Neuropeptides and inflammatory bowel disease.
OBJECTIVE
Inflammatory bowel disease (IBD) is a chronic intestinal inflammatory condition, the pathophysiology of which is not well understood. It has, however, become increasingly evident that interactions between the enteric nervous system and the immune system play an important role in the cause of IBD. Both the enteric nervous system and the central nervous system can amplify or modulate the aspects of intestinal inflammation through secretion of neuropeptides or small molecules. The purpose of this study is to present recent data on the role that neuropeptides play in the pathophysiology of IBD.


RESULTS
The best studied of the neuropeptides thought to play a role in the pathogenesis of IBD include substance P, corticotropin-releasing hormone, neurotensin, and vasoactive intestinal peptide; small molecules include acetylcholine and serotonin. Recently discovered functions of each of these neuropeptides with a discussion of implications of the data for therapy are reviewed.


CONCLUSIONS
Although the available data suggest an important role for neuropeptides in the pathophysiology of intestinal inflammation, there does yet not appear to be a function that can be taken as established for any of these molecules. The complexity of neuroimmune-endocrine systems, conflicting study results and dual mechanisms of action, warrant further research in this field. Clarification of the molecular mechanisms of action of neuropeptides and on immune and inflammatory reactions will likely yield new treatment options in the future.
Margolis
Kara Gross
KG
Morgan Stanley Children's Hospital, Department of Pediatrics, USA. kjg2133@columbia.edu
Gershon
Michael David
MD
D002490:Central Nervous System / Q000503:physiopathology; D003106:Colon / Q000503:physiopathology; D017615:Enteric Nervous System / Q000503:physiopathology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000503:physiopathology*; D007413:Intestinal Mucosa / Q000503:physiopathology*; D009479:Neuropeptides / Q000276:immunology / Q000502:physiology; D018013:Receptors, Neuropeptide / Q000502:physiology*
D009479:Neuropeptides; D018013:Receptors, Neuropeptide