Gastrointestinal afferents as targets of novel drugs for the treatment of functional bowel disorders and visceral pain

P Holzer - European journal of pharmacology, 2001 - Elsevier
P Holzer
European journal of pharmacology, 2001Elsevier
An intricate surveillance network consisting of enteroendocrine cells, immune cells and
sensory nerve fibres monitors the luminal and interstitial environment in the alimentary
canal. Functional bowel disorders are characterized by persistent alterations in digestive
regulation and gastrointestinal discomfort and pain. Visceral hyperalgesia may arise from an
exaggerated sensitivity of peripheral afferent nerve fibres and/or a distorted processing and
representation of gut signals in the brain. Novel strategies to treat these sensory bowel …
An intricate surveillance network consisting of enteroendocrine cells, immune cells and sensory nerve fibres monitors the luminal and interstitial environment in the alimentary canal. Functional bowel disorders are characterized by persistent alterations in digestive regulation and gastrointestinal discomfort and pain. Visceral hyperalgesia may arise from an exaggerated sensitivity of peripheral afferent nerve fibres and/or a distorted processing and representation of gut signals in the brain. Novel strategies to treat these sensory bowel disorders are therefore targeted at primary afferent nerve fibres. These neurons express a number of molecular traits including transmitters, receptors and ion channels that are specific to them and whose number and/or behaviour may be altered in chronic visceral pain. The targets under consideration comprise vanilloid receptor ion channels, acid-sensing ion channels, sensory neuron-specific Na+ channels, P2X3 purinoceptors, 5-hydroxytryptamine (5-HT), 5-HT3 and 5-HT4 receptors, cholecystokinin CCK1 receptors, bradykinin and prostaglandin receptors, glutamate receptors, tachykinin and calcitonin gene-related peptide receptors as well as peripheral opioid and cannabinoid receptors. The utility of sensory neuron-targeting drugs in functional bowel disorders will critically depend on the compounds' selectivity of action for afferent versus enteric or central neurons.
Elsevier