Document Type

Journal Article

Department/Unit

School of Chinese Medicine

Title

Adaptive cytoprotection and the brain-gut axis

Language

English

Abstract

Adaptive cytoprotection is a concept to counteract against the gastric mucosal injury caused by stress, strong irritants and drugs such as non-steroidal anti-inflammatory drugs. The process is mediated through diverse mediators and mechanisms. Studies on adaptive cytoprotection began from the discovery of prostaglandin (PG)-dependent and PG-independent pathways, followed by the investigation on the types and concentrations of mild irritants to be used. Upon the confirmation on the importance of the vagus nerve and the vago-vagal pathway in regulating the mucosal protective actions of the mild irritants, individual participating mediators for the neuronal modulatory processes were explored, including peptide neurotransmitters such as calcitonin gene-related peptide and substance P. Further correlation with the sympathetic nervous system, the sensory afferent neurons and the enteric nervous system of the gastric mucosa had been made. A close working relationship between the hypothalamic-pituitary-adrenal axis, the autonomic nervous system and the enteric nervous system was then proposed, with concurrent regulation of PG, nitric oxide and sensory neuropeptides by different mild irritants. Apart from these conventional concepts, there are now contemporary ideas on newer forms of adaptive cytoprotection such as ischemic preconditioning and heat-shock proteins, which will cast new light to novel approaches in facilitating gastric mucosal protection. Copyright © 2011 S. Karger AG.

Keywords

Adaptive cytoprotection, Afferent sensory neurons, Gastric mucosa, Hypothalamic-pituitary-adrenal axis, Mild irritants, Prostaglandins, Vagus nerve

Publication Date

2011

Source Publication Title

Digestion

Volume

83

Issue

Suppl. 1

Start Page

19

End Page

24

Publisher

Karger

DOI

10.1159/000323400

Link to Publisher's Edition

http://dx.doi.org/10.1159/000323400

ISSN (print)

00122823

ISSN (electronic)

14219867

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