The small intestine: prospects for therapeutic approaches in secretory diarrhoeal diseases.
In many diarrhoeal diseases the intestinal mucosa is stimulated to secrete salt and water. This occurs in diarrhoea as a result of several bacterial toxins, is associated with inflammation and release of inflammatory mediators, and, in many instances, occurs when a neural element is evident. An understanding of the basic underlying mechanisms of secretion could lead to improvements in therapy. Development of vaccines against cholera is showing promise, and a knowledge of the complex field of inflammatory mediators, many of which provoke secretion, provides a foundation for development of more specific and selective anti-inflammatory agents. A detailed understanding of the complicated intracellular second-messenger systems, which are switched on by externally perceived signals, and of the ion transport responses, which are responsible for secretion, may lead to the development of specific anti-diarrhoeal drugs. Meanwhile, the message that oral rehydration therapy for severe diarrhoea, including cholera, is successful, should continue to be widely promulgated and taken up.
University Dept. of Medicine, Hope Hospital, Salford, U.K.
L A
LA
Turnberg
D000209:Acute-Phase Proteins / Q000494:pharmacology; D000262:Adenylyl Cyclases / Q000502:physiology; D001427:Bacterial Toxins / Q000494:pharmacology; D002118:Calcium / Q000502:physiology; D003967:Diarrhea / Q000209:etiology / Q000628:therapy*; D006162:Guanylate Cyclase / Q000502:physiology; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism*; D007421:Intestine, Small; D007473:Ion Channels / Q000378:metabolism; D009479:Neuropeptides / Q000494:pharmacology; D015290:Second Messenger Systems / Q000502:physiology
D000209:Acute-Phase Proteins; D001427:Bacterial Toxins; D007473:Ion Channels; D009479:Neuropeptides; D000262:Adenylyl Cyclases; D006162:Guanylate Cyclase; D002118:Calcium