The Enteric Nervous System and Gastrointestinal Innervation: Integrated Local and Central Control
The Enteric Nervous System and Gastrointestinal Innervation: Integrated Local and Central Control
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DOI：
10.1007/978-1-4939-0897-4_3
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发表时间：
2014-01-01
期刊：
影响因子：
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通讯作者：
Cho, Hyun-Jung
中科院分区：
文献类型：
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作者：
Furness, John B.;Callaghan, Brid P.;Cho, Hyun-Jung
消化系统通过其与中枢神经系统（CNS）的连接以及胃肠道壁内的肠神经系统（ENS）受到神经支配。ENS与CNS反射和指挥中心以及通过交感神经节控制消化功能的神经通路协同工作。ENS与CNS、ENS与交感椎前神经节之间存在双向信息流，人ENS含有2 ~ 6亿个神经元，分布于成千上万个小神经节中，其中绝大多数神经元分布于肌间神经丛和粘膜下神经丛。肌间神经丛形成一个连续的网络，从食管上部延伸到肛门内括约肌。粘膜下神经节和连接纤维束在小肠和大肠中形成神经丛，但在胃和食管中不形成。ENS和CNS之间的连接由迷走神经和盆神经以及交感神经通路进行。神经元也从ENS投射到椎前神经节、胆囊、胰腺和气管。ENS和CNS的相对作用沿消化道有相当大的沿着差异。横纹肌食管的运动由中枢神经系统中的神经模式发生器决定。同样地，CNS在监测胃的状态中起主要作用，并且反过来通过迷走-迷走反射控制其收缩活动和酸分泌。相比之下，小肠和结肠中的ENS包含完整的反射回路，包括感觉神经元、中间神经元和几类运动神经元，通过它们控制肌肉活动、跨粘膜流体流量、局部血流和其他功能。中枢神经系统通过腰骶脊髓中的排便中心控制排便。ENS的重要性通过一些ENS神经病变的危及生命的影响而得到强调。相比之下，去除迷走神经或交感神经与胃肠道的连接对GI功能的影响较小。排便的自主控制是通过骨盆连接来实现的，但切断这些连接不会危及生命，其他功能也几乎不会受到影响。
The digestive system is innervated through its connections with the central nervous system (CNS) and by the enteric nervous system (ENS) within the wall of the gastrointestinal tract. The ENS works in concert with CNS reflex and command centers and with neural pathways that pass through sympathetic ganglia to control digestive function. There is bidirectional information flow between the ENS and CNS and between the ENS and sympathetic prevertebral ganglia.The ENS in human contains 200-600 million neurons, distributed in many thousands of small ganglia, the great majority of which are found in two plexuses, the myenteric and submucosal plexuses. The myenteric plexus forms a continuous network that extends from the upper esophagus to the internal anal sphincter. Submucosal ganglia and connecting fiber bundles form plexuses in the small and large intestines, but not in the stomach and esophagus. The connections between the ENS and CNS are carried by the vagus and pelvic nerves and sympathetic pathways. Neurons also project from the ENS to prevertebral ganglia, the gallbladder, pancreas and trachea.The relative roles of the ENS and CNS differ considerably along the digestive tract. Movements of the striated muscle esophagus are determined by neural pattern generators in the CNS. Likewise the CNS has a major role in monitoring the state of the stomach and, in turn, controlling its contractile activity and acid secretion, through vago-vagal reflexes. In contrast, the ENS in the small intestine and colon contains full reflex circuits, including sensory neurons, interneurons and several classes of motor neuron, through which muscle activity, transmucosal fluid fluxes, local blood flow and other functions are controlled. The CNS has control of defecation, via the defecation centers in the lumbosacral spinal cord. The importance of the ENS is emphasized by the life-threatening effects of some ENS neuropathies. By contrast, removal of vagal or sympathetic connections with the gastrointestinal tract has minor effects on GI function. Voluntary control of defecation is exerted through pelvic connections, but cutting these connections is not life-threatening and other functions are little affected.