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Sarkawi M, Raja Ali RA, Abdul Wahab N, Abdul Rathi ND, Mokhtar NM. A randomized, double-blinded, placebo-controlled clinical trial on Lactobacillus-containing cultured milk drink as adjuvant therapy for depression in irritable bowel syndrome. Sci Rep 2024; 14:9478. [PMID: 38658619 PMCID: PMC11043363 DOI: 10.1038/s41598-024-60029-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 04/18/2024] [Indexed: 04/26/2024] Open
Abstract
Irritable bowel syndrome (IBS) is frequently linked with coexisting mental illnesses. Our previous study discovered that 32.1% of IBS patients had subthreshold depression (SD), placing them at higher risk of developing major depression. Gut microbiota modulation through psychobiotics was found to influence depression via the gut-brain axis. However, the efficacy of lessening depression among IBS patients remains ambiguous. The study's aim was to investigate the roles of cultured milk drinks containing 109 cfu Lactobacillus acidophilus LA-5 and Lactobacillus paracasei L. CASEI-01 on depression and related variables among IBS participants with SD. A total of 110 IBS participants with normal mood (NM) and SD, were randomly assigned to one of four intervention groups: IBS-NM with placebo, IBS-NM with probiotic, IBS-SD with placebo, and IBS-SD with probiotic. Each participant was required to consume two bottles of cultured milk every day for a duration of 12 weeks. The following outcomes were assessed: depression risk, quality of life, the severity of IBS, and hormonal changes. The depression scores were significantly reduced in IBS-SD with probiotic and placebo from baseline (p < 0.001). Only IBS-SD with probiotic showed a significant rise in serotonin serum levels (p < 0.05). A significantly higher life quality measures were seen in IBS-SD with probiotic, IBS-SD with placebo, and IBS-NM with placebo (p < 0.05). All groups, both placebo and probiotic, reported significant improvement in IBS severity post-intervention with a higher prevalence of remission and mild IBS (p < 0.05). Dual strains lactobacillus-containing cultured milk drink via its regulation of relevant biomarkers, is a potential anti-depressive prophylactic agent for IBS patients at risk.
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Affiliation(s)
- Marlynna Sarkawi
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
- Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Malaysia
| | - Raja Affendi Raja Ali
- School of Medical and Life Sciences, Sunway University, Sunway City, 47500, Petaling Jaya, Malaysia
- GUT Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norhazlina Abdul Wahab
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
- GUT Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norshafila Diana Abdul Rathi
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Norfilza Mohd Mokhtar
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia.
- GUT Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
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Nyengaard R, Kallesøe KH, Rimvall MK, Ørnbøl E, Wellnitz KB, Olsen EM, Wyller VBB, Rask CU. Hair cortisol and self-perceived stress in adolescents with multi-system functional somatic disorders. BMC Psychiatry 2024; 24:101. [PMID: 38317120 PMCID: PMC10840144 DOI: 10.1186/s12888-024-05518-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 01/11/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Long-term stress causing altered hypothalamic-pituitary-adrenal (HPA) axis dynamics with cortisol dysfunction may be involved in the pathophysiology of functional somatic disorders (FSD), but studies on adolescents with multi-system FSD are lacking. Therefore, we investigated: 1) whether hair cortisol concentration (HCC) differentiates adolescents with multi-system FSD from a) a population-based sample and b) a subgroup derived from the sample reporting a high physical symptom load, and 2) whether FSD population HCC is associated with primary symptom presentations and self-perceived stress. METHODS We used data from a clinical sample with multi-system FSD (N = 91, age 15-19 years) and a population-based sample (N = 1,450, age 16-17 years) including a subgroup with top 10% total scores on physical symptoms (N = 147). Density plots and multiple linear regression were applied to compare HCC between groups. In the clinical sample, multiple linear regression was employed to assess the association between HCC and primary symptom clusters and self-perceived stress. RESULTS Median HCC was lower in the clinical sample than in the population-based sample (β = 0.80 (95%CI: 0.66, 0.97)), but not significantly different from median HCC in the derived subgroup (β = 0.84 (95%CI: 0.66, 1.07)). In the clinical sample, HCC was not significantly associated with primary symptom clusters (F(2, 82) = 0.13, p = 0.88) or self-perceived stress (F(4, 83) = 1.18, p = 0.33). CONCLUSION Our findings indicate that HCC is lowered in adolescents with multi-system FSD but not significantly associated with primary symptom presentations or self-perceived stress. Future studies including multiple measures of HPA axis dynamics alongside psychological measures may further elucidate the role of long-term stress in FSD. TRIAL REGISTRATION The AHEAD study was pre-registered at ClinicalTrials.gov (NCT02346071), 26/01/2015.
