A case for an immunological basis for irritable bowel syndrome

Collins, Stephen M.

doi:10.1053/gast.2002.34097

Cited by 70 publications

(43 citation statements)

References 21 publications

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“…Animal studies suggest that stress may enhance responsiveness to inflammatory stimuli in the gut, while inflammatory processes in the gut may influence behavior and brain function. [41][42][43][44] The close proximity of chronic inflammatory cells to enteric nerves in the mucosa 36,37 and muscularis externa 27 of patients with IBS, provides an interface for direct interaction between cells and the enteric nervous system. Potential mechanisms of immune activation in IBS that have been suggested include a previous episode of gastroenteritis, alterations in intestinal microflora, undiagnosed food allergies and genetic factors.…”

Section: Morphologic Changes and Pathophysiology Of Ibsmentioning

confidence: 99%

Histopathological alterations in irritable bowel syndrome

Kirsch

Riddell

2006

Modern Pathology

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Irritable bowel syndrome is a common disorder defined by a symptom complex including abdominal pain and altered bowel habit. The etiopathogenesis appears to be multifactorial and to involve altered gastrointestinal motor function, enhanced perception of visceral stimuli and psychosocial factors. More recently a role for mucosal immune activation has been suggested. Routine histologic examination reveals no mucosal abnormality in the majority of cases but quantitative histological, immunohistochemical and ultrastructural analyses reveal subtle morphologic changes involving lymphocytes, mast cells, enterochromaffin cells and enteric nerves. The recent appreciation of these changes has led to new hypotheses linking central and enteric nervous systems to immune processes. This review highlights the spectrum of morphologic changes that occur in irritable bowel syndrome, examines their relationship to the pathophysiology of irritable bowel syndrome and considers their relevance to daily pathology practice.

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Section: Morphologic Changes and Pathophysiology Of Ibsmentioning

confidence: 99%

Histopathological alterations in irritable bowel syndrome

Kirsch

Riddell

2006

Modern Pathology

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“…Surprisingly, given the aforementioned description of a direct relationship between symptoms and chronic inflammation among patients with post-infectious IBS, these authors did not find an association between either the nature of disease onset or disease duration and immunological findings. In an accompanying editorial, Collins suggested that the increased presence of CD25+ cells may have indicated "auto-or exogenous antigen challenge in these patients, and that the CD25+ cells are preventing the progression to a more florid inflammatory response" [33] . That IBS patients may be predisposed to an, albeit contained, inflammatory response to luminal triggers is also supported by the finding, of Gonsalkorale and colleagues, of a reduced frequency of the high-producer phenotype for the antiinflammatory cytokine interleukin-10 (IL-10) among IBS patients [9] .…”

Section: Infection Inflammation Immunity and Ibsmentioning

confidence: 99%

Changing face of irritable bowel syndrome

Quigley¹

2006

WJG

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Recent years have witnessed tremendous progress in our understanding of irritable bowel syndrome (IBS). It is evident that this is a truly global disease associated with significant symptoms and impairments in personal and social functioning for afflicted individuals. Advances in our understanding of gut flora-mucosal interactions, the enteric nervous system and the brain-gut axis have led to substantial progress in the pathogenesis of symptoms in IBS and have provided some hints towards the basic etiology of this disorder, in some subpopulations, at the very least. We look forward to a time when therapy will be addressed to pathophysiology and perhaps, even to primary etiology. In the meantime, a model based on a primary role for intestinal inflammation serves to integrate the various strands, which contribute to the presentation of IBS

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“…It is attractive to suggest that these immunological changes could result from exposure to an exogenous (such as bacterial) antigen challenge (50,51). That IBS patients may be predisposed to an, albeit contained, inflammatory response to luminal triggers is, indeed, supported by the finding of polymorphisms in genes that encode for the production of anti-inflammatory cytokines among IBS patients (52,53) and by the very recent description of high titers of anti-flagellin antibodies in serum derived from IBS patients (54,55).…”

Section: Inflammation and Ibsmentioning

confidence: 99%

Irritable bowel syndrome; update on pathophysiology and management

Quigley¹,

Craig²

2012

Turk J Gastroenterol

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The functional gastrointestinal disorders (FGID) are symptom-based disorders that cannot be currently explained by definable structural or biochemical causes (1). These disorders are common: the presence of at least one functional GI disorder was identified in 70% of participants in a large US householder survey (2). An associated co-morbid psychiatric condition such as anxiety, mood or panic disorder is seen in up to 60% of those attending gastroenterology outpatient clinics with a functional compliant (3). Functional GI disorders are associated with significant impairment of quality of

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A case for an immunological basis for irritable bowel syndrome

Cited by 70 publications

References 21 publications

Histopathological alterations in irritable bowel syndrome

Histopathological alterations in irritable bowel syndrome

Changing face of irritable bowel syndrome

Irritable bowel syndrome; update on pathophysiology and management

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