Cytokine imbalance in irritable bowel syndrome: a systematic review and meta‐analysis

Bashashati, Mohammad; Rezaei, Nima; Shafieyoun, Arezoo; McKernan, Declan P.; Chang, Lin; Öhman, Lena; Quigley, Eamonn Martin; Schmulson, Max; Sharkey, Keith A.; Simrén, Magnus

doi:10.1111/nmo.12358

Cited by 145 publications

(135 citation statements)

References 39 publications

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“…analyses of 6 studies, Bashashati et al 30 did not find serum IL-10 level differences between IBS and healthy controls. Contrary to our hypotheses, intestinal lactulose/mannitol ratio levels were not associated with improvements in the primary or secondary outcomes.…”

Section: Discussionmentioning

confidence: 99%

Balance of Autonomic Nervous System Predicts Who Benefits from a Self-management Intervention Program for Irritable Bowel Syndrome

Jarrett

Cain

Barney

et al. 2015

J Neurogastroenterol Motil

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Background/AimsTo determine if potential biomarkers can be used to identify subgroups of people with irritable bowel syndrome (IBS) who will benefit the most or the least from a comprehensive self-management (CSM) intervention. MethodsIn a two-armed randomized controlled trial a CSM (n = 46) was compared to a usual care (n = 46) group with follow-up at 3 and 6 months post randomization. Biomarkers obtained at baseline included heart rate variability, salivary cortisol, interleukin-10 produced by unstimulated peripheral blood mononuclear cells, and lactulose/mannitol ratio. Linear mixed models were used to test whether these biomarkers predicted improvements in the primary outcomes including daily abdominal pain, Gastrointestinal Symptom score and IBS-specific quality of life. ResultsThe nurse-delivered 8-session CSM intervention is more effective than usual care in reducing abdominal pain, reducing Gastrointestinal Symptom score, and enhancing quality of life. Participants with lower nighttime high frequency heart rate variability (vagal modulation) and increased low frequency/high frequency ratio (sympathovagal balance) had less benefit from CSM on abdominal pain. Salivary cortisol, IL-10, and lactulose/mannitol ratio were not statistically significant in predicting CSM benefit. Baseline symptom severity interacts with treatment, namely the benefit of CSM is greater in those with higher baseline symptoms. ConclusionsCognitively-focused therapies may be less effective in reducing abdominal pain in IBS patients with higher sympathetic tone. Whether this a centrally-mediated patient characteristic or related to heightened arousal remains to be determined.

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Section: Discussionmentioning

confidence: 99%

Balance of Autonomic Nervous System Predicts Who Benefits from a Self-management Intervention Program for Irritable Bowel Syndrome

Jarrett

Cain

Barney

et al. 2015

J Neurogastroenterol Motil

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“…There is evidence of sustained inflammation in IBS supported by numerous studies that have detected low anti-inflammatory cytokines in IBS patients [35] or others that found high levels of those pro-inflammatory ones or a misbalance of the pro-and anti-inflammatory cytokine proportion [36,37]. The complex dialogue between the structures involved in maintaining the homeostasis includes interrelation of nervous, immune, and endocrine systems [30,34], where a pivotal piece is the brain that governs the humoral and neurological systems [34,38,39], in a complex network with multidirectional communicating systems [10].…”

Section: Inflammation In Ibsmentioning

confidence: 79%

Inflammation as a Potential Therapeutic Target in IBS

Chira¹,

Chira²,

Dumitraşcu³

2016

Irritable Bowel Syndrome - Novel Concepts for Research and Treatment

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The pathogenesis of irritable bowel syndrome (IBS) has been intensively researched, and despite a long journey for unraveling all the structures and the pathways involved, it still remains partially obscure. Inflammation was the first to be hypothesized as a potential pathway for the pathogenesis of IBS. It remains a keystone in the complex machinery of the pathogenesis that is currently considered multifactorial. Elucidating the pathogenesis of IBS is crucial for a targeted therapy of the disease. In this chapter, we review information regarding gut inflammation in IBS, underlining some of the newest data or the cornerstones. Additionally, our aim was also to review treatment currently available and future perspectives regarding anti-inflammatory treatments for IBS. Newer techniques allow detection and research of mediators involved in inflammation, as well as their potential role to be targeted by pharmacological agents. Recent data supports not only further research of the newer agents that are currently being developed but also some of the available ones that do not have sufficient evidence. Emerging therapies that target inflammation are under evaluation, in trials. A multidrug or a multidisciplinary approach needs to be considered in some cases that fail to respond to current treatment.

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“…Se han implicado alteraciones tales como activación del sistema inmunitario, infecciones gastrointestinales e inflamación de bajo grado de la mucosa colónica, sugiriendo un probable origen orgánico 4,5 . En varios estudios se ha demostrado alteración en el balance de citocinas anti y proinflamatorias como la interleucina 10 y el factor de necrosis tumoral (TNFα) 6 . Así mismo, se ha propuesto una alteración en la permeabilidad de la mucosa intestinal que a su vez llevaría a una activación inmunitaria de la mucosa 7 .…”

Section: Introductionunclassified

Síndrome de intestino irritable y autoinmunidad

Sansón-Riofrío¹,

González-Huitrón²,

Turrent-Carriles³

et al. 2017

NGL

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RESUMENSi bien el síndrome de intestino irritable (SII) se considera un trastorno multifactorial, una de las más recientes teorías propone la presencia de activación inmunitaria anormal e inflamación de bajo grado a nivel de la mucosa intestinal. Además, se asocia con fibromialgia (FM), trastorno también frecuente en pacientes con lupus eritematoso sistémico (LES), artritis reumatoide (AR) y otras enfermedades reumáticas de etiología autoinmunitaria. Por todo lo anterior sería plausible considerar una asociación del SII con autoinmunidad. Nuestra revisión tuvo como objetivo identificar la posible relación entre el SII y las enfermedades autoinmunes. En abril de 2016 llevamos a cabo dos búsquedas, por dos revisores independientes, en PubMed utilizando los términos de búsqueda «Irritable Bowel Syndrome AND Autoimmune Disorders OR Autoimmunity» (síndrome de intestino irritable Y trastornos autoinmunes O autoinmunidad). Ambas obtuvieron el mismo resultado, 153 artículos. De estos artículos se descartaron 141 que no cumplieron con los criterios de búsqueda y finalmente se seleccionaron 13. Estos se complementaron con otras tres referencias no identificadas. Si bien nuestra revisión no encontró en general una mayor asociación de trastornos autoinmunes con el SII, sí parece haber una mayor frecuencia del SII en pacientes con LES (determinada por la presencia de FM y depresión) y en la esclerosis múltiple (EM). No queda claro si existe una relación del SII con el síndrome de Sjögren, pero al parecer esta

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Cytokine imbalance in irritable bowel syndrome: a systematic review and meta‐analysis

Abstract: There is an imbalance of proinflammatory TNF-α, and anti-inflammatory IL-10, cytokines in IBS. Stratifying IBS patients based on cytokine profile may represent an opportunity for personalized treatment of this condition.

Cited by 145 publications

References 39 publications

Balance of Autonomic Nervous System Predicts Who Benefits from a Self-management Intervention Program for Irritable Bowel Syndrome

Balance of Autonomic Nervous System Predicts Who Benefits from a Self-management Intervention Program for Irritable Bowel Syndrome

Inflammation as a Potential Therapeutic Target in IBS

Síndrome de intestino irritable y autoinmunidad

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