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Affiliation(s)
- Rebecca Nyengaard
- Research Unit Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, Aarhus N, 8200, Denmark
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
| | - Karen Hansen Kallesøe
- Research Unit Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, Aarhus N, 8200, Denmark.
| | - Martin Køster Rimvall
- Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Kildegaardsvej 28, Entrance 3A, 1st Floor, 2900, Hellerup, Denmark
- Department of Child and Adolescent Psychiatry, Psychiatry Region Zealand, Ny Østergade 12, 4000, Roskilde, Denmark
| | - Eva Ørnbøl
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, Aarhus N, 8200, Denmark
| | - Kaare Bro Wellnitz
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, Aarhus N, 8200, Denmark
| | - Else Marie Olsen
- Centre for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Ndr. Fasanvej 57, 1st Floor, Building 14, 2000, Frederiksberg, Denmark
- Psychiatric Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Maglevænget 2, 2750, Ballerup, Denmark
| | - Vegard Bruun Bratholm Wyller
- Department of Pediatric and Adolescent Medicine, Akershus University Hospital, Postboks 1000, 1478, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Blindern, P.O box 1171, 0318, Oslo, Norway
| | - Charlotte Ulrikka Rask
- Research Unit Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, Aarhus N, 8200, Denmark
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
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Sjödahl J, Ingemansson A, Bureychak T, Norlin AK, Jones MP, Faresjö Å, Walter S. Defecation symptoms in primary health care patients with irritable bowel syndrome. Scand J Gastroenterol 2024; 59:16-24. [PMID: 37612888 DOI: 10.1080/00365521.2023.2248538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND The objectives of the present study were to (a) measure the prevalence of defecation symptoms in IBS, (b) investigate the relationship between stool consistency and defecation symptoms in IBS, and (c) investigate the association of defecation symptoms with health-related quality of life (HRQL) and self-reported stress in patients with IBS cared for in a primary health care setting. METHODS Ten primary health care centres joined the study. 282 patients with IBS as well as 372 non-IBS controls filled in gastrointestinal symptom diaries prospectively for two weeks as well as the Perceived Stress Scale-14 (PSS14) and the EuroQol barometer to measure perceived stress and HRQL, respectively. RESULTS Incomplete evacuation was present in 51% vs. 21% of the stools among the IBS patients and the non-IBS controls, respectively. The need to strain during defecation was existing in 41% vs. 33% of the stools for the IBS patients and the non-IBS controls, respectively. Urgency was experienced in 37% of the stools in the IBS patients compared with 18% of the stools in the non-IBS controls. Patients with IBS experienced in a significant higher degree of overlapping symptoms per stool (p < 0.001 to p = 0.007). The occurrence of all defecation symptoms in the same patient was related to decreased HRQL, and increased stress (p = 0.001 to p < 0.001). CONCLUSIONS An overlap between IBS and symptoms from the anorectal region related to defecation was found in a primary health care population. Defecation symptoms are very common in primary care IBS-patients, it co-occurs with increased self-perceived stress, and decreased HRQL.
