Gastrointestinal tract junction

KA Kelly. Motility of the stomach and gastroduodenal junction. In LR Johnson, ed. Physiology of the Gastrointestinal Tract. New York Raven Press, 1981, pp 393-410. 

All botulin neurotoxins act in a similar way. They only differ in the amino-acid sequence of some protein parts (Prabakaran et al., 2001). Botulism symptoms are provoked both by oral ingestion and parenteral injection. Botulin toxin is not inactivated by enzymes present in the gastrointestinal tracts. Foodborne BoNT penetrates the intestinal barrier, presumably due to transcytosis. It is then transported to neuromuscular junctions within the bloodstream and blocks the secretion of the neurotransmitter acetylcholine. This results in muscle limpness and palsy caused by selective hydrolysis of soluble A-ethylmalemide-sensitive factor activating (SNARE) proteins which participate in fusion of synaptic vesicles with presynaptic plasma membrane. SNARE proteins include vesicle-associated membrane protein (VAMP), synaptobrevin, syntaxin, and synaptosomal associated protein of 25 kDa (SNAP-25). Their degradation is responsible for neuromuscular palsy due to blocks in acetylcholine transmission from synaptic terminals. In humans, palsy caused by BoNT/A lasts four to six months. 

Clinical use of reversible inhibitors is directed to eye, skeletal muscle, neuromuscular junctions, gastrointestinal tract, urinary tract, respiratory tract, and heart and used in treatment of glaucoma (an ocular disease caused by increased intraocular pressure due to inadequate drainage of aqueous humor at filtration angle), myasthenia gravis (an autoimmune disease... 

In summary, nasal epithelial intercellular junctions are less restrictive compared to the gastrointestinal tract. Such polar pathways will mainly be responsible for the transport of water-soluble compounds, providing a relatively slow, but significant route which is dependent on the molecular weight of the diffusing species. Secondly, transcellular (lipoidal) pathways permit extremely rapid absorption of lipophilic drugs with a rate dependency based on cell membrane partitioning. 

Junctional complexes comprise intercellular membrane specializations which encircle the cells, preventing access of luminal contents to the intercellular spaces. They are found between the cells of simple cuboidal (for example in the lungs) and simple columnar (for example in the gastrointestinal tract) epithelia, and he immediately below the luminal surface. They are made up of three components ... 

For almost one century, acetylcholine has been recognized as a neurotransmitter both in the central nervous system and the peripheral nervous system. In the peripheral nervous system, acetylcholine has been identified as the neurotransmitter of autonomic ganglia and the neuromuscular junction. Acetylcholine is involved in different peripheral functions such as heart rate, blood flow, gastrointestinal tract motility, and sweat production and smooth muscle activity. In the CNS, cholinergic neurotransmission plays a crucial role in a variety of CNS functions including sensory perception, motor function, cognitive processing, memory, arousal, attention, sleep, nociception, motivation, reward, mood, and psychosis. 

Tobacco smoke includes 4000 chemical species with varying potential which cause adverse effects. Nicotine is stimulating to the autonomic nervous system ganglia and neuromuscular junction. The most prominent effects relate to stimulation of the adrenal medulla, central nervous system (CNS), cardiovascular system (release of catecholamines), gastrointestinal tract (parasympathetic stimulation), salivary and bronchial glands, and the medullary vomiting center. There is subsequent blockade of autonomic ganglia and the neuromuscular junction transmission, inhibition of catecholamine release from the adrenal medulla, and CNS depression. 

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