Published online May 28, 2020. doi: 10.3748/wjg.v26.i20.2533
Peer-review started: December 23, 2019
First decision: April 1, 2020
Revised: April 7, 2020
Accepted: April 29, 2020
Article in press: April 29, 2020
Published online: May 28, 2020
Stress-induced gastric mucosal lesion (SGML) is one of the most common visceral complications after trauma. Exploring the nervous mechanisms of SGML has become a research hotspot. Restraint water-immersion stress (RWIS) can induce GML and has been widely used to elucidate the nervous mechanisms of SGML. It is believed that RWIS-induced GML is mainly caused by the enhanced activity of vagal parasympathetic nerves. Many central nuclei, such as the dorsal motor nucleus of the vagus, nucleus of the solitary tract, supraoptic nucleus and paraventricular nucleus of the hypothalamus, mediodorsal nucleus of the thalamus, central nucleus of the amygdala and medial prefrontal cortex, are involved in the formation of SGML in varying degrees. Neurotransmitters/neuromodulators, such as nitric oxide, hydrogen sulfide, vasoactive intestinal peptide, calcitonin gene-related peptide, substance P, enkephalin, 5-hydroxytryptamine, acetylcholine, catecholamine, glutamate, γ-aminobutyric acid, oxytocin and arginine vasopressin, can participate in the regulation of stress. However, inconsistent and even contradictory results have been obtained regarding the actual roles of each nucleus in the nervous mechanism of RWIS-induced GML, such as the involvement of different nuclei with the time of RWIS, the different levels of involvement of the sub-regions of the same nucleus, and the diverse signalling molecules, remain to be further elucidated.
Core tip: The nervous mechanisms of gastric mucosal lesion in rats subjected to restraint water-immersion stress were investigated. Abnormal regulation of the enteric nervous system, mainly due to the enhanced activity of the parasympathetic nervous system, can induce gastrointestinal dysfunction. The central nucleus such as dorsal motor nucleus of the vagus, nucleus ambiguous, nucleus of the solitary tract, paraventricular nucleus, supraoptic nucleus, mediodorsal nucleus of the thalamus, central nucleus of the amygdala and medial prefrontal cortex are all involved in the formation of stress-induced gastric mucosal lesion. Nitric oxide, 5-hydroxytryptamine, hydrogen sulfide, calcitonin gene-related peptide, vasoactive intestinal peptide, acetylcholine, catecholamine, glutamate, γ-aminobutyric acid, oxytocin and arginine vasopressin may be involved in the physiological process.