Intestinal epithelium and enteric nervous system

The intestinal epithelium and enteric nervous system (ENS) represent a highly integrated physiological unit essential for gastrointestinal health and systemic homeostasis (Furness, 2012). The epithelium acts as a critical semi-permeable barrier that facilitates nutrient absorption while preventing the translocation of pathogens and toxins into the bloodstream (Peterson & Artis, 2014). The ENS is an extensive network of neurons and glia embedded in the gut wall that autonomously manages motility, secretion, and local blood flow (Gershon, 1999). Communication between these two entities is mediated by specialized cells, such as enterochromaffin cells, which translate luminal stimuli into neurochemical signals that modulate ENS activity (Yoo & Mazmanian, 2017). Pathological disruptions in this axis are implicated in a wide range of disorders, including inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and neurodegenerative conditions like Parkinson’s disease (Rao & Gershon, 2016). Pharmacological strategies targeting this system often focus on specific receptors located on either the epithelial surface or within the neural plexuses to regulate intestinal transit and mucosal integrity (Blackshaw et al., 2007). Consequently, this system is a focal point for drug development aimed at treating chronic constipation, diarrhea, and visceral hypersensitivity.

Other names

Gut-brain axisGastrointestinal barrier and intrinsic innervationIntestinal mucosal-nervous system unitMyenteric and submucosal plexuses

Drugs acting on this system typically modulate specific receptors (e.g., 5-HT4, GC-C, mu-opioid) located on either the epithelial cells or enteric neurons to alter motility, secretion, or visceral sensation (Blackshaw et al., 2007; Furness, 2012).