Enteric nervous system
21 important questions on Enteric nervous system
Name some facts about the Enteric nervous system (4)
- Separate branch of the ANS
- Normally modified by extrinsic nerves
- Exhibits simple programmed functions (peristalsis)
- Multiple neurotransmitters play a role
What is the difference between the peripherial nervous system and the enteric nervous system?
How is the network through the GI tract organized?
- Submucosal
- Myenteric
Between the two muscle layers you have different plexuses. (they have interactions with each other) Ganglia of the meissner's plexus are smaller (picture)
Myenteric plexus
- motility
- afferent neurons
- interneurons
- motor neurons
- 200 ganglia
Submucosal plexus
- secretion and blood flow
- afferent neurons and motor neurons
- 30 ganglia
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How does the signal transmission work?
Exc post
- Achetylchonine
- cholecystokinin (CCK)
- CGRP
- serotonin
- histamine
- interleukins
- PACAP
- Vasoactive Intestinal peptide
- tumour necrosing factor
What is the peristaltic reflex?
=> controlled by the enteric nervous system
Which types of neurons belong to the cholinergic fast synaptic pathway?
Excitatory for the Longitudinal muscle
Ascending interneurons for the connection between these two.
What kind of non-cholinergic fast excitatory synaptic pathways are there?
- Serotonergic neurons
- Inhibiting neurons
- Excitatory neurons
Controlling and integrating different parts of the GI tract.
Help control movement bolus through the GI tract.
What are the slow excitatory synaptic pathways?
Descending and inhibitory motor neurons => important to inhibit contractions.
Secrotomotor neurons => secretion of mucus in the GI tract.
What is a really important neurotransmitter in the GI tract?
- Serotonin (5HT). (95% of the total serotonin is located in the gut)
- Synyhesized by enterochromaffin (EC) cells
- Causes reflex responses
=> vomiting, (secretion and peristalsis)
- Action of serotonin is terminated by SERT = serotonin-selective transporter in the CNS (reuptake serotonin)
Intrinsic reflex circuits => control mobility
Stimulation => release of serotonin => activate neurons within the myenteric plexus => contraction on the oral side and relaxation on the anal side.
What is a distinct difference between neurotransmission of a muscle and in the GI tract?
Which cells mediate the neurotransmission between (nerve terminals) NT and SMC (smooth muscle cells)?
What kind of medication is anti-diarrhoeals? And name two examples.
- Morphine
- Loperamide
Explain how mu opoid agonists work.
In what situation will the opiods be subscribed?
Opioids have different effect on the enteric nerves system and the central nerves system. Which effects?
Enteric nerve system:
Peripheral antagonist: blocking the effect in the GI tract. But in the central nerve system: no reversal of analgesia or opioid withdrawal.
Irritable bowel syndrome. What factors are related to the cause of it?
- pain, bloating, urge to defecate
How is the brain related to the gut?
Intestinal behavior => hyper-secretion and power propulsion (pain and diarrhea)
What was the first possible target for the irritable bowel syndrom?
- 5HT3 antagonists
- 5HT4 agonist
What went wrong with the serotonergic agent?
- clinical beneficial but serious side effects namely: ischemic colitis
5HT4 agonist: tegaserod
- increased thrombotic risk
Both together => no efficacy
What was the next target? And why?
Enterochromaffin (EC) cells responding to the pressure of a bolus => activation of neurons.
Neurons that are sensitive for Glu receptors are also positive for ChAT and substance P. Integration with VIP neurons that are responsible for secretion and neurons in the myenteric plexus.
So, is glutamate a good therapeutical target?
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