Clinical–alimentary tractHypothalamic-Pituitary-Gut Axis Dysregulation in Irritable Bowel Syndrome: Plasma Cytokines as a Potential Biomarker?
Section snippets
Study Population
Patients were recruited from gastroenterology clinics at St James’s Hospital (Dublin, Ireland). Individuals aged between 18 and 55 years who satisfied Rome II criteria for the diagnosis of IBS3 and in whom organic gastrointestinal diseases, including inflammatory bowel disease, and clinically significant systemic diseases had been excluded were considered for inclusion in the study. Pregnant women, individuals with known lactose intolerance or immunodeficiency, and individuals who had undergone
Baseline Characteristics
Classification of subjects at baseline by predominant symptom indicated that 30 were alternators, 36 diarrhea predominant, and 10 constipation predominant. Patients and control subjects were well matched in terms of alcohol use; however, 18 of the patients were cigarette smokers, whereas only 8 healthy controls smoked.
Differences in plasma cytokine levels were established. Levels of IL-6 (mean ± SEM) (Figure 1) in patients with IBS were 2.45 ± 0.19 pg/mL compared with 1.07 ± 0.10 pg/mL in
Discussion
Our results indicate that patients with IBS have an exaggerated stress response, as evidenced by the enhanced release of both ACTH and cortisol following CRH infusion. Such patients also showed increased levels of the proinflammatory cytokines IL-6 and IL-8. The former is known to be a potent activator of the HPA, and our analysis suggests that the HPA hyperresponsivity is related to elevation of IL-6 levels. We measured free plasma cytokine levels because these will reflect the biologic
References (50)
- et al.
AGA technical review on irritable bowel syndrome
Gastroenterology
(2002) - et al.
Evolving pathophysiological models of functional gastrointestinal disorders
Gastroenterology
(2002) - et al.
Relative importance of enterochromaffin cell hyperplasia, anxiety, and depression in postinfectious IBS
Gastroenterology
(2003) - et al.
Eradication of small bowel bacterial overgrowth reduces symptoms of irritable bowel syndrome
Am J Gastroenterol
(2000) - et al.
A randomized, placebo-controlled, double-blind comparison of the probiotic bacteria lactobacillus and bifidobacterium in irritable bowel syndrome (IBS)symptom responses and relationship to cytokine profiles
Gastroenterology
(2005) - et al.
Central nervous system effects of the neurohypophyseal hormones and related peptides
Front Neuroendocrinol
(1993) - et al.
The role of psychosocial factors in irritable bowel syndrome
Baillieres Clin Gastroenterol
(1999) Serotonin and the regulation of hypothalamic-pituitary-adrenal functiona minireview
Life Sci
(1996)Systemic interleukin-1 administration stimulates hypothalamic norepinephrine metabolism paralleling the increased plasma corticosterone
Life Sci
(1988)- et al.
Modulation of serotonin transporter function by interleukin 4
Life Sci
(2001)
Enhancement of serotonin transporter function by tumor necrosis factor alpha but not interleukin-6
Neurochem Int
Low levels of circulating inflammatory cytokines—do they affect human brain functions?
Brain Behav Immun
Activation of the mucosal immune system in irritable bowel syndrome
Gastroenterology
Full thickness biopsy of the jejunum reveals inflammation and enteric neuropathy in irritable bowel syndrome
Gastroenterology
Low levels of circulating inflammatory cytokines—do they affect brain functions
Brain Behav Immun
Reduced sensitivity to glucocorticoid feedback and reduced glucocorticoid receptor mRNA expression in the luteal phase of the menstrual cycle
Neuropsychopharmacology
Clinical studies with corticotropin releasing factorimplications for the diagnosis and pathophysiology of depression, Cushing’s disease and adrenal insufficiency
Psychoneuroendocrinology
Irritable bowel syndrome patients show enhanced modulation of visceral perception by auditory stress
Am J Gastroenterol
Enhanced evoked responses after early adversity and repeated platform exposurethe neurobiology of adversity?
Biol Psychiat
An evidence-based approach to the management of irritable bowel syndrome in North America
Am J Gastroenterol
Functional bowel disorders and functional abdominal pain
Gut
Irritable bowel syndrome in general practiceprevalence, characteristics, and referral
Gut
The prevalence, patterns and impact of irritable bowel syndromean international survey of 40,000 subjects
Aliment Pharmacol Ther
Current concepts of the irritable bowel syndrome
Scand J Gastroenterol
Increased rectal mucosal enteroendocrine cells, T lymphocytes, and increased gut permeability following acute Campylobacter enteritis and in post-dysenteric irritable bowel syndrome
Gut
Cited by (545)
Gender-specific insights into the irritable bowel syndrome pathophysiology. Focus on gut dysbiosis and permeability
2024, European Journal of Internal MedicineImportance of the Microbiota in Early Life and Influence on Future Health
2024, The Gut-Brain Axis, Second EditionNon-celiac gluten hypersensitivity
2023, Medecine des Maladies MetaboliquesUnderstanding the Connection between Gut Homeostasis and Psychological Stress
2023, Journal of NutritionROS-responsive thioketal-linked alginate/chitosan carriers for irritable bowel syndrome with diarrhea therapy
2022, International Journal of Biological MacromoleculesComparison of five diarrhea-predominant irritable bowel syndrome (IBS-D) rat models in the brain-gut-microbiota axis
2022, Biomedicine and Pharmacotherapy
Supported in part by Science Foundation Ireland in the form of a centre grant (Alimentary Pharmabiotic Centre), the Health Research Board of Ireland, the Higher Education Authority of Ireland, and the Wellcome Trust.