Capsaicin-Sensitive Vagal Afferent Nerve-Mediated Interoceptive Signals in the Esophagus.
Capsaicin-Sensitive Vagal Afferent Nerve-Mediated Interoceptive Signals in the Esophagus.
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DOI：
10.3390/molecules26133929
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发表时间：
2021-06-28
期刊：
影响因子：
--
通讯作者：
Yu S
中科院分区：
文献类型：
--
作者：
Yu M;Chang C;Undem BJ;Yu S
烧心和非心源性胸痛是许多食道疾病的主要症状，如胃食道反流病(GERD)、非糜烂性反流病(NERD)、功能性烧心和胸痛以及嗜酸性食管炎(EoE)。目前，食道内感觉信号传递的神经机制还不是很清楚。伤害性刺激可以激活食道神经末梢的初级传入神经元的一个亚群。诱发的动作电位通过脊髓和迷走神经通路传递到它们的中枢末梢，与中枢神经系统中的神经元突触，从而诱导食道伤害性感受。在过去的几十年里，我们对食道伤害性感觉的外周和中枢神经机制的理解已经取得了进展。本文主要介绍辣椒素敏感的迷走神经初级传入结节和颈静脉C纤维神经元在处理食道伤害性信息中的作用。我们简要比较了它们独特的表型特征和对食道机械和化学刺激的功能反应。然后，我们总结了酸、炎症细胞(嗜酸性粒细胞和肥大细胞)和介质(ATP、5-羟色胺、缓激肽、腺苷、S1P)对这两种伤害性C纤维亚型的激活和/或增敏作用。最后，我们讨论了辣椒素敏感的食道传入神经在处理食道感觉和伤害性感觉中的潜在作用。进一步了解食道初级传入神经的伤害性信号传递机制将有助于开发新的治疗方法来缓解食管伤害性症状，特别是那些对质子泵抑制剂无效的症状。
Heartburn and non-cardiac chest pain are the predominant symptoms in many esophageal disorders, such as gastroesophageal reflux disease (GERD), non-erosive reflux disease (NERD), functional heartburn and chest pain, and eosinophilic esophagitis (EoE). At present, neuronal mechanisms underlying the process of interoceptive signals in the esophagus are still less clear. Noxious stimuli can activate a subpopulation of primary afferent neurons at their nerve terminals in the esophagus. The evoked action potentials are transmitted through both the spinal and vagal pathways to their central terminals, which synapse with the neurons in the central nervous system to induce esophageal nociception. Over the last few decades, progress has been made in our understanding on the peripheral and central neuronal mechanisms of esophageal nociception. In this review, we focus on the roles of capsaicin-sensitive vagal primary afferent nodose and jugular C-fiber neurons in processing nociceptive signals in the esophagus. We briefly compare their distinctive phenotypic features and functional responses to mechanical and chemical stimulations in the esophagus. Then, we summarize activation and/or sensitization effects of acid, inflammatory cells (eosinophils and mast cells), and mediators (ATP, 5-HT, bradykinin, adenosine, S1P) on these two nociceptive C-fiber subtypes. Lastly, we discuss the potential roles of capsaicin-sensitive esophageal afferent nerves in processing esophageal sensation and nociception. A better knowledge of the mechanism of nociceptive signal processes in primary afferent nerves in the esophagus will help to develop novel treatment approaches to relieve esophageal nociceptive symptoms, especially those that are refractory to proton pump inhibitors.
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