Diabetic gastrointestinal motility disorders and the role of enteric nervous system: Current status and future directions

• Type of Material: Article
• Authors: Shadi S. Yarandi, Emory University; Shanthi Srinivasan, Emory University
• Language: English
• Date: 2014-05-01
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 John Wiley & Sons Ltd.
• Final Published Version (URL): http://dx.doi.org/10.1111/nmo.12330
• Title of Journal or Parent Work: Neurogastroenterology and Motility
• ISSN: 1350-1925
• Volume: 26
• Issue: 5
• Start Page: 611
• End Page: 624
• Grant/Funding Information: This work is supported by the National Institutes of Health grant number NIH‐RO1‐DK080684 and VA‐Merit Award.
• Keywords: SMOOTH-MUSCLE; Neurosciences & Neurology; INTERSTITIAL-CELLS; AUTONOMIC NEUROPATHY; GLYCATION END-PRODUCTS; GROWTH-FACTOR-I; PERIPHERAL NEUROPATHY; HIGH-FAT DIET; smooth muscle; interstitial cells of Cajal; Gastroenterology & Hepatology; enteric nervous system; enteric neurons; Life Sciences & Biomedicine; diabetes; Clinical Neurology; Neurosciences; GASTRIC MYOELECTRICAL ACTIVITY; NITRIC-OXIDE SYNTHASE; Science & Technology; MYENTERIC PLEXUS; oxidative stress
• Research Categories: Health Sciences, Medicine and Surgery; Biology, Neuroscience

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