Objective: In this review we focused on understanding the cause-and-effect relationships of gastroduodenal pathology aiming to clarify the role of vagus nerve. Results: The spectrum of vagus nerve biological effects in gastroduodenal area is related to its numerous targets and a wide range of its receptors. A variety of vagus nerve effects are related to the broad expression of cholinergic receptors on the target cells: smooth muscle cells, covering and glandular epithelium of stomach and duodenum, myofibroblasts and mast cells, vascular endothelium, intramural ganglion neurons, endocrine cells, platelets and blood leukocytes. In this paper, we discussed the following issues: 1) role of sensory nerve endings in the vagal reflex regulation; 2) impact of gastrin and leptin on vagal afferentation; 3) targets of vagus efferent nerves; 4) the role of acetylcholine in regulation of functional activity of oxyntic cells; 5) relationship of vagus efferents with enteroendocrine cells; 6) the role of vagus nerve in realization of compensatory and adaptive reactions in gastroduodenal area. Conclusion: Vagus nerve is one of the key regulators of mucosal activity and blood supply, modulating adaptive reactions and maintaining the gastrointestinal barrier.
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