The gut–brain axis in irritable bowel syndrome and inflammatory bowel disease

Ancona, Angela; Petito, Claudia; Iavarone, Irene; Petito, Valentina; Galasso, Linda; Leonetti, Alessia; Turchini, Laura; Belella, Daniela; Ferrarrese, Daniele; Addolorato, Giovanni; Armuzzi, Alessandro; Gasbarrini, Antonio; Scaldaferri, Franco

doi:10.1016/j.dld.2020.11.026

Cited by 52 publications

(47 citation statements)

References 91 publications

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“…The rationale for the use of probiotics in IBD is based on accumulating evidence suggesting that the endogenous intestinal microbiota plays a crucial role in its pathogenesis. However, thus far, data from clinical trials suggest that the efficacy of probiotics in IBD treatment is rather low and limited to UC patients, since CD patients do not seem to have any benefit from probiotic administration [36,347]. Evidence from a number of controlled trials featuring different probiotic organisms, including nonpathogenic E. Coli, S. boulardii, Lactobacillus, and Bifidobacterium, is suggestive for the efficacy of probiotics in maintaining remission in UC and in treating mild to moderate flare-ups, while other studies have been less favorable [348,349].…”

Section: Probiotics and Prebioticsmentioning

confidence: 99%

Impact of Microbial Metabolites on Microbiota–Gut–Brain Axis in Inflammatory Bowel Disease

Banfi

Moro

Bosi

et al. 2021

IJMS

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The complex bidirectional communication system existing between the gastrointestinal tract and the brain initially termed the “gut–brain axis” and renamed the “microbiota–gut–brain axis”, considering the pivotal role of gut microbiota in sustaining local and systemic homeostasis, has a fundamental role in the pathogenesis of Inflammatory Bowel Disease (IBD). The integration of signals deriving from the host neuronal, immune, and endocrine systems with signals deriving from the microbiota may influence the development of the local inflammatory injury and impacts also more distal brain regions, underlying the psychophysiological vulnerability of IBD patients. Mood disorders and increased response to stress are frequently associated with IBD and may affect the disease recurrence and severity, thus requiring an appropriate therapeutic approach in addition to conventional anti-inflammatory treatments. This review highlights the more recent evidence suggesting that alterations of the microbiota–gut–brain bidirectional communication axis may concur to IBD pathogenesis and sustain the development of both local and CNS symptoms. The participation of the main microbial-derived metabolites, also defined as “postbiotics”, such as bile acids, short-chain fatty acids, and tryptophan metabolites in the development of IBD-associated gut and brain dysfunction will be discussed. The last section covers a critical evaluation of the main clinical evidence pointing to the microbiome-based therapeutic approaches for the treatment of IBD-related gastrointestinal and neuropsychiatric symptoms.

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Section: Probiotics and Prebioticsmentioning

confidence: 99%

Impact of Microbial Metabolites on Microbiota–Gut–Brain Axis in Inflammatory Bowel Disease

Banfi

Moro

Bosi

et al. 2021

IJMS

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“…During the last years, a substantial number of studies on the impact of gut microbiota and host health have been conducted, showing that the disruption of gut microbiota homeostasis (called dysbiosis) is related to a large array of diseases. These include metabolic diseases like obesity and metabolic-associated fatty liver disease [ 7 , 8 ], irritable bowel syndrome [ 9 ] as well as several immune-related diseases like allergies [ 10 ], autoimmune diseases [ 11 ], and inflammatory bowel disease [ 12 ]. These latter associations illustrate the direct interaction between gut microbiota and the immune system.…”

