Enteric nervous system and colonic mucosa (ENS)

The enteric nervous system (ENS) is a vast, quasi-autonomous network of neurons and glial cells embedded within the gastrointestinal tract wall, often termed the 'second brain' (Furness, 2012, Autonomic Neuroscience). It plays a critical role in regulating intestinal motility, local blood flow, and transmucosal transport. The colonic mucosa is the innermost tissue layer of the colon, consisting of an epithelial barrier and immune cells that facilitate water absorption and host defense (Mowat & Agace, 2014, Nature Reviews Immunology). While these structures are essential for gastrointestinal health, they represent anatomical systems and tissue layers rather than specific molecular targets like receptors or enzymes. Many drugs exert their effects within these systems by targeting specific proteins, such as 5-HT4 receptors in the ENS or guanylate cyclase-C in the mucosa (Black & Ford, 2020, The Lancet). Dysregulation of the ENS and colonic mucosa is central to the pathophysiology of functional disorders like irritable bowel syndrome and inflammatory conditions like ulcerative colitis (Vanner et al., 2016, Gastroenterology). Therapeutic interventions often aim to modulate neuro-epithelial signaling to alleviate symptoms of constipation, diarrhea, or inflammation. Understanding the complex interaction between the ENS and the mucosal barrier is vital for developing targeted therapies for gastrointestinal diseases.

Other names

ENSIntrinsic nervous systemGastrointestinal mucosal barrierGut-brain axis

Drugs targeting this system typically act as agonists or antagonists of specific receptors (e.g., 5-HT4, GC-C, or opioid receptors) to modulate neuronal signaling or epithelial secretion.