The joint power of sex and stress to modulate brain–gut–microbiota axis and intestinal barrier homeostasis: implications for irritable bowel syndrome

Pigrau, Marc; Rodiño-Janeiro, Bruno K.; Casado‐Bedmar, Maite; Lobo, Beatriz; Vicario, María; Santos, Javier; Alonso-Cotoner, Carmen

doi:10.1111/nmo.12717

Cited by 65 publications

(61 citation statements)

References 257 publications

(474 reference statements)

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“…Future research is clearly needed to carefully and systematically assess the putative role of hormonal status, particularly fluctuations in estrogen . These may, potentially in tight interaction with neuroimmunological and neuroendocrine pathways, as previously suggested, affect visceral sensitivity and contribute to the overrepresentation of women among patients with IBS.…”

Section: Discussionmentioning

confidence: 95%

“…Thus, the major goal for future investigations remains to disentangle the complex factors and their interactions, which contribute to an increased risk for visceral pain chronification in women. This calls for studies combining different lines of research where sex differences have previously been documented, including but not limited to measures of psychological distress, neuroendocrine and immune parameters, as well as of the autonomic and central nervous system . Ultimately, a complex interplay between central and peripheral processes rather than isolated factors is likely to adversely affect brain‐gut interactions, including visceral sensitivity.…”

Section: Discussionmentioning

confidence: 99%

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Are there sex differences in visceral sensitivity in young healthy men and women?

Icenhour

Labrenz

Roderigo

et al. 2019

Neurogastroenterology Motil

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Background Visceral hypersensitivity plays a key role in the pathophysiology of chronic visceral pain like irritable bowel syndrome (IBS), which is significantly more prevalent in women. Possible sex differences in visceral sensitivity remain poorly studied. We assessed sex differences in visceral sensitivity and their association with subclinical symptoms, trait anxiety, and chronic stress in a large sample of healthy men and women. Methods In 280 young healthy volunteers (50% female), visceral sensory and pain thresholds were determined using rectal balloon distensions. Gastrointestinal (GI) symptoms, chronic stress, and trait anxiety as IBS‐related risk factors were assessed with questionnaires. Men and women were compared regarding visceral sensitivity and multiple regression analyses were conducted to evaluate the predictive value of sex and risk factors for visceral sensitivity. Subgroups with high, intermediate, and low sensitivity were compared regarding psychological and biological characteristics. Key Results Men and women did not differ in sensory or pain thresholds or in IBS‐related risk factors. In multiple regression analyses, no predictor of visceral sensitivity could be identified. While sensitivity subgroups differed in sensory and pain thresholds, the proportions of men and women were comparable, and groups did not differ in IBS‐related risk factors. Conclusions and Inferences Despite the large sample size, we found no evidence supporting sex differences in visceral sensitivity. At least in healthy young volunteers, our findings suggest that sex, GI symptoms, anxiety, or chronic stress do not contribute to altered visceral sensitivity.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Are there sex differences in visceral sensitivity in young healthy men and women?

Icenhour

Labrenz

Roderigo

et al. 2019

Neurogastroenterology Motil

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“…1), has received considerable attention in recent years and may be associated with sex differences in a number of psychological and neurological conditions [69]. This gut-brain axis also provides the link between certain sexually dimorphic GIT disorders, such as the greater female susceptibility to irritable bowel syndrome and the behavioural comorbidities that occur with this disorder [71]. …”

Section: The Human Microbiota-gut-brain Axis and Sex Differences In Bmentioning

confidence: 99%

The microgenderome revealed: sex differences in bidirectional interactions between the microbiota, hormones, immunity and disease susceptibility

