THE ENTERIC NERVOUS-SYSTEM IN INTESTINAL INFLAMMATION

Since about the 1950s nerves in the wall of the intestine have been po stulated to play a role in the pathogenesis of inflammatory bowel dise ase (IBD). Human and animal studies examining the role of nerves in in testinal inflammation are the focus of this review. Consideration is g iven to two possible ways that nerves are involved in IBD. First, nerv es may play a role in the development or maintenance of inflammation t hrough local release of transmitters. Second, once initiated (by whate ver means), the processes of inflammation may disrupt the normal patte rn of innervation and the interactions of nerves and their target tiss ues. Many of the functional disturbances observed in IBD are likely du e to an alteration in the enteric nervous system either structurally t hrough disruptions of nerve-target relationships or by modifications o f neurotransmitters or their receptors. Finally, it appears that the e nteric nervous system may be a potential therapeutic target in IBD and that neuroactive drugs acting locally can represent useful agents in the management of this disease.