title: Gut-Brain Axis in Gastric Mucosal Damage and Protection.
abstract: BACKGROUND
  The gut-brain axis plays a potential role in numerous physiological and pathological conditions. Several substances link stomach with central nervous system. In particular, hypothalamo-pituitary-adrenocortical axis, thyrotropinreleasing factor-containing nerve fibers and capsaicin-sensitive nerves are principal mediators of the harmful and protective central nervous system-mediated effects on gastric mucosa. Also, existing evidence indicates that nitric oxide, prostaglandins and calcitonin gene-related peptide play a role as final effectors of gastric protection.
  
  
  METHODS
  We undertook a structured search of bibliographic databases for peerreviewed research literature with the aim of focusing on the role of gut-brain axis in gastric damage and protection. In particular, we examined manuscripts dealing with the role of steroids, thyrotropin-releasing hormone, prostaglandins, melatonin, hydrogen sulfide and peptides influencing food intake (i.e. leptin, cholecystokinin, peptide YY, central glucagon-like peptide-1, and ghrelin). Also, the role of GABAergic and glutamatergic pathways in gastric mucosal protection have been examined.
  
  
  RESULTS
  We found and reviewed 61 peer-reviewed papers dealing with the major aspects related to the role of gut brain axis in gastric mucosal damage and protection.
  
  
  CONCLUSIONS
  A dense neuronal network links stomach with central nervous system and a number of neurotransmitters and peptides functionally and anatomically related to central nervous system play a major role in contributing to gastric mucosal integrity. Exploiting the mechanisms underlying the connection between brain and gut may lead to a better understanding of the pathophysiology of gastric mucosal injury and to an improvement in the prevention and, eventually, management of gastric damage.
authors.forename: Dolores
authors.initials: D
authors.lastname: Sgambato
authors.forename: Annalisa
authors.initials: A
authors.lastname: Capuano
authors.forename: Maria Giuseppa
authors.initials: MG
authors.lastname: Sullo
authors.forename: Agnese
authors.initials: A
authors.lastname: Miranda
authors.forename: Alessandro
authors.initials: A
authors.lastname: Federico
authors.affiliation: Division of Hepato-Gastroenterology, Department of Clinical and Experimental Medicine, Second University of Naples, Via Pansini 5, 80131 Naples, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Romano
mesh_terms: D000818:Animals; D001921:Brain / Q000378:metabolism*; D005753:Gastric Mucosa / Q000378:metabolism*; D006801:Humans