Unexpected roles for the second brain: enteric nervous system as master regulator of bowel function

S Schneider, CM Wright… - Annual review of …, 2019 - annualreviews.org
Annual review of physiology, 2019annualreviews.org
At the most fundamental level, the bowel facilitates absorption of small molecules, regulates
fluid and electrolyte flux, and eliminates waste. To successfully coordinate this complex
array of functions, the bowel relies on the enteric nervous system (ENS), an intricate network
of more than 500 million neurons and supporting glia that are organized into distinct layers
or plexi within the bowel wall. Neuron and glial diversity, as well as neurotransmitter and
receptor expression in the ENS, resembles that of the central nervous system. The most …
At the most fundamental level, the bowel facilitates absorption of small molecules, regulates fluid and electrolyte flux, and eliminates waste. To successfully coordinate this complex array of functions, the bowel relies on the enteric nervous system (ENS), an intricate network of more than 500 million neurons and supporting glia that are organized into distinct layers or plexi within the bowel wall. Neuron and glial diversity, as well as neurotransmitter and receptor expression in the ENS, resembles that of the central nervous system. The most carefully studied ENS functions include control of bowel motility, epithelial secretion, and blood flow, but the ENS also interacts with enteroendocrine cells, influences epithelial proliferation and repair, modulates the intestinal immune system, and mediates extrinsic nerve input. Here, we review the many different cell types that communicate with the ENS, integrating data about ENS function into a broader view of human health and disease. In particular, we focus on exciting new literature highlighting relationships between the ENS and its lesser-known interacting partners.
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