Gut-lung crosstalk in pulmonary involvement with inflammatory bowel diseases

Abstract

Pulmonary abnormalities, dysfunction or hyper-reactivity occurs in association with inflammatory bowel disease (IBD) more frequently than previously recognized. Emerging evidence suggests that subtle inflammation exists in the airways among IBD patients even in the absence of any bronchopulmonary symptoms, and with normal pulmonary functions. The pulmonary impairment is more pronounced in IBD patients with active disease than in those in remission. A growing number of case reports show that the IBD patients develop rapidly progressive respiratory symptoms after colectomy, with failure to isolate bacterial pathogens on repeated sputum culture, and often request oral corticosteroid therapy. All the above evidence indicates that the inflammatory changes in both the intestine and lung during IBD. Clinical or subclinical pulmonary inflammation accompanies the main inflammation of the bowel. Although there are clinical and epidemiological reports of chronic inflammation of the pulmonary and intestinal mucosa in IBD, the detailed mechanisms of pulmonary-intestinal crosstalk remain unknown. The lung has no anatomical connection with the main inflammatory site of the bowel. Why does the inflammatory process shift from the gastrointestinal tract to the airways? The clinical and subclinical pulmonary abnormalities, dysfunction, or hyper-reactivity among IBD patients need further evaluation. Here, we give an overview of the concordance between chronic inflammatory reactions in the airways and the gastrointestinal tract. A better understanding of the possible mechanism of the crosstalk among the distant organs will be beneficial in identifying therapeutic strategies for mucosal inflammatory diseases such as IBD and allergy.

Presence of commensal house dust mite allergen in human gastrointestinal tract: a potential contributor to intestinal barrier dysfunction

“…These novel data, along with increased awareness of potential linkbetween asthma (where HDM is clearly implicated) and IBD,37 it is tempting to speculate a central role of HDM in the link between these two diseases. In addition, we can envisage that HDM effect may be potentiated in inflammatory conditions where lower GIT becomes susceptible to IgE-mediated responses 38 39.…”

Lung inflammation and disease: A perspective on microbial homeostasis and metabolism

“…The microbiome residing on various mucosal surfaces plays a central role in health and disease (1,58,127). While much is known about gut microbiome, fecal microbial transplant (FMT) has been used only in the context of difficult gut infections like Clostridium difficile, and that too in an effective, yet simple approach, where "normal" microbiota is obtained from an identified and monitored cohort of individuals and cryopreserved for future FMT applications (128)(129)(130)(131)(132).…”

Inflammatory bowel disease and risk of mortality in COPD

“…The reviews of the underlying mechanisms that can explain the association between the two chronic inflammatory conditions point towards systemic inflammation and immunological dysfunctions [9,10] triggered by environmental factors that IBD and COPD seem to share, such as smoking [25,26] or air pollution [27,28]. Furthermore, pulmonary involvement [29][30][31] is a common extra-intestinal manifestation of IBD and an increased intestinal permeability, one of the factors that may increase susceptibility to develop IBD, was described in COPD patients [32].…”

“…While the association with neoplasms and cardiovascular diseases has been extensively explored, along with the role of cigarette smoke and systemic inflammation in the pathogenesis of these conditions, other comorbid conditions have received far less attention. COPD has been shown to be associated with other chronic inflammatory diseases, such as inflammatory bowel disease (IBD) [9,10]. Epidemiological studies have shown significant increases in incidence [11] and prevalence [12,13] of IBD in patients with airway diseases.…”