Interplay between bile acid metabolism and microbiota in irritable bowel syndrome

Dior, Marie; Delagrèverie, Héloïse; Duboc, Henri; Jouët, Pauline; Coffin, Benoït; Brot, Loïc; Humbert, Lydie; Trugnan, Germain; Seksik, Philippe; Sokol, Harry; Rainteau, Dominique; Sabaté, Jean‐Marc

doi:10.1111/nmo.12829

Cited by 108 publications

(128 citation statements)

References 45 publications

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“…Recent research has demonstrated the complex interactions among these factors. For example, rapid colonic transit is associated with altered microbiota in rats 174 and with dysbiosis 175 and fecal bile acids 161,175 in humans; further integrated research is required. Advances in our understanding of epithelial biology, as well as interactions of the microbiota with host physiology (including neurohormonal factors and organic anions), should yield targeted therapies for chronic diarrhea.…”

Section: Future Directionsmentioning

confidence: 99%

Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea

2017

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Chronic watery diarrhea poses a diagnostic and therapeutic challenge and is often a disabling condition for patients. Although acute diarrhea is likely to be caused by infection, the causes of chronic diarrhea (more than 4 weeks in duration) are more elusive. We review on the pathophysiology, diagnosis, and treatment of chronic diarrhea. Drawing on recent insights into the molecular mechanisms of intestinal epithelial transport and barrier function, we discuss how diarrhea can result from a decrease in luminal solute absorption, an increase in secretion, or both, as well as derangements in barrier properties. We also describe the various extra-epithelial factors that activate diarrheal mechanisms. Finally, clinical evaluation and tests used in assessment of patients presenting with chronic diarrhea are reviewed, and an algorithm guiding therapeutic decisions and pharmacotherapy is presented.

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Section: Future Directionsmentioning

confidence: 99%

Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea

2017

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“…Alternatively, the microbiota may have modified in response to dietary change in a less‐favorable way to reduce tolerance. Lastly, future research may consider the possibility of utilizing dietary fiber supplements to modulate or reduce bile acids which may be implicated in the pathophysiology of IBS …”

Section: Future Dietary Research—key Research Questionsmentioning

confidence: 99%

Dietary therapies for functional bowel symptoms: Recent advances, challenges, and future directions

Tuck

Vanner

2017

Neurogastroenterology Motil

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“…Specifically, it has been confirmed in several studies that enteric infection with Salmonella , such as the foodborne pathogenic gram-negative Salmonella typhimurium , is a significant risk factor for the development of IBS 6, 7 . Evidence also suggests that IBS can be associated with an altered gut microbiota composition or dysbiosis 8 , including the presence of Escherichia (E.) coli 9, 10 . Some of the observed changes in species richness or community composition may reflect alterations in gastrointestinal transit 11 .…”

Section: Introductionmentioning

confidence: 99%

Vasoactive Intestinal Polypeptide and Mast Cells Regulate Increased Passage of Colonic Bacteria in Patients With Irritable Bowel Syndrome

et al. 2017

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Background & Aims Irritable bowel syndrome (IBS) is associated with intestinal dysbiosis and symptoms of IBS develop following gastroenteritis. We aimed to study passage of live bacteria through the colonic epithelium, and determine the role of mast cells and vasoactive intestinal polypeptide (VIP) in barrier regulation in IBS and healthy individuals. Methods Colon biopsies from 32 women with IBS and 15 age-matched healthy women (controls) were mounted in Ussing chambers; we measured numbers of fluorescently labeled Escherichia coli HS and Salmonella typhimurium that passed through from the mucosal side to the serosal side of the tissue. Some biopsies were exposed to agents that block the VIP receptors (VPAC1 and VPAC2) or mast cells. Levels of VIP and tryptase were measured in plasma and biopsy lysates. Number of mast cells and mast cells that express VIP or VIP receptors were quantified by immunofluorescence. Biopsies from an additional 5 patients with IBS and 4 controls were mounted in chambers and Salmonella were added; we studied passage routes through the epithelium by transmission electron microscopy and expression of tight junctions by confocal microscopy Results In colon biopsies from patients with IBS, larger numbers of E coli HS and Salmonella passed through the epithelium than in biopsies from controls (P<.0005). In transmission electron microscopy analyses, bacteria were found to cross the epithelium via only the transcellular route. Bacterial passage was reduced in biopsies from patients with IBS and controls after addition of antibodies against VPACs or ketotifen, which inhibits mast cells. Plasma samples from patients with IBS had higher levels of VIP than plasma samples from controls. Biopsies from patients with IBS had higher levels of tryptase, larger numbers of mast cells, and a higher percentage of mast cells that express VPAC1 than biopsies from controls. In biopsies from patients with IBS, addition of Salmonella significantly reduced levels of occludin; subsequent addition of ketotifen significantly reversed this effect. Conclusions We found that colonic epithelium tissues from patients with IBS have increased translocation of commensal and pathogenic live bacteria, compared with controls. Mechanisms of increased translocation include mast cells and VIP.

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Interplay between bile acid metabolism and microbiota in irritable bowel syndrome

Cited by 108 publications

References 45 publications

Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea

Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea

Dietary therapies for functional bowel symptoms: Recent advances, challenges, and future directions

Vasoactive Intestinal Polypeptide and Mast Cells Regulate Increased Passage of Colonic Bacteria in Patients With Irritable Bowel Syndrome

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