[Digestive endocrinology, today].

Abstract

The authors discuss the changing role of gastrointestinal endocrinology during the last twenty years starting from the early sixties when techniques such as radioimmunoassay and immunocytochemistry allowed major advances of our knowledge on this field. Using these techniques several regulatory peptides have been identified and the concept of the diffuse neuroendocrine system as a morphofunctional apparatus regulating the majority of physiological activities, was postulated. Therefore gut endocrinology was enclosed as a part of neuroendocrinology and similarly the importance of peptidergic substances in neural physiology was recognized. Nevertheless, the usefulness of gut endocrinology in the clinical management of gastrointestinal diseases, following an emphatic start, is now restricted to gastrointestinal neuroendocrine tumours. In these pathological conditions some regulatory peptides have been shown to be responsible for the associated symptoms and can be useful markers in the diagnosis and follow-up. However, recent advances in gut endocrinology make us think to new possibilities of clinical applications of gut hormones, at least in the understanding of the pathophysiology of some diseases (i.e. constipation, incontinence, short-bowel syndrome, etc.). Moreover, new events are now occurring in gut endocrinology since major improvements in molecular biology and genetic engineering can now allow us to sequence and clone DNA strands encoding several regulatory peptides and their precursors. Similarly membrane receptors and intracellular messengers have been characterized elucidating the complex metabolic pathways of neuroendocrine cells. Using advanced molecular biology techniques we can obtain today large amount of different regulatory peptides highly purified that can be employed in the diagnosis and therapy of several diseases.(ABSTRACT TRUNCATED AT 250 WORDS)