Review article: the psychoneuroimmunology of irritable bowel syndrome – an exploration of interactions between psychological, neurological and immunological observations

Arebi, Naila; Gurmany, S.; Bullas, Dominic; Hobson, Anthony; Stagg, Andrew J.; Kamm, Michael A.

doi:10.1111/j.1365-2036.2008.03801.x

Cited by 50 publications

(42 citation statements)

References 81 publications

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“…Several authors found altered microbiota in IBS patients (53)(54)(55)(56)(57). Intestinal bacteria may play a significant role in inducing IBS because a change in the microbiota can lead to an activation of the immune system, which could explain symptom generation and the effects on the central nervous system (58)(59)(60)(61)(62)(63)(64). Probiotic intake may preserve the fecal microbiota (5), normalize the cytokine blood levels (4), improve the intestinal transit time (30), decrease the small intestine permeability (31), and alter the fermentation pattern reducing the small intestinal bacterial overgrowth (65) in these patients, but further research is required to confirm these results.…”

Section: Discussionmentioning

confidence: 99%

Effect of probiotic species on irritable bowel syndrome symptoms: A bring up to date meta-analysis

Ortiz-Lucas

Tobías

Saz

et al. 2013

Rev. esp. enferm. dig.

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Background and objectives: immune system alteration in irritable bowel syndrome (IBS) patients may be modulated by probiotics. We assessed the efficacy of some probiotic species in alleviating characteristic IBS symptoms.Material and methods: a meta-analysis of all identified randomized controlled trials comparing probiotics with placebo in treating IBS symptoms was performed with continuous data summarized using standardized mean differences (SMDs) with 95% confidence intervals (95% CIs), where appropriate. The random-effects model was employed in cases of heterogeneity; otherwise, fixed-effects models were used.Results: meta-analysis was performed with 10 of 24 studies identified as suitable for inclusion. Probiotics improved pain scores if they contained Bifidobacterium breve (SMD, -0.34; 95% CI, -0.66; -0.02), Bifidobacterium longum (SMD, -0.48; 95% CI, -0.91; -0.06), or Lactobacillus acidophilus (SMD, -0.31; 95% CI, -0.61; -0.01) species. Distension scores were improved by probiotics containing B. breve (SMD, 95% CI, Conclusions: some probiotics are an effective therapeutic option for IBS patients, and the effects on each IBS symptom are likely species-specific. Future studies must focus on the role of probiotics in modulating intestinal microbiota and the immune system while considering individual patient symptom profiles. INTRODUCTIONDefining and treating irritable bowel syndrome (IBS) can be challenging. Among the wide variety of treatment options, probiotics appear to be one of the best options (1). Recently, growing evidence has suggested an alteration in the immune system cell profile of IBS patients and a close relationship between the immune and nervous systems (2,3). Furthermore, several authors have studied the relationship between probiotic intake and blood cytokine levels (4) or changes in fecal microbiota (5,6). Several reviews and meta-analyses that have evaluated the role of probiotics in IBS therapy have concluded that probiotics appear to improve overall IBS symptoms (7-12). However, a meta-analysis that includes any probiotic in the evaluation of symptom relief may not be the best method for assessing the efficacy of specific probiotics (11-13). Therefore, we assessed the efficacy of each specific probiotic species in alleviating characteristic IBS symptoms. Effect of probiotic species on irritable bowel ORIGINAL PAPERSOrtiz-Lucas M, Tobias A, Saz P, Sebastián JJ. Effect of probiotic species on irritable bowel syndrome symptoms: A bring up to date meta-analysis. Rev Esp Enferm

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Section: Discussionmentioning

confidence: 99%

Effect of probiotic species on irritable bowel syndrome symptoms: A bring up to date meta-analysis

Ortiz-Lucas

Tobías

Saz

et al. 2013

Rev. esp. enferm. dig.

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“…In a PCA of the 14 phylotype targeting assays and three timepoints (0, 3 and 6 mo), the IBSD group differed from the control group (P = 0.01), IBSM (P = 0.00), www.wjgnet.com For the R. torques 93% assay the sequence AY305319 [62] was used for primer design; 2 The Bifidobacterium longum DSM 20219T 16S rRNA gene was used as standard in the universal qPCR assay. qPCR: Quantitative real-time polymerase chain reaction.…”

Section: Divergences In the Intestinal Microbiota In Ibsmentioning

confidence: 99%

“…Although IBS does not predispose to malignancies, it essentially lowers the patients' quality of life. Multiple interacting mechanisms lie behind IBS aetiology [2,3] . These include psychological stress and disturbances, physiological features, such as altered GI motility and visceral hypersensitivity, lowgrade inflammation, and bacterial gastroenteritis.…”

Section: Introductionmentioning

confidence: 99%

Diarrhoea-predominant irritable bowel syndromedistinguishable by 16S rRNA gene phylotype quantifcation

