Abstract
The regulation of energy balance requires the complex integration of homeostatic and hedonic pathways, but sensory inputs from the gastrointestinal (GI) tract are increasingly recognized as playing critical roles. The stomach and small intestine relay sensory information to the central nervous system (CNS) via the sensory afferent vagus nerve. This vast volume of complex sensory information is received by neurons of the nucleus of the tractus solitarius (NTS) and is integrated with responses to circulating factors as well as descending inputs from the brainstem, midbrain, and forebrain nuclei involved in autonomic regulation. The integrated signal is relayed to the adjacent dorsal motor nucleus of the vagus (DMV), which supplies the motor output response via the efferent vagus nerve to regulate and modulate gastric motility, tone, secretion, and emptying, as well as intestinal motility and transit; the precise coordination of these responses is essential for the control of meal size, meal termination, and nutrient absorption. The interconnectivity of the NTS implies that many other CNS areas are capable of modulating vagal efferent output, emphasized by the many CNS disorders associated with dysregulated GI functions including feeding. This review will summarize the role of major CNS centers to gut-related inputs in the regulation of gastric function with specific reference to the regulation of food intake.
Highlights
Sensory information from the gastrointestinal (GI) tract is relayed centrally via neural and humoral pathways; the central nervous system (CNS) integrates this large volume of sensory afferent information and coordinates a precise series of efferent responses to regulate food and caloric intake including the modulation of gastric motility, tone, and emptying, as well as intestinal motility, transit, secretion and absorption
Mucosal afferents are in close contact with enteroendocrine cells (EEC), and are respond to released gut endocrine peptides to induce an appropriate response in the vagal afferent neurons, and, subsequently, within the nucleus of the tractus solitarius (NTS), dorsal motor nucleus of the vagus (DMV), and the arcuate nucleus of the hypothalamus, [8] to regulate gastric emptying, pancreatic exocrine signaling, and intestinal fluid secretion, regulating food and caloric intake [5,9]
It is highly vascularized with fenestrated capillaries and has dendritic projections that extend to the basal lamina side of the vascular endothelial cells, allowing it to be more exposed to circulating factors than the other regions of the brainstem that are involved in controlling feeding behavior [64]
Summary
Sensory information from the gastrointestinal (GI) tract is relayed centrally via neural and humoral pathways; the central nervous system (CNS) integrates this large volume of sensory afferent information and coordinates a precise series of efferent responses to regulate food and caloric intake including the modulation of gastric motility, tone, and emptying, as well as intestinal motility, transit, secretion and absorption. This efferent output is regulated meticulously in order to maintain homeostasis based on current energy needs and visceral sensory stimuli.
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