Enteroendocrine and neuronal mechanisms in pathophysiology of acute infectious diarrhea.
Enteroendocrine and neuronal mechanisms in pathophysiology of acute infectious diarrhea.
复制标题
DOI：
10.1007/s10620-011-1939-9
复制
发表时间：
2012-01
影响因子：
3.1
通讯作者：
Nelsen, Tyler
中科院分区：
文献类型：
--
作者：
Camilleri, Michael;Nullens, Sara;Nelsen, Tyler
虽然肠上皮细胞分泌被认为是急性肠道感染引起分泌性腹泻的主要机制，但有几条证据支持腹泻中控制液体和电解质分泌的替代机制。目的：综述急性感染性腹泻发病的肠内分泌和神经机制。细菌毒素引起的急性感染性腹泻（例如，cholera，E.大肠杆菌耐热肠毒素C.艰难梭菌）和轮状病毒都与肠内分泌细胞分泌递质有关（例如，5-HT）和刺激粘膜下分泌运动神经元的传入神经元的激活。后者分泌乙酰胆碱（与上皮细胞上的毒蕈碱受体结合）和VIP。通过抑制细菌毒素诱导的分泌（由六甲双铵（烟碱）、河豚毒素（Na+通道阻滞剂）和利多卡因（内脏/粘膜传入））证明神经受累。尼古丁受体存在于分泌运动神经元上，这些神经元通过肠中间神经元或外源性传出纤维释放乙酰胆碱而激活。特定的微生物还改变了可能导致急性腹泻发展的其他机制。因此，粘蛋白分泌、运动机制激活、粘膜通透性增加和胆汁酸吸收抑制在特定类型的急性感染性腹泻中已有报道。针对神经和递质介导的新疗法，包括5-HT，VIP，NPY，以及急性感染性腹泻期间激活的毒素受体和通道，可以引入一种新的方法来增强用于治疗急性腹泻的葡萄糖电解质溶液。
While enterocyte secretion is the predominant mechanism considered responsible for secretory diarrhea in response to acute enteric infections, there are several lines of evidence that support alternative mechanisms controlling fluid and electrolyte secretion in diarrhea. To review enteroendocrine and neuronal mechanisms that participate in the development of acute infectious diarrhea. Acute infectious diarrheas due to bacterial toxins (e.g., cholera, E. coli heat-stable enterotoxin, C. difficile) and rotavirus are all associated with secretion of transmitters from enteroendocrine cells (e.g., 5-HT) and activation of afferent neurons that stimulate submucosal secretomotor neurons. The latter secrete acetylcholine (which binds to muscarinic receptors on epithelial cells) and VIP. Involvement of nerves was demonstrated by inhibition of bacterial toxin-induced secretion by hexamethonium (nicotinic), tetrodotoxin (Na+ channel blocker), and lidocaine (visceral/mucosal afferents). Nicotinic receptors are present on secretomotoneurons and these are activated by release of acetylcholine from enteric interneurons or extrinsic efferent fibers. Specific organisms also modify other mechanisms that may contribute to development of acute diarrhea. Thus, mucin secretion, activation of motor mechanisms, increased mucosal permeability and inhibition of bile acid absorption have been reported in specific types of acute infectious diarrhea. New therapies targeting neural and transmitter mediation including 5-HT, VIP, NPY, as well as toxin receptors and channels activated during acute infectious diarrhea could usher in a novel approach to enhancing glucose–electrolyte solutions used in the treatment of acute diarrhea.
登录
查看更多内容
影响因子：
1.9
作者：
CASSUTO, J;JODAL, M;LUNDGREN, O
通讯作者：
LUNDGREN, O
DOI：
10.1007/bf01962788
发表时间：
1979-01-01
期刊：
EXPERIENTIA
影响因子：
--
作者：
CASSUTO, J;JODAL, M;LUNDGREN, O
通讯作者：
LUNDGREN, O
影响因子：
7.3
作者：
Banks, MR;Farthing, MJG;Burleigh, DE
通讯作者：
Burleigh, DE
影响因子：
29.4
作者：
JODAL, M;HOLMGREN, S;SJOQVIST, A
通讯作者：
SJOQVIST, A
影响因子：
24.5
作者：
CASSUTO, J;FAHRENKRUG, J;LUNDGREN, O
通讯作者：
LUNDGREN, O