Crosstalk at the mucosal border: importance of the gut microenvironment in IBS

Öhman, Lena; Törnblom, Hans; Simrén, Magnus

doi:10.1038/nrgastro.2014.200

Cited by 155 publications

(152 citation statements)

References 216 publications

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“…There is a blossoming literature on this topic, and excellent reviews conclude that it is clear that the colonic microbiome may play a major role in IBS [79][80][81][82]. A summary of current thinking is presented below [79][80][81][82] 1. In animal studies it has been shown that the colonic microbiome alters visceral pain responses, intestinal permeability and brain function and behaviour.…”

Section: The Gut Microbiome-stomach Duodenum and Colonmentioning

confidence: 99%

Therapeutic strategies for functional dyspepsia and irritable bowel syndrome based on pathophysiology

2015

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Functional gastrointestinal disorders (FGIDs) are common and distressing. They are so named because a defined pathophysiology in terms of structural or biochemical pathways is lacking. Traditionally FGIDs have been conceptualized as brain-gut disorders, with subgroups of patients demonstrating visceral hypersensitivity and motility abnormalities as well as psychological distress. However, it is becoming apparent that there are certain structural or biochemical gut alterations among subsets with the common FGIDs, most notably functional dyspepsia (FD) and irritable bowel syndrome (IBS). For example, a sodium channel mutation has been identified in IBS that may account for 2 % of cases, and subtle intestinal inflammation has been observed in both IBS and FD. Other research has implicated early life events and stress, autoimmune disorders and atopy and infections, the gut microbiome and disordered mucosal immune activation in patients with IBS or FD. Understanding the origin of symptoms in FGIDs will allow therapy to be targeted at the pathophysiological changes, not at merely alleviating symptoms, and holds hope for eventual cure in some cases.For example, there are promising developments in manipulating the microbiome through diet, prebiotics and antibiotics in IBS, and testing and treating patients for Helicobacter pylori infection remains a mainstay of therapy in patients with dyspepsia and this infection. Locally acting drugs such as linaclotide have been an advance in treating the symptoms of constipation-predominant IBS, but do not alter the natural history of the disease. A role for a holistic approach to patients with FGIDs is warranted, as brain-togut and gut-to-brain pathways appear to be activated.

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Section: The Gut Microbiome-stomach Duodenum and Colonmentioning

confidence: 99%

Therapeutic strategies for functional dyspepsia and irritable bowel syndrome based on pathophysiology

2015

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“…En la fisiopatología del SII participan diversos factores, entre ellos ha sido ampliamente descrita la presencia de alteraciones biológicas que afectan la comunicación neuro-inmune de la mucosa intestinal 14 , proceso que se ve favorecido frente a condiciones genéticas predisponentes 15 . Dentro de los mecanismos biológicos alterados se incluyen: la activación de células inmunes en la mucosa intestinal, tales como linfocitos T, linfocitos B y mastocitos; las alteraciones en la composición y aumento del número de la microbiota intestinal, que llevan al procesamiento anormal de moléculas presentes en la dieta; y la mayor liberación de sustancias bioactivas por células enterocromafines (EC) 11,14,16,17 .…”

Section: Artículo Originalunclassified

“…Dentro de los mecanismos biológicos alterados se incluyen: la activación de células inmunes en la mucosa intestinal, tales como linfocitos T, linfocitos B y mastocitos; las alteraciones en la composición y aumento del número de la microbiota intestinal, que llevan al procesamiento anormal de moléculas presentes en la dieta; y la mayor liberación de sustancias bioactivas por células enterocromafines (EC) 11,14,16,17 . La respuesta inflamatoria intestinal es reforzada por una mayor actividad nerviosa entérica, relacionada al aumento de la sensibilidad visceral e incremento en la estimulación de terminales nerviosos aferentes y a la alteración del eje intestino-cerebro en estos pacientes 18 .…”

Section: Artículo Originalunclassified

Parasitosis y síndrome de intestino irritable

Ibarra

Herrera

Arce

et al. 2016

Rev. chil. infectol.

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“…Increased mucosal permeability is frequently observed in IBS and can be caused by specific pathogens and diet (cow milk allergy or high fat diet), especially in patients with susceptibility genes. 133,134 Activation of mucosal mast cells by short-chain fatty acid (through short-chain free fatty acid receptor 2 [FFA2]) and other stimuli triggers the release of specific proteases and inflammatory cytokines which further increase mucosal permeability. 135 Dysregulated repair/ regenerative signals (Wnt, Notch, and TGF-β) could also contribute to the barrier leakage by their effects on cell-cell-junction, function and number of secretory cells and their indirect effects through immune cells.…”

Section: Irritable Bowel Syndromementioning

confidence: 99%

Stem Cells in the Intestine: Possible Roles in Pathogenesis of Irritable Bowel Syndrome

Ratanasirintrawoot

Israsena

2016

J Neurogastroenterol Motil

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Irritable bowel syndrome is one of the most common functional gastrointestinal (GI) disorders that significantly impair quality of life in patients. Current available treatments are still not effective and the pathophysiology of this condition remains unclearly defined. Recently, research on intestinal stem cells has greatly advanced our understanding of various GI disorders. Alterations in conserved stem cell regulatory pathways such as Notch, Wnt, and bone morphogenic protein/TGF -β have been well documented in diseases such as inflammatory bowel diseases and cancer. Interaction between intestinal stem cells and various signals from their environment is important for the control of stem cell self-renewal, regulation of number and function of specific intestinal cell types, and maintenance of the mucosal barrier. Besides their roles in stem cell regulation, these signals are also known to have potent effects on immune cells, enteric nervous system and secretory cells in the gut, and may be responsible for various aspects of pathogenesis of functional GI disorders, including visceral hypersensitivity, altered gut motility and low grade gut inflammation. In this article, we briefly summarize the components of these signaling pathways, how they can be modified by extrinsic factors and novel treatments, and provide evidenced support of their roles in the inflammation processes. Furthermore, we propose how changes in these signals may contribute to the symptom development and pathogenesis of irritable bowel syndrome.

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Crosstalk at the mucosal border: importance of the gut microenvironment in IBS

Cited by 155 publications

References 216 publications

Therapeutic strategies for functional dyspepsia and irritable bowel syndrome based on pathophysiology

Therapeutic strategies for functional dyspepsia and irritable bowel syndrome based on pathophysiology

Parasitosis y síndrome de intestino irritable

Stem Cells in the Intestine: Possible Roles in Pathogenesis of Irritable Bowel Syndrome

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