S S Yarandi1, S Srinivasan. 1. Division of Digestive Diseases, Emory University, Atlanta, GA; Atlanta VA Medical Center, Decatur, Georgia, USA.
Abstract
BACKGROUND: Gastrointestinal manifestations of diabetes are common and a source of significant discomfort and disability. Diabetes affects almost every part of gastrointestinal tract from the esophagus to the rectum and causes a variety of symptoms including heartburn, nausea, vomiting, abdominal pain, diarrhea and constipation. Understanding the underlying mechanisms of diabetic gastroenteropathy is important to guide development of therapies for this common problem. Over recent years, the data regarding the pathophysiology of diabetic gastroenteropathy is expanding. In addition to autonomic neuropathy causing gastrointestinal disturbances the role of enteric nervous system is becoming more evident. PURPOSE: In this review, we summarize the reported alterations in enteric nervous system including enteric neurons, interstitial cells of Cajal and neurotransmission in diabetic animal models and patients. We also review the possible underlying mechanisms of these alterations, with focus on oxidative stress, growth factors and diabetes induced changes in gastrointestinal smooth muscle. Finally, we will discuss recent advances and potential areas for future research related to diabetes and the ENS such as gut microbiota, micro-RNAs and changes in the microvasculature and endothelial dysfunction.
BACKGROUND: Gastrointestinal manifestations of diabetes are common and a source of significant discomfort and disability. Diabetes affects almost every part of gastrointestinal tract from the esophagus to the rectum and causes a variety of symptoms including heartburn, nausea, vomiting, abdominal pain, diarrhea and constipation. Understanding the underlying mechanisms of diabetic gastroenteropathy is important to guide development of therapies for this common problem. Over recent years, the data regarding the pathophysiology of diabetic gastroenteropathy is expanding. In addition to autonomic neuropathy causing gastrointestinal disturbances the role of enteric nervous system is becoming more evident. PURPOSE: In this review, we summarize the reported alterations in enteric nervous system including enteric neurons, interstitial cells of Cajal and neurotransmission in diabetic animal models and patients. We also review the possible underlying mechanisms of these alterations, with focus on oxidative stress, growth factors and diabetes induced changes in gastrointestinal smooth muscle. Finally, we will discuss recent advances and potential areas for future research related to diabetes and the ENS such as gut microbiota, micro-RNAs and changes in the microvasculature and endothelial dysfunction.
Authors: Kyoung Moo Choi; Jin Zhu; Gary J Stoltz; Steven Vernino; Michael Camilleri; Joseph H Szurszewski; Simon J Gibbons; Gianrico Farrugia Journal: Am J Physiol Gastrointest Liver Physiol Date: 2007-09-20 Impact factor: 4.052
Authors: Chloe M Stenkamp-Strahm; Yvonne E A Nyavor; Adam J Kappmeyer; Sarah Horton; Martin Gericke; Onesmo B Balemba Journal: Cell Tissue Res Date: 2015-02-28 Impact factor: 5.249
Authors: Jennifer Christie; Sagar Shroff; Nikrad Shahnavaz; Latoya A Carter; Melanie S Harrison; Karan A Dietz-Lindo; John Hanfelt; Shanthi Srinivasan Journal: Am J Gastroenterol Date: 2016-12-06 Impact factor: 10.864
Authors: Per M Hellström; Jan Tack; Lakshmi Vasist Johnson; Kimberley Hacquoil; Matthew E Barton; Duncan B Richards; David H Alpers; Gareth J Sanger; George E Dukes Journal: Br J Pharmacol Date: 2016-04-13 Impact factor: 8.739
Authors: Viktor József Horváth; Zsuzsanna Putz; Ferenc Izbéki; Anna Erzsébet Körei; László Gerő; Csaba Lengyel; Péter Kempler; Tamás Várkonyi Journal: Curr Diab Rep Date: 2015-11 Impact factor: 4.810