Effect of Psychoneural Factors on Intestinal Epithelial Function

Abstract

W olf and Wolff (1) described vascular and motor changes associated with various moods in a patient with a gastric fistula. Stress has been associated with abnormal gastrointestinal function, including diarrhea and abdominal pain (2), and stress-associated gastric ulceration has frequently been documented. Stress can also exacerbate ongoing pathophysiology, and often precedes relapses in patients with inflammatory bowel disease or irritable bowel syndrome (3). The relatively new field of psychoneuroimmunology is involved with the elucidation of mechanisms that explain the link between the central nervous system (CNS) and immune-mediated pathophysiology. This review discusses recent progress examining the interaction among the nervous system, the immune system and the epithelium of the intestine, and examines the evidence for CNS control of this interaction. INTESTINAL EPITHELIUMThe intestine is lined with a single layer of epithelial cells that form a barrier between the lumen contents and the interstitium. The epithelial layer has two main roles: transport and barrier functions. Tight junctions between enterocytes Stress has been associated with abnormal gastrointestinal function, including diarrhea and abdominal pain, and stress-associated gastric ulceration has frequently been documented. Stress can also exacerbate ongoing pathophysiology and often precedes relapses in patients with inflammatory bowel disease or irritable bowel syndrome. The relatively new field of psychoneuroimmunology is involved with the elucidation of mechanisms that explain the link between the central nervous system and immune-mediated pathophysiology. Recent progress examining the interaction among the nervous system, the immune system and the epithelium of the intestine is discussed, and the evidence for central nervous sysytem control of this interaction is examined. Key Words: Abnormal gastrointestinal function, Intestinal epithelium, Psychoneuroimmunology, StressEffet des facteurs psychoneuraux sur la fonction épithéliale intestinale RÉSUMÉ : Le stress a été associé à la dysfonction gastrointestinale, y compris à la diarrhée et à la douleur abdominale et des ulcères gastriques associés au stress ont souvent été documentés. Le stress peut également exacerber la physiopathologie existante et précède souvent la rechute chez des patients atteints de maladie inflammatoire de l'intestin ou du syndrome du côlon irritable. Nouveau domaine de recherche, la psychoneuro-immunologie se penche sur l'élucidation des mécanismes pouvant expliquer le lien entre le système nerveux central et la physiopathologie à médiation immunitaire. De récents progrès réalisés grâce à l'examen d'une interaction entre le système nerveux, le système immunitaire et l'épithélium intestinal sont abordés ici, de même que certaines preuves du contrôle de cette interaction par le système nerveux central.

The neurobiology of stress and gastrointestinal disease

“…In the periphery, 12 different functional groups of sympathetic neurones have been identified 78. Some of these pathways regulate mucin production by large intestinal goblet cells, net water absorption by intestinal epithelial cells,79 mucosal permeability,80 81 mast cell degranulation,82 and possibly release of peptides from enterochromaffin cells.…”