to determine which enteric neurons are most affected and how ENS function could be modulated to ameliorate GI symptoms in patients. Although AD is far more common than PD and AD patients also experience GI symptoms, understanding of ENS dysfunction in AD is in its infancy. Much work remains to be done in both of these fields to determine how the ENS contributes to and/or is altered by these disorders, and how to target the ENS for more effective treatment of GI comorbidities.
神经疾病会引发胃肠道（GI）症状，这些症状使人虚弱，显著降低患者的生活质量。肠神经系统（ENS）是胃肠道的内在神经系统，常被称为“第二大脑”，与中枢神经系统有许多共同特征。ENS在调节包括蠕动和液体分泌在内的许多胃肠道功能中起着至关重要的作用。因此，肠神经元变性可能是神经疾病中常见胃肠道症状的原因。在这里，我们描述了ENS的组织结构和功能，然后回顾了ENS参与两种常见神经退行性疾病——帕金森病（PD）和阿尔茨海默病（AD）的证据。来自患者和动物模型的数据表明，PD会影响ENS中不同的神经元和神经胶质细胞亚群，并且ENS可能参与了这种疾病的发病机制。虽然人们对通过检测ENS来诊断或治疗监测PD的可能性抱有极大热情，但仍需要进一步研究来确定哪些肠神经元受影响最大，以及如何调节ENS功能以改善患者的胃肠道症状。尽管AD比PD更为常见，且AD患者也会出现胃肠道症状，但对AD中ENS功能障碍的了解仍处于起步阶段。在这两个领域都还有很多工作要做，以确定ENS如何促成这些疾病和/或在这些疾病中发生改变，以及如何针对ENS更有效地治疗胃肠道合并症。