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Affiliation(s)
- Jenny Sjödahl
- Department of Gastroenterology, University Hospital Linköping, County Council of Östergötland, Linköping, Sweden
| | - Anna Ingemansson
- Department of Gastroenterology, University Hospital Linköping, County Council of Östergötland, Linköping, Sweden
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences (BKV), Linköping University, Linköping, Sweden
| | - Tetyana Bureychak
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences (BKV), Linköping University, Linköping, Sweden
| | - Anna-Karin Norlin
- Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden
| | - Michael P Jones
- School of Psychological Sciences, Macquarie University, North Ryde, NSW, Australia
| | - Åshild Faresjö
- Department of Health, Medicine and Caring Sciences (HMV), Division of Society and Health/Public Health, Linköping University, Linköping, Sweden
| | - Susanna Walter
- Department of Gastroenterology, University Hospital Linköping, County Council of Östergötland, Linköping, Sweden
- Department of Health, Medicine and Caring Sciences (HMV), Division of Diagnostics and Specialist Medicine, Linköping University, Linköping, Sweden
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Bureychak T, Faresjö Å, Sjödahl J, Norlin A, Walter S. Symptoms and health experience in irritable bowel syndrome with focus on men. Neurogastroenterol Motil 2022; 34:e14430. [PMID: 36082394 PMCID: PMC9787742 DOI: 10.1111/nmo.14430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 05/30/2022] [Accepted: 06/10/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a disorder with a predominance in women; IBS in men is less studied. The present study evaluated symptoms as well as health and social experiences of men with IBS. METHODS This cross-sectional study included 293 patients with IBS (64 men) and 363 non-IBS controls (62 men). Gastrointestinal symptom diaries were filled in prospectively, and data on comorbidities and healthcare-seeking behavior were assessed by questionnaires. Men with IBS were compared with men without IBS and women with IBS. KEY RESULTS Compared with women with IBS, men with IBS had fewer contacts with the healthcare system, fewer psychiatric comorbidities, fewer sleeping problems, and less chronic pain. Urgency to defecate and nausea were less common, and stool frequency was higher in men with IBS. There was no difference between men with and without IBS in terms of educational level, satisfaction with household economy, or living with a partner. In contrast, women with IBS more often lived alone, were more often dissatisfied with household economy, and had a lower educational level than women without IBS. Men with IBS had the same proportion of full-time employment as men without IBS but in contrast, the proportion of women with IBS in full-time employment was only 34%, compared to 50% of the women without IBS. CONCLUSION AND INFERENCES The present study improves the understanding of men's experiences of IBS and suggests that sex and gender may be integrated into the biopsychosocial model of IBS.
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Affiliation(s)
- Tetyana Bureychak
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences (BKV)Linköping UniversityLinköpingSweden
| | - Åshild Faresjö
- Division of Society and Health, Department of Health, Medicine and Caring Sciences (HMV)Linköping UniversityLinköpingSweden
| | - Jenny Sjödahl
- Department of Gastroenterology, University Hospital LinköpingCounty Council of ÖstergötlandLinköpingSweden
| | - Anna‐Karin Norlin
- Department of Health, Medicine and Caring Sciences (HMV), Division of Prevention, Rehabilitation and Community MedicineLinköping UniversityLinköpingSweden
| | - Susanna Walter
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences (BKV)Linköping UniversityLinköpingSweden,Department of Gastroenterology, University Hospital LinköpingCounty Council of ÖstergötlandLinköpingSweden
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Fischer S, Skoluda N, Ali N, Nater UM, Mewes R. Hair cortisol levels in women with medically unexplained symptoms. J Psychiatr Res 2022; 146:77-82. [PMID: 34954363 DOI: 10.1016/j.jpsychires.2021.12.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 11/10/2021] [Accepted: 12/20/2021] [Indexed: 11/18/2022]
Abstract
Stress has been demonstrated to be involved in the development of medically unexplained symptoms. A key underlying mechanism could be lower levels of cortisol, which can contribute to symptoms such as fatigue or pain. However, the literature is highly equivocal, which may be due to methodological limitations inherent in short-term cortisol assessment. The aim of this case-control study was to investigate, for the first time, whether individuals with different forms of medically unexplained symptoms show altered hair cortisol concentrations, a long-term marker of hypothalamic-pituitary-adrenal functioning. Two groups of women with medically unexplained symptoms were recruited. The first had a functional somatic syndrome, characterised by specific medically unexplained symptoms (i.e., chronic fatigue syndrome, fibromyalgia, or irritable bowel syndrome, n = 33). The second had somatic symptom disorder, characterised by excessive thoughts, feelings, and behaviours devoted to various medically unexplained symptoms (n = 23). These groups were contrasted with healthy controls (n = 30), and women with depression (n = 27). Cortisol representing the previous three months was extracted from hair. Chronic stress and childhood trauma were assessed (retrospectively). Women with somatic symptom disorder had lower hair cortisol than healthy controls and women with functional somatic syndromes. No differences in hair cortisol were found between healthy controls, functional somatic syndromes, and depression. Neither childhood trauma nor chronic stress was correlated with hair cortisol. Provided that our findings are replicated, they may suggest that hypocortisolism is found in a specific subgroup of individuals with medically unexplained symptoms, and potentially in those characterised by excessive thoughts, feelings, and behaviours about symptoms.
