Revisiting concepts of visceral nociception in irritable bowel syndrome

Keszthelyi, Dániel; Troost, Freddy J.; Simrén, Magnus; Ludidi, Samefko; Kruimel, Joanna W.; Conchillo, José M.; Masclee, Ad

doi:10.1002/j.1532-2149.2012.00147.x

Cited by 41 publications

(37 citation statements)

References 80 publications

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“…176 Studies also show that SP, serotonin, and histamine, which can be released by mast cells, sensitize visceral afferents. 177 Patients with recurrent abdominal pain showed significantly greater expression of VIP, neurokinin 1 receptors, and TNF-α mRNA compared to control. 178,179 Thus it seems that electroacupuncture decreases numerous chemicals at peripheral sites to desensitize visceral afferents and alleviate visceral pain.…”

Section: Visceral Pain Modelsmentioning

confidence: 92%

Mechanisms of Acupuncture–Electroacupuncture on Persistent Pain

Zhang

Lao

Ren³

et al. 2014

Anesthesiology

650

465

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In the last decade, preclinical investigations of electroacupuncture mechanisms on persistent tissue-injury (inflammatory), nerve-injury (neuropathic), cancer, and visceral pain have increased. These studies show that electroacupuncture activates the nervous system differently in health than in pain conditions, alleviates both sensory and affective inflammatory pain, and inhibits inflammatory and neuropathic pain more effectively at 2–10 Hz than at 100 Hz. Electroacupuncture blocks pain by activating a variety of bioactive chemicals through peripheral, spinal, and supraspinal mechanisms. These include opioids, which desensitize peripheral nociceptors and reduce pro-inflammatory cytokines peripherally and in the spinal cord, and serotonin and norepinephrine, which decrease spinal n-methyl-d-aspartate receptor subunit GluN1 phosphorylation. Additional studies suggest that electroacupuncture, when combined with low dosages of conventional analgesics, provides effective pain management that can forestall the side effects of often-debilitating pharmaceuticals.

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Section: Visceral Pain Modelsmentioning

confidence: 92%

Mechanisms of Acupuncture–Electroacupuncture on Persistent Pain

Zhang

Lao

Ren³

et al. 2014

Anesthesiology

650

465

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“…Inflammation is able to cause post-inflammatory hyperalgesia and is among the principal local factors involved in VH occurring in patients with IBS. 44 Distal peripheral afferents including mucosal afferents, serosal and mesenteric afferents, as well as muscular afferents have a principal role in gut-brain axis communication. It has been confirmed that one of the main mechanisms involved in the pathophysiology of VH in IBS symptoms is sensitization of the distal peripheral afferents.…”

Section: Pathophysiology and Etiology Of Visceral Hypersensitivitymentioning

confidence: 99%

The Role of Visceral Hypersensitivity in Irritable Bowel Syndrome: Pharmacological Targets and Novel Treatments

Farzaei

Bahramsoltani

Abdollahi

et al. 2016

J Neurogastroenterol Motil

152

122

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Irritable bowel syndrome (IBS) is the most common disorder referred to gastroenterologists and is characterized by altered bowel habits, abdominal pain, and bloating. Visceral hypersensitivity (VH) is a multifactorial process that may occur within the peripheral or central nervous systems and plays a principal role in the etiology of IBS symptoms. The pharmacological studies on selective drugs based on targeting specific ligands can provide novel therapies for modulation of persistent visceral hyperalgesia. The current paper reviews the cellular and molecular mechanisms underlying therapeutic targeting for providing future drugs to protect or treat visceroperception and pain sensitization in IBS patients. There are a wide range of mediators and receptors participating in visceral pain perception amongst which substances targeting afferent receptors are attractive sources of novel drugs. Novel therapeutic targets for the management of VH include compounds which alter gut-brain pathways and local neuroimmune pathways. Molecular mediators and receptors participating in pain perception and visceroperception include histamine-1 receptors, serotonin (5-hydrodytryptamine) receptors, transient receptor potential vanilloid type I, tachykinins ligands, opioid receptors, voltage-gated channels, tyrosine receptor kinase receptors, protease-activated receptors, adrenergic system ligands, cannabinoid receptors, sex hormones, and glutamate receptors which are discussed in the current review. Moreover, several plant-derived natural compounds with potential to alleviate VH in IBS have been highlighted. VH has an important role in the pathology and severity of complications in IBS. Therefore, managing VH can remarkably modulate the symptoms of IBS. More preclinical and clinical investigations are needed to provide efficacious and targeted medicines for the management of VH. (J Neurogastroenterol Motil 2016;22:558-574)

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“…Colonic hypersensitivity was associated with many factors, including the sensitization of peripheral nociceptive afferents 7, 29, 30 . Changes of ion channel activities in DRG neurons play a significant role in the generation of peripheral sensitization and nociceptive sensation 7, 31, 32 .…”

Section: Discussionmentioning

confidence: 99%

Alpha-lipoic Acid suppresses P2X receptor activities and visceral hypersensitivity to colorectal distention in diabetic rats

Xin

Song

et al. 2017

Sci Rep

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The present study was designed to investigate the roles of P2X3 receptors in dorsal root ganglion (DRG) neurons in colonic hypersensitivity and the effects of alpha-lipoic acid (ALA) on P2X3 receptor activity and colonic hypersensitivity of diabetic rats. Streptozotocin (STZ) was used to induce diabetic model. Abdominal withdrawal reflex (AWR) responding to colorectal distention (CRD) was recorded as colonic sensitivity. ATP-induced current density of colon-specific DRG (T13-L2 DRGs) neurons was measured with whole-cell patch clamp. The expression of P2X3Rs of T13-L2 DRGs was measured by western blot analysis. The results showed that AWR scores significantly increased after STZ injection. P2X3R expression and ATP current density of T13-L2 DRG neurons were enhanced in diabetic rats. Intraperitoneal injection with ALA once a day for 1 week remarkably reduced P2X3R expression and ATP current density in diabetic rats. Importantly, ALA treatment attenuated colonic hypersensitivity in diabetic rats. Our data suggest that STZ injection increases expression and function of P2X3 receptors of colon-specific DRG neurons, thus contributing to colonic hypersensitivity in diabetic rats. Administration of ALA attenuates diabetic colonic hypersensitivity, which is most likely mediated by suppressing expression and function of P2X3 receptors in DRGs of diabetic rats.

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Revisiting concepts of visceral nociception in irritable bowel syndrome

Cited by 41 publications

References 80 publications

Mechanisms of Acupuncture–Electroacupuncture on Persistent Pain

Mechanisms of Acupuncture–Electroacupuncture on Persistent Pain

The Role of Visceral Hypersensitivity in Irritable Bowel Syndrome: Pharmacological Targets and Novel Treatments

Alpha-lipoic Acid suppresses P2X receptor activities and visceral hypersensitivity to colorectal distention in diabetic rats

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