[Physiopathology of the enteric nervous system: recent advances and clinical implications]

Enteric neuropathies may significantly affect the patient's quality of life, although they have a fatal outcome only in a minority of cases. Motor derangement (often, hypomotility) is a typical feature of primary and secondary neuropathies affecting the myenteric plexus. This review addresses some pathophysiological aspects of enteric neuropathies and tries to outline the limitations of the experimental evidence obtained so far as well as some questions that can possibly receive an answer by applying new concepts and new techniques. In particular, the concept of neuronal plasticity, originally developed by investigators studying the central nervous system, is discussed and applied to the enteric microenvironment, with specific reference to adaptive phenomena occurring during intestinal inflammation. The role of neurotrophins and the potential therapeutic applications are also briefly discussed.