The field of neurogastroenterology is rapidly developing, with increasing interest now focused on characterizing the function of the enteric nervous system (ENS) in both gastroenterological and neurological disorders. The ENS is involved in a number of processes: determining the patterns of movement of the gastrointestinal tract; the control of gastric acid secretion; regulation of movement of fluid across the lining epithelium; changing local blood flow; modification of nutrient handling; and interactions with the gut immune and endocrine systems. ENS function is affected in a variety of diseases; these enteric neuropathies include IBS, functional dyspepsia, constipation, diabetes-related motility disorders, Parkinson disease, postoperative ileus and Hirschsprung disease. Research into treatment of multiple functional gastrointestinal diseases, digestive motility and neurogastroenterological disorders are ongoing; indeed, several clinical trials are currently in progress. In this special Collection, Nature Reviews Gastroenterology & Hepatology present a selection of articles published throughout 2012 and into 2013 that highlight the burgeoning interest in the ENS and encompass the latest advances in this field.
All content for this Collection has been chosen by the Nature Reviews Gastroenterology & Hepatology editors and the collection has been made freely available for 6 months thanks to support from Ferring Pharmaceuticals
Image courtesy of S.-C. Tang.
REVIEWS
The enteric nervous system and neurogastroenterology
John B. Furness
doi:10.1038/nrgastro.2012.32
Nature Reviews Gastroenterology & Hepatology 9, 286-294 (2012)
Neurogastroenterology encompasses control of digestion through the enteric nervous system, the central nervous system and integrative centers in sympathetic ganglia. In this Review, John Furness provides a broad overview of the rapidly developing field of neurogastroenterology, with a focus on the roles of the enteric nervous system in the control of the musculature of the gastrointestinal tract and transmucosal fluid movement.
Novel functional roles for enteric glia in the gastrointestinal tract
Brian D. Gulbransen & Keith A. Sharkey
doi:10.1038/nrgastro.2012.138
Nature Reviews Gastroenterology & Hepatology 9, 625-632 (2012)
Enteric glia encompass a diverse range of glial cells that populate the gastrointestinal tract. In this Review, Gulbransen & Sharkey provide a timely update on the different types of enteric glia and their role in normal and abnormal gut function. In addition, key areas in which further knowledge is needed to fully appreciate the physiology of these cells are also highlighted.
Regulation of gastrointestinal motility—insights from smooth muscle biology
Kenton M. Sanders, Sang Don Koh, Seungil Ro & Sean M. Ward
doi:10.1038/nrgastro.2012.168
Nature Reviews Gastroenterology & Hepatology 9, 633-645 (2012)
Gastrointestinal motility results from coordinated contractions of the smooth muscle tissues forming the tunica muscularis of the alimentary canal. Smooth muscle cells are organized into an electrical syncytium that also incorporates interstitial cells. Myogenic, neural and humoral factors provide integrated control of contractile activity. Kenton Sanders and colleagues provide an overview of the cells and mechanisms that generate and regulate smooth muscle contractile behaviour and gastrointestinal motility.
Ghrelin, the proglucagon-derived peptides and peptide YY in nutrient homeostasis
Charlotte X. Dong & Patricia L. Brubaker
doi:10.1038/nrgastro.2012.185
Nature Reviews Gastroenterology & Hepatology, advance online publication, Published online 02 October 2012
This Review focuses on several of the hormones released by the gastrointestinal tract prior to or during nutrient ingestion that have key roles in maintaining energy balance. These hormones include the gastric orexigenic hormone, ghrelin, and the distal L cell anorex-igenic and metabolic hormones, glucagon-like peptide (GLP) 1, GLP 2, oxyntomodulin and peptide YY. Their biological actions are outlined, as well as potential or actual uses as treatments for obesity and type 2 diabetes mellitus.
The digestive neuronal–glial–epithelial unit: a new actor in gut health and disease
Michel Neunlist, Laurianne Van Landeghem, Maxime M. Mahé, Pascal Derkinderen, Stanislas Bruley des Varannes & Malvyne Rolli-Derkinderen
doi:10.1038/nrgastro.2012.221
Nature Reviews Gastroenterology & Hepatology, advance online publication, Published online 20 November 2012
The permeability of the intestinal epithelial barrier has a central role in the regulation of fluid and nutrient intake as well as in the control of the passage of pathogens. In this Review, Michel Neunlist and colleagues summarize current studies characterizing neuronal and glial effects on the intestinal epithelial barrier and outline the novel concept of a digestive neuronal–glial–epithelial unit.