Lyra¹,

Rinttilä²,

Nikkilä³

et al. 2009

WJG

145

131

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AIM:To study whether selected bacterial 16S ribosomal RNA (rRNA) gene phylotypes are capable of distinguishing irritable bowel syndrome (IBS). METHODS:The faecal microbiota of twenty volunteers with IBS, subdivided into eight diarrhoea-predominant (IBS-D), eight constipation-predominant (IBS-C) and four mixed symptom-subtype (IBS-M) IBS patients, and fifteen control subjects, were analysed at three timepoints with a set of fourteen quantitative real-time polymerase chain reaction assays. All assays targeted 16S rRNA gene phylotypes putatively associated with IBS, based on 16S rRNA gene library sequence analysis.The target phylotypes were affiliated with Actinobacteria , Bacteroidetes and Firmicutes . Eight of the target phylotypes had less than 95% similarity to cultured bacterial species according to their 16S rRNA gene sequence. The data analyses were made with repeatedmeasures ANCOVA-type modelling of the data and principle component analysis (PCA) with linear mixed-effects models applied to the principal component scores. RESULTS:Bacterial phylotypes Clostridium cocleatum 88%, Clostridium thermosuccinogenes 85%, Coprobacillus catenaformis 91%, Ruminococcus bromii -like, Ruminococcus torques 91%, and R. torques 93% were detected from all samples analysed. A multivariate analysis of the relative quantities of all 14 bacterial 16S rRNA gene phylotypes suggested that the intestinal microbiota of the IBS-D patients differed from other sample groups. The PCA on the first principal component (PC1), explaining 30.36% of the observed variation in the IBS-D patient group, was significantly altered from all other sample groups (IBS-D vs control, P = 0.01; IBS-D vs IBS-M, P = 0.00; IBS-D vs IBS-C, P = 0.05). Significant differences were also observed in the levels of distinct phylotypes using relative values in proportion to the total amount of bacteria. A phylotype with 85% similarity to C. thermosuccinogenes was quantified in significantly different quantities among the IBS-D and control subjects (-4.08 ± 0.90 vs -3.33 ± 1.16, P = 0.04) and IBS-D and IBS-M subjects (-4.08 ± 0.90 vs -3.08 ± 1.38, P = 0.05). Furthermore, a phylotype with 94% similarity to R. torques was more prevalent in IBS-D patients' intestinal microbiota than in that of control subjects (-2.43 ± 1.49 vs -4.02 ± 1.63, P = 0.01). A phylotype with 93% similarity to R. torques was associated with control samples when compared with IBS-M (-2.41 ± 0.53 vs -2.92 ± 0.56, P = 0.00). Additionally, a R. bromii -like phylotype was associated with IBS-C patients in comparison to control subjects (-1.61 ± 1.83 vs -3.69 ± 2.42, P = 0.01). All of the above mentioned phylotype specific alterations were independent of the effect of time. CONCLUSION: Significant phylotype level alterations

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“…The etiology of IBS is complex and appears to be multi-factorial, including altered gastrointestinal (GI) motility, visceral hypersensitivity, heredity, inflammation, and psycho-social factors. 1,2 Nevertheless, the etiology of IBS remains unknown.…”

Section: Introductionmentioning

confidence: 99%

Changes in Enteric Neurons of Small Intestine in a Rat Model of Irritable Bowel Syndrome with Diarrhea

Fei

Fang

et al. 2016

J Neurogastroenterol Motil

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Background/AimsPhysical and/or emotional stresses are important factors in the exacerbation of symptoms in irritable bowel syndrome (IBS). Several lines of evidence support that a major impact of stress on the gastrointestinal tract occurs via the enteric nervous system. We aimed to evaluate histological changes in the submucosal plexus (SMP) and myenteric plexus (MP) of the distal ileum in concert with the intestinal motor function in a rat model of IBS with diarrhea. MethodsThe rat model was induced by heterotypic chronic and acute stress (CAS). The intestinal transit was measured by administering powdered carbon by gastric gavage. Double immunohistochemical fluorescence staining with whole-mount preparations of SMP and MP of enteric nervous system was used to assess changes in expression of choline acetyltransferase, vasoactive intestinal peptide, or nitric oxide synthase in relation to the pan neuronal marker, anti-Hu. ResultsThe intestinal transit ratio increased significantly from control values of 50.8% to 60.6% in the CAS group. The numbers of enteric ganglia and neurons in the SMP were increased in the CAS group. The proportions of choline acetyltransferase-and vasoactive intestinal peptide-immunoreactive neurons in the SMP were increased (82.1 ± 4.3% vs. 76.0 ± 5.0%, P = 0.021; 40.5 ± 5.9% vs 28.9 ± 3.7%, P = 0.001), while nitric oxide synthase-immunoreactive neurons in the MP were decreased compared with controls (23.3 ± 4.5% vs 32.4 ± 4.5%, P = 0.002). ConclusionsThese morphological changes in enteric neurons to CAS might contribute to the dysfunction in motility and secretion in IBS with diarrhea. (J Neurogastroenterol Motil 2016;22:310-320)

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Review article: the psychoneuroimmunology of irritable bowel syndrome – an exploration of interactions between psychological, neurological and immunological observations

Cited by 50 publications

References 81 publications

Effect of probiotic species on irritable bowel syndrome symptoms: A bring up to date meta-analysis

Effect of probiotic species on irritable bowel syndrome symptoms: A bring up to date meta-analysis

Diarrhoea-predominant irritable bowel syndromedistinguishable by 16S rRNA gene phylotype quantifcation

Changes in Enteric Neurons of Small Intestine in a Rat Model of Irritable Bowel Syndrome with Diarrhea

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