Abstract:Objective: In this review we focused on understanding the cause-and-effect relationships of gastroduodenal pathology aiming to clarify the role of vagus nerve. Results: The spectrum of vagus nerve biological effects in gastroduodenal area is related to its numerous targets and a wide range of its receptors. A variety of vagus nerve effects are related to the broad expression of cholinergic receptors on the target cells: smooth muscle cells, covering and glandular epithelium of stomach and duodenum, myofibroblasts and mast cells, vascular endothelium, intramural ganglion neurons, endocrine cells, platelets and blood leukocytes. In this paper, we discussed the following issues: 1) role of sensory nerve endings in the vagal reflex regulation; 2) impact of gastrin and leptin on vagal afferentation; 3) targets of vagus efferent nerves; 4) the role of acetylcholine in regulation of functional activity of oxyntic cells; 5) relationship of vagus efferents with enteroendocrine cells; 6) the role of vagus nerve in realization of compensatory and adaptive reactions in gastroduodenal area. Conclusion: Vagus nerve is one of the key regulators of mucosal activity and blood supply, modulating adaptive reactions and maintaining the gastrointestinal barrier. Keywords: Gastroduodenal Area, Vagus Nerve, Afferent and Efferent NervesGastrointestinal pathology takes one of the leading places in the morbidity rate. A long-time comprehensive study has helped in determining the spectrum of exogenous and endogenous pathological factors that are associated with gastroduodenal pathology. It can be stated, that issues of digestive system regulation has been in focus of scientist for more than two centuries [1]. Nevertheless, pathogenesis of such disorders as gastroesophageal reflux disease, gastritis, peptic ulcer disease, duodenitis is still not clear.Structural homeostasis and functions of gastroduodenal area (GDA) are controlled by neural link, specific gastrointestinal regulatory peptides that have endo-, paraand neuroendocrine effects; and local factors -cytokines, growth factors, nitric oxide, etc. [2-3]. These regulatory molecules are produced by various cells of the mucosa and neurons of intramural ganglia. The auto-regulation, synchronicity, sequence, integration and protection of digestive organs are achieved due to the potentiation and modulation of these molecules [4,5]. At the same time there is a hierarchy of GDA regulatory mechanisms, due to which any disorder automatically activates higher levels of management and control, that's why neuro-endocrine control goes on the forefront [3,6]. Initially, the centers of autonomic nervous systems are activated that leads us to the aim of this review to fully analyze the structural organization of the parasympathetic innervation and role of vagus nerve in the pathology and compensatory-adaptive processes in GDA.Vagus nerve dependent gastric reflexes are mediated through vagal afferent fibers synapsing upon neurons of the nucleus tractus solitarius which, in turn, modulates the...
Objective: Neuroimmune interplay is one of the basic elements that determine mucosal health and disease. Continuing discussion of the vagus nerve in maintenance of homeostasis of gastroduodenal area, we aim to revise immunomodulating effects of acetylcholine. Results: Vagus nerve plays a major role in gut mucosa immunity due to cytoprotective properties and modulation of leukocytes activity. Stimulation of vagus nerve after mucosa damage is accompanied by cholinergic anti-inflammatory pathway that is realized directly through alfa7-nicotinergic cholinoreceptors on neutrophils, macrophages and lymphocytes, which activation causes decrease of NF-kB expression and TNF and IL-6 secretion. Indirect effect of acetylcholine through enteroendocrine cells regulation is quite important in determination of neuro-immune-endocrine interplay in gastroduodenal mucosa. In addition, the changes in vagus nerve activity and neurohumoral control of gastroduodenal area under antisecretory therapy of gastroduodenal diseases are deliberated in this review. Conclusion: Vagus nerve dysfunction is likely to be the main cause of gastroduodenal inflammation, dysregeneration and cancerogenesis.
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