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Nerve-Gut Research Laboratory, Department of Gastroenterology, Hepatology and General Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia
GABAB receptors are inhibitory G protein-coupled receptors that are commonly associated with presynaptic inhibition of transmitter release in the central nervous system. In the brain-gastroesophageal axis, a role has recently been demonstrated for GABAB receptors on extrinsic afferent endings within the stomach and esophagus, where they reduce mechanosensitivity. This action is compounded by inhibition of communication centrally from these afferents in the brain stem and within central circuits. There is a final peripheral action on the motor pathway where GABAB receptors reduce output of acetylcholine from vagal preganglionic motoneurons. These potent, multiple actions of GABAB receptors may have therapeutic benefit by reducing the triggering of transient lower esophageal relaxations, which are the major cause of gastroesophageal reflux. An important clinical application is therefore emerging for this recent discovery.
vagal afferents; mechanoreceptors; transient lower esophageal relaxations; gastroesophageal reflux
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