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Affiliation(s)
- Susanne Fischer
- University of Zurich, Institute of Psychology, Clinical Psychology and Psychotherapy, Switzerland.
| | - Nadine Skoluda
- University of Vienna, Department of Psychology, Clinical Psychology, Austria
| | - Nida Ali
- University of Vienna, Department of Psychology, Clinical Psychology, Austria
| | - Urs M Nater
- University of Vienna, Department of Psychology, Clinical Psychology, Austria
| | - Ricarda Mewes
- University of Vienna, Department of Psychology, Outpatient Unit for Research, Teaching and Practice, Austria.
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Milovac I, Vidović V, Ramić J, Lojo-Kadrić N, Hadžić M, Mavija Z, Vidović S, Pojskić L. Identification of gene candidates associated with Irritable bowel syndrome. SCRIPTA MEDICA 2022. [DOI: 10.5937/scriptamed53-39890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background/Aim: Irritable bowel syndrome (IBS) belongs to the gastrointestinal disorders characterised by abdominal discomfort and pain, altered constipation, diarrhoea and stomach distension. The aim was to assess relationship between the selected genetic polymorphisms with IBS, their combined genotype effect as well as to assess a difference in the distribution of allele and genotype frequencies of selected loci between case and control group. Methods: This was a prospective study which included 29 participants, 20 individuals diagnosed with IBS based on Rome III criteria and 9 healthy individuals. The study analysed the selected genetic polymorphisms as possible risk factors for IBS according to the model of the case-control study. Genotyping was performed for FKBP5, DRD2 and DAT polymorphisms qualified as risk factors for IBS in previous researches. Results: The results revealed a significant association between DAT polymorphism with IBS, both, at the allelic level (p = 0.006) and genotype level (p = 0.031). Individuals with 434 allelic variant in the genotype have six time higher probability for developing IBS, in comparison to the individuals without this allelic variant. The statistical association between other analysed polymorphism and IBS was not reached. The analysis of combined effects of selected polymorphisms revealed no association with IBS, except FKBP5 and DAT which result was at the level of statistical significance (p = 0.05). Conclusion: Further analysis which would include DAT polymorphism with larger sample size, as well as other genes involved in dopamine neurotransmitter system would be of great interest to define closer conclusion of IBS aetiology.
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Gudjonsdottir J, Runnäs M, Hagander L, Theodorsson E, Salö M. Associations of hair cortisol concentrations with paediatric appendicitis. Sci Rep 2021; 11:15281. [PMID: 34315979 PMCID: PMC8316495 DOI: 10.1038/s41598-021-94828-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 07/14/2021] [Indexed: 11/09/2022] Open
Abstract
The pathogenesis of paediatric appendicitis is still an enigma. In recent years, it has become more evident that our inherent immunological responses affect the trajectory of the disease course. Long-term stress has an impact on our immune system; however, it is practically and ethically challenging to prospectively track blood measurements of cortisol-levels in asymptomatic children should an acute appendicitis episode develop. The aim of this case–control study was therefore to evaluate the effect of increased stress measured as historical imprints in hair (hair cortisol concentrations [HCC]), on the risk of developing appendicitis and complicated appendicitis. 51 children (aged < 15 years) with appendicitis (34 with complicated appendicitis), were compared to 86 healthy controls. HCC reflecting the activity of the HPA-axis 0–3 and 4–6 months prior to sampling was evaluated and compared between groups as well as between the two measurements of each study subject. In the univariate analysis with both cases and controls, an increase in HCC between the measurement timepoints was associated with a substantial increase in risk of appendicitis (OR 7.52 [95% CI 2.49–22.67], p = 0.001). This increased risk remained in the multivariate analysis after adjustment for age, sex and season (aOR OR 10.76 [95%CI 2.50–46.28], p = 0.001). When comparing the cases of uncomplicated and complicated appendicitis through a multivariate analysis, adjusted for age and sex, the children with an increased HCC prior to appendicitis had a substantial and statistically significant increase in risk of complicated appendicitis (aOR 7.86 [95% CI 1.20–51.63], p = 0.03). Biological stress, measured as an increase in HCC, seems to be associated with an increased risk of paediatric appendicitis and a more complicated disease course.
