Pro-inflammatory and anti-inflammatory cytokine response in diarrhoea-predominant Irritable bowel syndrome patients

Abstract

Background and aim: Irritable bowel syndrome (IBS) is referred to as a functional bowel disorder which is diagnosed by a number of characteristic symptoms (Rome II criteria) in the absence of detectable structural abnormalities. Low-grade inflammation of the intestine may be one of the reasons for development of diarrhoea-predominant IBS (IBS-D). We undertook this study to estimate the serum levels of pro-inflammatory (IL-6, TNF-α) and anti-inflammatory (IL-10) cytokines in IBS-D patients. Methods: A total of 108 diarrhoea patients were screened. Out of these only 63 adult IBS-D patients were enrolled. Age and sex matched 62 apparently healthy controls with no GI symptoms were also recruited. Out of 63 IBS-D patients, 37 were males while there were 32 males among the controls. The patients with IBS-D were diagnosed according to the Rome II criteria. Levels of serum IL-6, TNF-α and IL-10 were measured in all subjects using ELISA. Results: Mean (+SD) age of IBS-D patients (42.6+19.5 years) was comparable (p=0.64) to that of controls (43.5+18.7 years). The mean (+SD) levels of IL-6 in IBS-D patients (32.2+12.01pg/ ml) was significantly higher (p<0.001) than in controls (7.48+2.55pg/ml). The levels of TNF-α in IBS-D patients (16.3+5.2 pg/ml) were also significantly higher (p<0.05) than in controls (7.94+2.19 pg/ml). There was no significant difference in the serum levels of IL-10 (p=0.23) between IBS-D patients (5.75+2.1 pg/ml) and controls (5.84+1.9 pg/ml). Conclusion: Our results indicate that mild inflammation is involved in IBS-D patients as proinflammatory cytokines were increased although no difference in anti-inflammatory cytokine was observed.

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

“…Several investigators have reported reduced levels of serum anti-inflammatory cytokine IL-10 12,13 or no difference between those with IBS and controls. 14 The aim of the current study is to determine whether measures such as nighttime ANS balance, lactulose/mannitol ratio (intestinal permeability measure), and serum IL-10, identified in the literature as potential markers in IBS, are predictive of outcomes with a cognitively-focused behavioral therapy. Based on the literature, we hypothesized that those IBS patients with lower HRV, higher salivary cortisol, and higher IL-10 levels would show greater improvement with an intervention combining CBT, diet counselling, and education.…”

Immune activation in irritable bowel syndrome: from basic to clinic

“…Studies on circulating or mucosal cytokine levels in IBS patients versus controls had inconsistent results and were not all methodologically comparable. While some of these studies measured the serum/plasma or mucosal levels/expression (Table 2) [17][18][19][20][21][22][23][24][25][26] , others have focused on cytokine production by monocyte or lymphocyte supernatants in the presence or absence of stimulators such as lipopolysaccharides (LPSs) 9,[27][28][29][30] .…”

Evaluation of Tryptophan Metabolism in Chronic Immune Activation

“…The increased level of T-cell activation is consistent with the hypothesis of low-grade immune activation in IBS (Ohman et al 2009 ). Mild infl ammation is involved in diarrhea-predominant IBS patients as proinfl ammatory cytokine TNF-alpha is signifi cantly higher, although no difference in anti-infl ammatory cytokine is observed (Rana et al 2012 ). Although IBS is characterized by the increase of proinfl ammatory cytokines, IL-6 and IL-8, IBS patients with certain extraintestinal comorbid conditions are distinguished by additional elevations in IL-1beta and TNF-alpha (Scully et al 2010 ).…”