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Related Experiment Videos

Noxious stimulation of emesis.

I M Lang1

  • 1Department of Medicine and Dysphagia Institute, Medical College of Wisconsin, Milwaukee 53226, USA.

Digestive Diseases and Sciences
|September 18, 1999
PubMed
Summary

This review explores how peripheral receptors and factors trigger or suppress nausea and vomiting. It highlights thoracic and abdominal receptors, including serotonin receptors, involved in emesis pathways and their brain-gut interactions.

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Area of Science:

  • Neuroscience
  • Gastroenterology
  • Physiology

Background:

  • Emesis (nausea and vomiting) can be triggered by peripheral stimuli, involving complex neural pathways.
  • Receptors in the thorax and abdomen play crucial roles in initiating or inhibiting emetic responses.
  • Serotonin (5-HT) receptors, specifically 5-HT3 and 5-HT4, are implicated in mediating vomiting induced by various stimuli.

Purpose of the Study:

  • To review the mechanisms of emesis initiated or inhibited by peripheral receptors or peripherally released humoral factors.
  • To elucidate the roles of thoracic and abdominal receptors in the emetic reflex.
  • To explore the neural pathways and neurotransmitter systems involved in peripheral emesis.

Main Methods:

  • Review of existing literature on peripheral mechanisms of emesis.
  • Analysis of studies investigating thoracic and abdominal receptor activation.
  • Examination of the role of serotonin and its receptors in emesis.

Main Results:

  • Both excitatory and inhibitory receptors are present in the thorax, potentially linked to cardiac events and vagal stimulation.
  • Pulmonary vagal afferents may tonically inhibit vomiting, while abdominal mechano- and chemoreceptors activate emesis.
  • Peripheral 5-HT3 and 5-HT4 receptors are key mediators for vomiting induced by toxins, chemotherapy, and irradiation.

Conclusions:

  • Peripheral receptors in the thorax and abdomen, along with peripherally released factors like serotonin, are significant contributors to emesis.
  • Afferent pathways from the periphery converge in the brainstem (nucleus tractus solitarius and area postrema) to modulate emetic responses.
  • Understanding these peripheral mechanisms is crucial for developing antiemetic strategies and investigating conditions like cyclic vomiting.

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