Neurotransmitter Dysfunction in Irritable Bowel Syndrome: Emerging Approaches for Management.
Neurotransmitter Dysfunction in Irritable Bowel Syndrome: Emerging Approaches for Management.
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DOI：
10.3390/jcm10153429
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发表时间：
2021-07-31
影响因子：
3.9
通讯作者：
Latorre E
中科院分区：
文献类型：
--
作者：
Gros M;Gros B;Mesonero JE;Latorre E
肠易激综合征（IBS）是一种功能性胃肠疾病，其病因尚不明确。大多数假说指出肠 - 脑轴是IBS的关键因素。该轴由通过神经递质相互沟通的不同解剖和功能结构组成。然而，关键神经递质如去甲肾上腺素、血清素、谷氨酸、γ - 氨基丁酸（GABA）或乙酰胆碱在IBS中的作用研究甚少。本综述的目的是评估关于IBS中神经递质功能障碍的现有证据，并探索潜在的治疗方法。结直肠运动改变的IBS患者血浆中去甲肾上腺素和乙酰胆碱水平升高，中枢血清素受体敏感性增加。结肠黏膜血清素转运体减少以及α2肾上腺素能受体下调也与内脏高敏感性相关，同时伴有5 - 羟吲哚乙酸水平升高、高亲和力胆碱转运体表达增强以及GABA水平降低。鉴于这些神经递质功能障碍，诸如5 - HT3受体拮抗剂和5 - HT4受体激动剂等新型药理学方法因其止吐和促动力作用正在被探索用于IBS的治疗。正在考虑使用GABA类似药物来减轻内脏疼痛。此外，毒蕈碱受体激动剂和拮抗剂正在进行临床试验。针对神经递质功能障碍可能为IBS的治疗提供有前景的新方法。
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder whose aetiology is still unknown. Most hypotheses point out the gut-brain axis as a key factor for IBS. The axis is composed of different anatomic and functional structures intercommunicated through neurotransmitters. However, the implications of key neurotransmitters such as norepinephrine, serotonin, glutamate, GABA or acetylcholine in IBS are poorly studied. The aim of this review is to evaluate the current evidence about neurotransmitter dysfunction in IBS and explore the potential therapeutic approaches. IBS patients with altered colorectal motility show augmented norepinephrine and acetylcholine levels in plasma and an increased sensitivity of central serotonin receptors. A decrease of colonic mucosal serotonin transporter and a downregulation of α2 adrenoceptors are also correlated with visceral hypersensitivity and an increase of 5-hydroxyindole acetic acid levels, enhanced expression of high affinity choline transporter and lower levels of GABA. Given these neurotransmitter dysfunctions, novel pharmacological approaches such as 5-HT3 receptor antagonists and 5-HT4 receptor agonists are being explored for IBS management, for their antiemetic and prokinetic effects. GABA-analogous medications are being considered to reduce visceral pain. Moreover, agonists and antagonists of muscarinic receptors are under clinical trials. Targeting neurotransmitter dysfunction could provide promising new approaches for IBS management.
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影响因子：
4.3
作者：
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通讯作者：
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DOI：
10.1152/ajpgi.00072.2010
发表时间：
2010-07-01
影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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