et al. 2018

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Sex differences in immunity are well described in the literature and thought to be mainly driven by sex hormones and sex-linked immune response genes. The gastrointestinal tract (GIT) is one of the largest immune organs in the body and contains multiple immune cells in the GIT-associated lymphoid tissue, Peyer’s patches and elsewhere, which together have profound effects on local and systemic inflammation. The GIT is colonised with microbial communities composed of bacteria, fungi and viruses, collectively known as the GIT microbiota. The GIT microbiota drives multiple interactions locally with immune cells that regulate the homeostatic environment and systemically in diverse tissues. It is becoming evident that the microbiota differs between the sexes, both in animal models and in humans, and these sex differences often lead to sex-dependent changes in local GIT inflammation, systemic immunity and susceptibility to a range of inflammatory diseases. The sexually dimorphic microbiome has been termed the ‘microgenderome’. Herein, we review the evidence for the microgenderome and contemplate the role it plays in driving sex differences in immunity and disease susceptibility. We further consider the impact that biological sex might play in the response to treatments aimed at manipulating the GIT microbiota, such as prebiotics, live biotherapeutics, (probiotics, synbiotics and bacteriotherapies) and faecal microbial transplant. These alternative therapies hold potential in the treatment of both psychological (e.g., anxiety, depression) and physiological (e.g., irritable bowel disease) disorders differentially affecting males and females.

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“…3, 105,106 Several mechanisms are involved in the stress-induced alteration of the bacterial composition of the GI tract including changes in the epithelial cell function, mucus secretion and gut motility.…”

Section: Stress and Ibsmentioning

confidence: 99%

Irritable bowel syndrome, the microbiota and the gut-brain axis

Raskov¹,

et al. 2016

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Irritable bowel syndrome is a common functional gastrointestinal disorder and it is now evident that irritable bowel syndrome is a multi-factorial complex of changes in microbiota and immunology. The bidirectional neurohumoral integrated communication between the microbiota and the autonomous nervous system is called the gut-brain-axis, which integrates brain and GI functions, such as gut motility, appetite and weight. The gut-brain-axis has a central function in the perpetuation of irritable bowel syndrome and the microbiota plays a critical role. The purpose of this article is to review recent research concerning the epidemiology of irritable bowel syndrome, influence of microbiota, probiota, gut-brainaxis, and possible treatment modalities on irritable bowel syndrome. The integrated actions and communication between the microbiota and the autonomous nervous system are central players in the perpetuation of IBS symptoms. This signaling pathway is called the GutBrain Axis (GBA). The GBA is a bidirectional neurohumoral communication system that integrates brain and GI functions, such as gut motility, appetite and weightand here the microbiota plays a critical role. 2Changes in gastrointestinal or central nervous system physiology may result in an altered habitat, which again may cause changes in the composition of the microbiota.Disruption of the physiologic symbiotic relationship (eubiosis) between the human host and the microbiota is called dysbiosis and is regarded a basic factor for initiating and maintaining IBS in the majority of patients. Current evidence has suggested that the dysbiosis observed in IBS and the resulting immunological response may drive and perpetuate gastrointestinal symptoms of IBS suggesting that IBS is in fact a disorder of the microbiota and the GBA. It is unclear whether the initiating factor is brain abnormalities that drive the gut changes or if changes in the gut alter brain function through vagal and sympathetic pathways.3,4 The purpose of this article is to review recent research concerning the influence of microbiota and gut-brain-axis on IBS. IBSIt is estimated that approximately 10% of the World population and 15% of the population in the Western World suffer from IBS characterized by a mixture of recurrent abdominal pain, bloating, changing stool consistency such as diarrhea (IBS-D), constipation (IBS-C), or interchanging diarrhea and constipation (mixed-type or IBS-M), mucus secretion, and nausea. 5,6 Community-based data indicate that IBS-M is the most prevalent type followed by IBS-D and IBS-C and that switching among subtypes occurs. Bloating is the most prevalent symptom reported by 96% of patients with IBS of whatever subgroup. 7 In addition to abdominal symptoms, poor sleep, headache, CONTACT Hans Raskov raskov@mail.dk Lundevangsvej 23, DK-2900 Hellerup, Denmark. Color versions of one or more of the figures in the article can be found online at www.tandfonline.com/kgmi.

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The joint power of sex and stress to modulate brain–gut–microbiota axis and intestinal barrier homeostasis: implications for irritable bowel syndrome

Abstract: We aim to critically review the evidence linking sex, and stress to intestinal barrier and brain-gut-microbiome axis dysfunction and the implications for irritable bowel syndrome.

Cited by 65 publications

References 257 publications

Are there sex differences in visceral sensitivity in young healthy men and women?

Are there sex differences in visceral sensitivity in young healthy men and women?

The microgenderome revealed: sex differences in bidirectional interactions between the microbiota, hormones, immunity and disease susceptibility

Irritable bowel syndrome, the microbiota and the gut-brain axis

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