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He YQ, Zhu JR, Sun WJ, Luo YY, Wu XF, Yang M, Chen DF. ZO-1 and IL-1RAP Phosphorylation: Potential Role in Mediated Brain-Gut Axis Dysregulation in Irritable Bowel Syndrome-like Stressed Mice. Int J Med Sci 2024; 21:1738-1755. [PMID: 39006851 PMCID: PMC11241095 DOI: 10.7150/ijms.95848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 05/22/2024] [Indexed: 07/16/2024] Open
Abstract
Background and Objectives: Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder often exacerbated by stress, influencing the brain-gut axis (BGA). BGA dysregulation, disrupted intestinal barrier function, altered visceral sensitivity and immune imbalance defects underlying IBS pathogenesis have been emphasized in recent investigations. Phosphoproteomics reveals unique phosphorylation details resulting from environmental stress. Here, we employ phosphoproteomics to explore the molecular mechanisms underlying IBS-like symptoms, mainly focusing on the role of ZO-1 and IL-1RAP phosphorylation. Materials and Methods: Morris water maze (MWM) was used to evaluate memory function for single prolonged stress (SPS). To assess visceral hypersensitivity of IBS-like symptoms, use the Abdominal withdrawal reflex (AWR). Colonic bead expulsion and defecation were used to determine fecal characteristics of the IBS-like symptoms. Then, we applied a phosphoproteomic approach to BGA research to discover the molecular mechanisms underlying the process of visceral hypersensitivity in IBS-like mice following SPS. ZO-1, p-S179-ZO1, IL-1RAP, p-S566-IL-1RAP and GFAP levels in BGA were measured by western blotting, immunofluorescence staining, and enzyme-linked immunosorbent assay to validate phosphorylation quantification. Fluorescein isothiocyanate-dextran 4000 and electron-microscopy were performed to observe the structure and function of the intestinal epithelial barrier. Results: The SPS group showed changes in learning and memory ability. SPS exposure affects visceral hypersensitivity, increased fecal water content, and significant diarrheal symptoms. Phosphoproteomic analysis displayed that p-S179-ZO1 and p-S566-IL-1RAP were significantly differentially expressed following SPS. In addition, p-S179-ZO1 was reduced in mice's DRG, colon, small intestine, spinal and hippocampus and intestinal epithelial permeability was increased. GFAP, IL-1β and p-S566-IL-1RAP were also increased at the same levels in the BGA. And IL-1β showed no significant difference was observed in serum. Our findings reveal substantial alterations in ZO-1 and IL-1RAP phosphorylation, correlating with increased epithelial permeability and immune imbalance. Conclusions: Overall, decreased p-S179-ZO1 and increased p-S566-IL-1RAP on the BGA result in changes to tight junction structure, compromising the structure and function of the intestinal epithelial barrier and exacerbating immune imbalance in IBS-like stressed mice.
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Affiliation(s)
- Yu-Qin He
- Gastroenterology, Chongqing Key Laboratory of Digestive Malignancies, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China
| | - Jian-Ru Zhu
- Gastroenterology, Chongqing Key Laboratory of Digestive Malignancies, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China
| | - Wen-Jing Sun
- Department of Gastroenterology and Hepatology, The Thirteenth People's Hospital of Chongqing, 400030, China
| | - Yuan-Yuan Luo
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400030, China
| | - Xiao-Feng Wu
- Department of Stem Cell and Regenerative Medicine, Gastroenterology, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Min Yang
- Gastroenterology, Chongqing Key Laboratory of Digestive Malignancies, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China
| | - Dong-Feng Chen
- Gastroenterology, Chongqing Key Laboratory of Digestive Malignancies, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China
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Ishibashi N, Nanjo T, Tao S. Photobiomodulation improves acute restraint stress-induced visceral hyperalgesia in rats. Lasers Med Sci 2024; 39:143. [PMID: 38806837 PMCID: PMC11133191 DOI: 10.1007/s10103-024-04091-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 05/18/2024] [Indexed: 05/30/2024]
Abstract
The purpose of this study is to explore the potential application of photobiomodulation to irritable bowel syndrome. We established the following experimental groups: the Non-Stress + Sham group, which consisted of rats that were not restrained and were only subjected to sham irradiation; the Stress + Sham group, which underwent 1 hour of restraint stress followed by sham irradiation; and the Stress + Laser group, which was subjected to restraint stress and percutaneous laser irradiation bilaterally on the L6 dorsal root ganglia for 5 minutes each. The experiment was conducted twice, with three and two laser conditions examined. Following laser irradiation, a barostat catheter was inserted into the rat's colon. After a 30-minute acclimatization period, the catheter was inflated to a pressure of 60 mmHg, and the number of abdominal muscle contractions was measured over a 5-minute period. The results showed that photobiomodulation significantly suppressed the number of abdominal muscle contractions at average powers of 460, 70, and 18 mW. However, no significant suppression was observed at average powers of 1 W and 3.5 mW. This study suggests that photobiomodulation can alleviate visceral hyperalgesia induced by restraint stress, indicating its potential applicability to irritable bowel syndrome.