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Affiliation(s)
- Johanna Gudjonsdottir
- Department of Clinical Sciences, Pediatrics, Lund University, Lasarettsgatan 48, 221 85, Lund, Sweden. .,Department of Surgery, Skåne University Hospital, Malmö, Sweden.
| | - Michaela Runnäs
- Department of Clinical Sciences, Pediatrics, Lund University, Lasarettsgatan 48, 221 85, Lund, Sweden
| | - Lars Hagander
- Department of Clinical Sciences, Pediatrics, Lund University, Lasarettsgatan 48, 221 85, Lund, Sweden.,Department of Paediatric Surgery, Skåne University Hospital, Lund, Sweden
| | - Elvar Theodorsson
- Department of Biomedical and Clinical Science, Clinical Chemistry, Linköping University, Linköping, Sweden
| | - Martin Salö
- Department of Clinical Sciences, Pediatrics, Lund University, Lasarettsgatan 48, 221 85, Lund, Sweden.,Department of Paediatric Surgery, Skåne University Hospital, Lund, Sweden
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Miao B, Mao G, Wu J, Zhao B, Shi H, Fei S. Protective effect of HCN2-induced SON sensitization on chronic visceral hypersensitivity in neonatal-CRD rat model. Brain Res 2021; 1767:147538. [PMID: 34052259 DOI: 10.1016/j.brainres.2021.147538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/23/2021] [Accepted: 04/25/2021] [Indexed: 02/07/2023]
Abstract
Abnormal brain-gut interactions contribute to the development of chronic visceral hypersensitivity (CVH), which is the pivotal feature of irritable bowel syndrome (IBS). Despite the consensus with respect to the vital role of hyperpolarization-activated cyclic nucleotide-gated 2 (HCN2) channels in promoting painful symptoms in the peripheral nervous system, we identified that the upregulation of HCN2 in supraoptic nucleus (SON) was involved in the modulation of CVH in rat model of neonatal colorectal distention (n-CRD). Specifically, colorectal distention (CRD) upregulated the expression of c-Fos in SON in adult CVH rats, indicating the involvement of SON sensitazation in visceral sensation. Moreover, the administration of ZD7288 (the pan-HCN channel inhibitor) rather than 8-Br-cAMP (the non-specific HCN channel agonist) aggravated the CVH symptoms and reduced the phosphorylation level of CaMKII-CREB cascade. Together, the findings indicated that the upregulation of supraoptic HCN2 contributed to the sensitization of SON, which had protective effects on the modulation of CVH with the involvement of CaMKII-CREB cascade in n-CRD rat model.
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Affiliation(s)
- Bei Miao
- Department of Gastroenterology, Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Xuzhou 221002, Jiangsu Province, China; Institute of Digestive Diseases, Xuzhou Medical University, 84 West Huaihai Road, Xuzhou 221002, Jiangsu Province, China
| | - Guangtong Mao
- Department of Pathology, Xinyi People's Hospital, 16 Renmin Road, Xinyi 221400, Jiangsu Province, China
| | - Jiaojiao Wu
- Department of Gastroenterology, Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Xuzhou 221002, Jiangsu Province, China
| | - Benhuo Zhao
- Department of Gastroenterology, Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Xuzhou 221002, Jiangsu Province, China
| | - Hengliang Shi
- Central Laboratory, Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Xuzhou 221002, Jiangsu Province, China.
| | - Sujuan Fei
- Department of Gastroenterology, Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Xuzhou 221002, Jiangsu Province, China; Institute of Digestive Diseases, Xuzhou Medical University, 84 West Huaihai Road, Xuzhou 221002, Jiangsu Province, China.
