Neural reflexes controlling intestinal microcirculation.

It has long been established that neural reflexes are involved in the regulation of gastrointestinal vascular function, in particular the mucosal hyperemia that follows food ingestion. However, more precise identification of reflex pathways involved in the control of mucosal blood flow had not previously been forthcoming because of a lack of adequate methods to examine resistance arterioles within the intestinal wall. Recent advances have employed novel in vitro preparations and videomicroscopic techniques to investigate the neural control of the gastrointestinal microvasculature and involvement of intrinsic and extrinsic vasodilatory neurons in mucosal reflexes. Vasoconstrictor innervation to submucosal arterioles is mediated solely by extrinsic sympathetic nerves that release ATP onto arteriolar P2n-purinoceptors. Neurogenic vasodilation of submucosal arterioles occurs by release of acetylcholine and/or neuropeptides from intrinsic submucosal neurons as well as by release of substance P and calcitonin gene-related peptide from extrinsic sensory nerves. Both vasodilator pathways can be activated independently by mucosal stimulation, and both have afferent and efferent components confined to the mucosa and submucosal neuronal plexus. We speculate that the intrinsic enteric cholinergic reflex pathways are involved in local physiological control of mucosal blood flow, whereas extrinsic sensory reflex pathways are preferentially activated during inflammatory states.