Enteric nervous system and intestinal mucosa

The enteric nervous system (ENS) and intestinal mucosa constitute a highly integrated physiological system essential for maintaining gastrointestinal homeostasis. The ENS is an extensive network of neurons and glia located within the gut wall that autonomously regulates motility, secretion, and blood flow (Furness, 2014). The intestinal mucosa acts as a selective barrier, facilitating nutrient absorption while providing a robust immune defense against luminal pathogens (Mowat & Agace, 2014). Communication between the ENS and the mucosal immune system, often termed the neuro-immune axis, is vital for responding to physiological and pathological stimuli (Rao & Gershon, 2016). Dysfunctions in this system are implicated in a wide range of conditions, including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and various motility disorders (StatPearls, 2023). Although the ENS and mucosa are not single molecular targets, they contain numerous specific receptors and signaling pathways, such as serotonin receptors and guanylate cyclase-C, that serve as therapeutic focal points for treating digestive diseases.

Other names

ENSGastrointestinal mucosaIntestinal barrierIntrinsic nervous system of the gutNeuro-mucosal unit

Pharmacological agents do not target the system as a whole but rather modulate specific molecular components within these tissues, such as serotonin receptors (5-HT3, 5-HT4), opioid receptors (mu, kappa), guanylate cyclase-C (GC-C), chloride channels, and various inflammatory cytokines to regulate motility, fluid secretion, and immune response (Furness, 2014; StatPearls, 2023).