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9
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Norlin AK, Walter S, Icenhour A, Keita ÅV, Elsenbruch S, Bednarska O, Jones MP, Simon R, Engström M. Fatigue in irritable bowel syndrome is associated with plasma levels of TNF-α and mesocorticolimbic connectivity. Brain Behav Immun 2021; 92:211-222. [PMID: 33249172 DOI: 10.1016/j.bbi.2020.11.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 10/17/2020] [Accepted: 11/23/2020] [Indexed: 02/06/2023] Open
Abstract
Irritable bowel syndrome (IBS) is a symptom-based disorder of gut-brain interactions generating abdominal pain. It is also associated with a vulnerability to develop extraintestinal symptoms, with fatigue often reported as one of the most disturbing. Fatigue is related to brain function and inflammation in several disorders, however, the mechanisms of such relations in IBS remain elusive. This study aimed to elucidate fatigue and its association with a resting state network of mesocorticolimbic regions of known importance in fatigue, and to explore the possible role of circulating TNF-α levels in IBS and healthy controls (HC). Resting state functional magnetic resonance imaging (fMRI) was conducted in 88 IBS patients and 47 HC of similar age and gender to investigate functional connectivity between mesocorticolimbic regions. Further, fatigue impact on daily life and plasma levels of the proinflammatory cytokine tumor necrosis factor-α (TNF-α), of known relevance to immune activation in IBS, were also measured. The selected mesocorticolimbic regions indeed formed a functionally connected network in all participants. The nucleus accumbens (NAc), in particular, exhibited functional connectivity to all other regions of interest. In IBS, fatigue impact on daily life was negatively correlated with the connectivity between NAc and dorsolateral prefrontal cortex bilaterally (left p = 0.019; right p = 0.038, corrected for multiple comparisons), while in HC, fatigue impact on daily life was positively correlated to the connectivity between the right NAc and anterior middle insula in both hemispheres (left p = 0.009; right p = 0.011). We found significantly higher levels of TNF-α in IBS patients compared to HC (p = 0.001) as well as a positive correlation between TNF-α and fatigue impact on daily life in IBS patients (rho = 0.25, p = 0.02) but not in HC (rho = -0.13, p = 0.37). There was no association between functional connectivity in the mesocorticolimbic network and plasma levels of TNF-α in either group In summary, this novel multimodal study provides the first evidence that the vulnerability to fatigue in IBS is associated with connectivity within a mesocorticolimbic network as well as immune activation. These findings warrant further investigation, both peripherally and potentially with measurements of central immune activation as well.
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Affiliation(s)
- Anna-Karin Norlin
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - Susanna Walter
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Adriane Icenhour
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping Sweden; Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Åsa V Keita
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Sigrid Elsenbruch
- Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Bochum, Germany
| | - Olga Bednarska
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Michael P Jones
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Rozalyn Simon
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping Sweden
| | - Maria Engström
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping Sweden
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10
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Wang YT, Xu WX. Role of stress in pathophysiology of irritable bowel syndrome. Shijie Huaren Xiaohua Zazhi 2018; 26:1064-1070. [DOI: 10.11569/wcjd.v26.i17.1064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Irritable bowel syndrome (IBS), one of the most common functional gastrointestinal disorders in the world, is characterized by chronic intermittent abdominal discomfort and colon dysmotility with altered bowel habits, significantly impacting patients' quality of life. The pathophysiology of IBS remains incompletely understood although some contributing factors have been identified. Increased visceral sensitivity and intestinal permeability may play an important role in the pathophysiology of IBS. Psychological factors, especially stress, play an important role in the occurrence, development, and regulation of IBS. To facilitate further research of IBS, this review focuses on the relationship between stress and IBS in animal models, as well as the role of stress in increased visceral sensitivity and intestinal permeability in IBS.
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Affiliation(s)
- Yu-Ting Wang
- Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China
| | - Wen-Xie Xu
- Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200240, China
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