Enteric nervous system and intestinal epithelial regulation of the gut-brain axis

The gut-brain axis describes a bidirectional interplay within the enteric environment between the intestinal epithelium, the mucosal immune system, and the microbiota with the enteric nervous system. This interplay provides a link between exogenous environmental stimuli such as nutrient sensing, and nervous system function, as well as a mechanism of feedback from cortical and sensory centers of the brain to enteric activities. The intestinal epithelium is one of the human body's largest sources of hormones and neurotransmitters, which have critical effects on neuronal function. The influence of the gut microbiota on these processes appears to be profound; yet to date, it has been insufficiently explored. Disruption of the intestinal microbiota is linked not only to diseases in the gut but also to brain symptomatology, including neurodegenerative and behavioral disorders (Parkinson disease, Alzheimer disease, autism, and anxiety and/or depression). In this review we discuss the cellular wiring of the gut-brain axis, with a particular focus on the epithelial and neuronal interaction, the evidence that has led to our current understanding of the intestinal role in neurologic function, and future directions of research to unravel this important interaction in both health and allergic disease.

Automated summary

The gut-brain axis refers to the bidirectional interaction between the intestinal environment, including the epithelium, immune system, microbiota, and the enteric nervous system. This interaction plays a crucial role in linking environmental stimuli and nervous system function, as well as providing feedback from the brain to intestinal activities. The gut microbiota has a profound influence on these processes, which has not been extensively studied. Disruption of the gut microbiota is associated with both gut diseases and brain symptoms such as neurodegenerative and behavioral disorders.