Section: Gut Microbiota and Immune Systemmentioning

confidence: 99%

The Immune System through the Lens of Alcohol Intake and Gut Microbiota

Calleja‐Conde

Echeverry‐Alzate

Bühler

et al. 2021

IJMS

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The human gut is the largest organ with immune function in our body, responsible for regulating the homeostasis of the intestinal barrier. A diverse, complex and dynamic population of microorganisms, called microbiota, which exert a significant impact on the host during homeostasis and disease, supports this role. In fact, intestinal bacteria maintain immune and metabolic homeostasis, protecting our organism against pathogens. The development of numerous inflammatory disorders and infections has been linked to altered gut bacterial composition or dysbiosis. Multiple factors contribute to the establishment of the human gut microbiota. For instance, diet is considered as one of the many drivers in shaping the gut microbiota across the lifetime. By contrast, alcohol is one of the many factors that disrupt the proper functioning of the gut, leading to a disruption of the intestinal barrier integrity that increases the permeability of the mucosa, with the final result of a disrupted mucosal immunity. This damage to the permeability of the intestinal membrane allows bacteria and their components to enter the blood tissue, reaching other organs such as the liver or the brain. Although chronic heavy drinking has harmful effects on the immune system cells at the systemic level, this review focuses on the effect produced on gut, brain and liver, because of their significance in the link between alcohol consumption, gut microbiota and the immune system.

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“…Here, we found that there was no significant difference in neuroinflammation of mPFC, amygdala and ventral hippocampus between DSS-treated WT mice and DSS-treated ERβ -/mice in the aspect of microglia cells density. It is well known that stress, including visceral stress and systemic pro-inflammatory cytokines, activates the secretion of the Crh from hypothalamus, stimulates ACTH secretion from the pituitary gland, which leads to the release of corticosterone, and causes anxiety disorder [37]. We observed that the corticosterone and ACTH levels in the plasma were elevated in ERβ -/mice after treatment with DSS.…”

Section: Discussionmentioning

confidence: 60%

“…IBD is a chronic and devastating gastrointestinal disease, and is usually complicated by psychological comorbidities. It has been reported that up to 60-80% IBD patients with active disease and 30% with clinical remission suffer from mood disorders, especially anxiety and depression [37]. Nowadays, clinicians raise an idea that exploring integrated model of care for both psychological and physiological disorders in IBD patients [38].…”

Section: Discussionmentioning

confidence: 99%

Estrogen Receptor β Deficiency Impairs Gut Microbiota: A Possible Mechanism for IBD-Related Anxiety-Like Behavior

Ma¹,

Tianyao²,

Li³

et al. 2021

Preprint

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Background: Although lack of ERβ is an acknowledged risk factor for the development of inflammatory bowel disease (IBD) and psychiatric disorders, the underlying cellular and molecular mechanisms are not fully understood. Here, we revealed the role of gut microbiota in the development of IBD and related anxiety-like behavior in ERβ deficiency mice. Results: In this study, we showed that ERβ knockout mice upon dextran sodium sulfate (DSS) insult displayed significant shifts in fecal microbiota composition with increasing enrichment of genus Prevotellaceae_UCG_001, aggravated colitis severity and anxiety-like behaviors. In addition, DSS induced colitis also enhanced hypothalamic-pituitary-adrenal (HPA) axis hyperactivity in ERβ-deficiency mice, which linked colitis and anxiety-like behaviors. In line with these observations, RNA sequencing data further identified ErbB4 might be the target of ERβ involved in regulating HPA axis hyperactivity caused by DSS insult. Gut microbiota remodeling by co-housing showed both colitis severity and anxiety-like behaviors were aggravated in co-housed WT mice compared with single-housed WT mice, suggesting that gut microbiota plays a critical role in mediating colitis disease activity and related anxiety-like behaviors via aberrant neural processing within the gut-brain axis. Conclusions: Our findings demonstrate ERβ has the potential to inhibit colitis development and anxiety-like behaviors via remodeling of gut microbiota, which reveals ERβ as a promising therapeutic target for treating IBD and related anxiety-like behaviors.

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The gut–brain axis in irritable bowel syndrome and inflammatory bowel disease

Cited by 52 publications

References 91 publications

Impact of Microbial Metabolites on Microbiota–Gut–Brain Axis in Inflammatory Bowel Disease

Impact of Microbial Metabolites on Microbiota–Gut–Brain Axis in Inflammatory Bowel Disease

The Immune System through the Lens of Alcohol Intake and Gut Microbiota

Estrogen Receptor β Deficiency Impairs Gut Microbiota: A Possible Mechanism for IBD-Related Anxiety-Like Behavior

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