The Brain-Gut Axis: From Pathophysiology to Possible Future Strategies of Treatment

The enteric nervous system (ENS) controls and modulates various functions of the digestive tract such as motility, exocrine and endocrine secretion, local microcirculation, inflammation and neuroimmunity. This system is autonomous from the central nervous system (CNS), although they share many neurons and neurotransmitters. The CNS may exert a modulatory role on ENS through brainstem and subcortical areas, peripheral and autonomic fibers. The brain-gut axis is the complex system regulating the interactions and mutual influences between the nervous system and the gut. This axis is divided into various levels through receptors, afferents, integration centers, efferents and effectors, and exploits multiple messengers belonging to the nervous, immune and endocrine systems. The proper functioning of this apparatus is essential in intestinal physiology, its involvement has been recognized as one of the leading pathophysiological basis of many digestive disorders and a target for current and future therapeutical