Review article: the role of the autonomic nervous system in the pathogenesis and therapy of IBD

Mogilevski, Tamara; Burgell, Rebecca; Aziz, Qasim; Gibson, Peter R

doi:10.1111/apt.15433

Cited by 56 publications

(48 citation statements)

References 157 publications

(198 reference statements)

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“…The results obtained to date indicate novel approaches to targeted therapy of ANS dysfunction in sepsis and other conditions of immune dysregulation [90][91][92][93]. It is crucial to determine the type of ANS dysfunction -in the form of sympathetic or parasympathetic hyperactivity -for subsequent targeted therapy of systemic inflammation using sympathomimetic or sympatholytic agents [94][95][96][97][98].…”

Section: Therapeutic Interventions In Ans Dysfunction and Generalizedmentioning

confidence: 99%

Dysfunction of the Autonomic Nervous System and Its Role in the Pathogenesis of Septic Critical Illness (Review)

Kiryachkov

Bosenko

Muslimov³

et al. 2020

Sovrem Tehnol Med

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Dysfunction of the autonomic nervous system (ANS) of the brain in sepsis can cause severe systemic inflammation and even death. Numerous data confirmed the role of ANS dysfunction in the occurrence, course, and outcome of systemic sepsis. The parasympathetic part of the ANS modifies the inflammation through cholinergic receptors of internal organs, macrophages, and lymphocytes (the cholinergic antiinflammatory pathway). The sympathetic part of ANS controls the activity of macrophages and lymphocytes by influencing β2-adrenergic receptors, causing the activation of intracellular genes encoding the synthesis of cytokines (anti-inflammatory beta2-adrenergic receptor interleukin-10 pathway, β2AR-IL-10). The interaction of ANS with infectious agents and the immune system ensures the maintenance of homeostasis or the appearance of a critical generalized infection. During inflammation, the ANS participates in the inflammatory response by releasing sympathetic or parasympathetic neurotransmitters and neuropeptides. It is extremely important to determine the functional state of the ANS in critical conditions, since both cholinergic and sympathomimetic agents can act as either anti-or pro-inflammatory stimuli.

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Section: Therapeutic Interventions In Ans Dysfunction and Generalizedmentioning

confidence: 99%

Dysfunction of the Autonomic Nervous System and Its Role in the Pathogenesis of Septic Critical Illness (Review)

Kiryachkov

Bosenko

Muslimov³

et al. 2020

Sovrem Tehnol Med

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“…motility, inflammation in patients with inflammatory bowel diseases, and abdominal sensations) has been reported. 14,15,17,32,33 The number of rumination episodes was reported by patients (not by objective testing). In our previous report, 37 24-hour impedance pH-metry showed that patients with RS reported their symptoms…”

Section: Discussionmentioning

confidence: 99%

Rumination syndrome: Assessment of vagal tone during and after meals and during diaphragmatic breathing

Hoshikawa

Fitzke

Sweis

et al. 2020

Neurogastroenterology Motil

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Background: Pathophysiology of rumination syndrome (RS) is not well understood. Treatment with diaphragmatic breathing improves rumination syndrome. The aim of the study was to characterize vagal tone in patients with rumination syndrome during and after meals and during diaphragmatic breathing. Methods: We prospectively recruited 10 healthy volunteers (HV) and 10 patients with RS. Subjects underwent measurement of vagal tone using heart rate variability. Vagal tone was measured during baseline, test meal and intervention (diaphragmatic (DiaB), slow deep (SlowDB), and normal breathing). Vagal tone was assessed using mean values of root mean square of successive differences (RMSSD), and area under curves (AUC) were calculated for each period. We compared baseline RMSSD, the AUC and meal-induced discomfort scores between HV and RS. Furthermore, we assessed the effect of respiratory exercises on symptom scores, and number of rumination episodes. Key Results: There was no significant difference in baseline vagal tone between HV and RS. During the postprandial period, there was a trend to higher vagal tone in RS, but not significantly (P > .2 for all). RS had the higher total symptom scores than HV (P < .011). In RS, only DiaB decreased the number of rumination episodes during the intervention period (P = .028), while both DiaB and SlowDB increased vagal tone (P < .05 for both). The symptom scores with the 3 breathing exercises showed very similar trends. Conclusions and inferences: Patients with RS do not have decreased vagal tone related to meals. DiaB reduced number of rumination events by a mechanism not related to changes in vagal tone. K E Y W O R D S autonomic nervous system, breathing exercises, gastro-esophageal reflux disease, gastrointestinal diseases, rumination syndrome How to cite this article: Hoshikawa Y, Fitzke H, Sweis R, et al. Rumination syndrome: Assessment of vagal tone during and after meals and during diaphragmatic breathing.

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“…This vagal activity appears to have protective properties on the intestinal barrier, inflammatory mechanisms, and the microbiome. This potentially useful pathway deserves to be explored therapeutically [8,13].…”

Section: The Role Of Gut Microbiotamentioning

confidence: 99%

The Brain-Gut Team

Malagelada

2020

Dig Dis

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Background: Interactions between brain and gut have been suspected for centuries but our understanding of the neural centers and neurohormonal links that establish bidirectional regulatory communication between these 2 body systems has advanced significantly in the last decades. The label "brain-gut axis" designates a useful but deceivingly simple concept, since the mechanistic complexity of brain-gut interaction is enormous. Summary: The significance of the brain-gut axis is perhaps best conceived as "a team" since both systems are physiologically coordinated to ensure a healthy status. However, under pathophysiological conditions, the axis also contributes substantially to distort homeostasis. For instance, normal signals emanating from the gut may be inappropriately received and interpreted by the central nervous system that responds by inadequately recruiting other brain structures and generate both symptoms and commands that disturb normal gut activity. Key Messages: Thus, at each end and in the brain-gut connecting routes, there is the potential for altering perceived and unperceived sensations and further impinging on normal function.

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Review article: the role of the autonomic nervous system in the pathogenesis and therapy of IBD

Cited by 56 publications

References 157 publications

Dysfunction of the Autonomic Nervous System and Its Role in the Pathogenesis of Septic Critical Illness (Review)

Dysfunction of the Autonomic Nervous System and Its Role in the Pathogenesis of Septic Critical Illness (Review)

Rumination syndrome: Assessment of vagal tone during and after meals and during diaphragmatic breathing

The Brain-Gut Team

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