Development and developmental disorders of the enteric nervous system
Florian Obermayr, Ryo Hotta, Hideki Enomoto & Heather M. Young
doi:10.1038/nrgastro.2012.234
Nature Reviews Gastroenterology & Hepatology, Advance online publication, Published online: 11 December 2012
The enteric nervous system (ENS) arises from neural crest-derived cells. Here, Heather Young and colleagues provide an overview of the progress made in the past five years in our understanding of ENS development and the potential involvement of defects in ENS development in paediatric motility disorders.
New perspectives in the diagnosis and management of enteric neuropathies
Charles H. Knowles, Greger Lindberg, Emanuele Panza & Roberto De Giorgio
doi:10.1038/nrgastro.2013.18
Nature Reviews Gastroenterology & Hepatology, Advance online publication, Published online: 12 February 2013
Functional gastrointestinal disorders span a wide spectrum of clinical phenotypes. This Review discusses advances in the diagnosis and management of achalasia, gastroparesis, intestinal pseudo-obstruction and chronic constipation that result from enteric neuropathies, including both primary (idiopathic) and secondary forms.
Extrinsic primary afferent signalling in the gut
Simon J. H. Brookes, Nick J. Spencer, Marcello Costa & Vladimir P. Zagorodnyuk
doi:10.1038/nrgastro.2013.29
Nature Reviews Gastroenterology & Hepatology, Advance online publication, Published online: 26 February 2013
The gut is innervated by many types of extrinsic sensory neurons, and little consensus exists about the different classes that these afferents might belong to. In this Review, Simon Brookes and colleagues suggest that five different morphological types of endings can be distinguished by their structure, and that this scheme is compatible with physiologically based classifications.
YEAR IN REVIEW
Neurogastroenterology in 2011: Emerging concepts in neurogastroenterology and motility
Keith A. Sharkey & Gary M. Mawe
doi:10.1038/nrgastro.2011.247
Nature Reviews Gastroenterology & Hepatology 9, 74-76 (2012)
RESEARCH HIGHLIGHTS
Motility: An enteric neuropathy might underlie diverticular disease
Caroline Barranco
doi:10.1038/nrgastro.2010.53
Nature Reviews Gastroenterology & Hepatology 7, 240 (2010)
Neurogastroenterology: Modification of basal brain metabolism and neuronal activity is an acquired feature of obesity
Natalie J. Wood
doi:10.1038/nrgastro.2011.16
Nature Reviews Gastroenterology & Hepatology 8, 119 (2011)
Neurogastroenterology: A role for enteric glial cells in mucosal healing
Shreeya Nanda
doi:10.1038/nrgastro.2011.45
Nature Reviews Gastroenterology & Hepatology 8, 242 (2011)
IBD: Intestinal inflammation affected by density of enteric neurons
Katrina Ray
doi:10.1038/nrgastro.2011.145
Nature Reviews Gastroenterology & Hepatology 8, 534 (2011)
Neurogastroenterology: Improving 3D imaging of the enteric nervous system
Katherine Smith
doi:10.1038/nrgastro.2011.167
Nature Reviews Gastroenterology & Hepatology 8, 600 (2011)
Motility: Searching for 5-HT4 receptors in the colonic mucosa
Katrina Ray
doi:10.1038/nrgastro.2012.13
Nature Reviews Gastroenterology & Hepatology 9, 125 (2012)
Neurogastroenterology: New approach enables live recordings of nerve activity in intestinal biopsy samples
Natalie J. Wood
doi:10.1038/nrgastro.2012.56
Nature Reviews Gastroenterology & Hepatology 9, 244 (2012)
Motility: Mapping gastric dysrhythmias in gastroparesis—a slow wave of electrical activity
Katrina Ray
doi:10.1038/nrgastro.2012.116
Nature Reviews Gastroenterology & Hepatology 9, 363 (2012)
IBS: Distinct neuro–immune patterns defined in IBS subtypes
Katrina Ray
doi:10.1038/nrgastro.2012.142
Nature Reviews Gastroenterology & Hepatology 9, 489 (2012)
Neurogastroenterology: New view of enteric nervous system development
Katherine Smith
doi:10.1038/nrgastro.2012.171
Nature Reviews Gastroenterology & Hepatology 9, 559 (2012)