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.
Turnberg
L A
LA
University Dept. of Medicine, Hope Hospital, Salford, U.K.
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