Department of Basic Medical Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 East Second Street, Pomona, CA 91766, USA.
School of Medicine, Universidad Iberoamericana, Av. Francia 129, Santo Domingo 10203, Dominican Republic.
Int J Mol Sci. 2021 May 28;22(11):5797. doi: 10.3390/ijms22115797.
Nausea and vomiting are common gastrointestinal complaints that can be triggered by diverse emetic stimuli through central and/or peripheral nervous systems. Both nausea and vomiting are considered as defense mechanisms when threatening toxins/drugs/bacteria/viruses/fungi enter the body either via the enteral (e.g., the gastrointestinal tract) or parenteral routes, including the blood, skin, and respiratory systems. While vomiting is the act of forceful removal of gastrointestinal contents, nausea is believed to be a subjective sensation that is more difficult to study in nonhuman species. In this review, the authors discuss the anatomical structures, neurotransmitters/mediators, and corresponding receptors, as well as intracellular emetic signaling pathways involved in the processes of nausea and vomiting in diverse animal models as well as humans. While blockade of emetic receptors in the prevention of vomiting is fairly well understood, the potential of new classes of antiemetics altering postreceptor signal transduction mechanisms is currently evolving, which is also reviewed. Finally, future directions within the field will be discussed in terms of important questions that remain to be resolved and advances in technology that may help provide potential answers.
恶心和呕吐是常见的胃肠道疾病，可通过中枢和/或外周神经系统由各种催吐刺激物引发。恶心和呕吐均被认为是一种防御机制，当威胁毒素/药物/细菌/病毒/真菌通过肠内（例如，胃肠道）或肠外途径（包括血液、皮肤和呼吸系统）进入体内时，就会发生这种情况。虽然呕吐是强力清除胃肠道内容物的行为，但恶心被认为是一种更难在非人类物种中研究的主观感觉。在这篇综述中，作者讨论了在不同动物模型和人类中，与恶心和呕吐过程相关的解剖结构、神经递质/介质以及相应的受体，还有细胞内催吐信号通路。虽然在预防呕吐方面，催吐受体的阻断已经得到了相当的理解，但目前正在不断发展改变受体后信号转导机制的新型抗恶心药物的潜力，这也在综述中进行了讨论。最后，将根据仍有待解决的重要问题以及可能有助于提供潜在答案的技术进步，讨论该领域的未来方向。