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Affiliation(s)
- Naoya Ishibashi
- Bio-medical Engineering Group, Drug Discovery Laboratory, Teijin Institute for Bio-medical Research, Teijin Pharma Ltd., 4-3-2, Asahigaoka, Hino-shi, Tokyo, 191-8512, Japan.
| | - Takuya Nanjo
- Bio-medical Engineering Group, Drug Discovery Laboratory, Teijin Institute for Bio-medical Research, Teijin Pharma Ltd., 4-3-2, Asahigaoka, Hino-shi, Tokyo, 191-8512, Japan
| | - Shinichi Tao
- Bio-medical Engineering Group, Drug Discovery Laboratory, Teijin Institute for Bio-medical Research, Teijin Pharma Ltd., 4-3-2, Asahigaoka, Hino-shi, Tokyo, 191-8512, Japan
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3
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Kader L, Willits AB, Meriano S, Christianson JA, La JH, Feng B, Knight B, Kosova G, Deberry JJ, Coates MD, Hyams JS, Baumbauer KM, Young EE. Identification of Arginine-Vasopressin Receptor 1a (Avpr1a/Avpr1a) as a Novel Candidate Gene for Chronic Visceral Pain Sheds Light on the Potential Role of Enteric Neurons in the Development of Visceral Hypersensitivity. THE JOURNAL OF PAIN 2024:104572. [PMID: 38768798 DOI: 10.1016/j.jpain.2024.104572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 05/14/2024] [Accepted: 05/14/2024] [Indexed: 05/22/2024]
Abstract
Chronic abdominal pain in the absence of ongoing disease is the hallmark of disorders of gut-brain interaction (DGBIs), including irritable bowel syndrome (IBS). While the etiology of DGBIs remains poorly understood, there is evidence that both genetic and environmental factors play a role. In this study, we report the identification and validation of arginine-vasopressin receptor 1A (Avpr1a) as a novel candidate gene for visceral hypersensitivity (VH), a primary peripheral mechanism underlying abdominal pain in DGBI/IBS. Comparing 2 C57BL/6 (BL/6) substrains (C57BL/6NTac and C57BL/6J) revealed differential susceptibility to the development of chronic VH following intrarectal zymosan instillation, a validated preclinical model for postinflammatory IBS. Using whole-genome sequencing, we identified a single-nucleotide polymorphism differentiating the 2 strains in the 5' intergenic region upstream of Avpr1a, encoding the protein Avpr1a. We used behavioral, histological, and molecular approaches to identify distal colon-specific gene expression and neuronal hyperresponsiveness covarying with Avpr1a genotype and VH susceptibility. While the 2 BL/6 substrains did not differ across other gastrointestinal phenotypes (eg, fecal water retention), VH-susceptible BL/6NTac mice had higher colonic Avpr1a mRNA and protein expression. These results parallel findings that patients' colonic Avpr1a mRNA expression corresponded to higher pain ratings. Moreover, neurons of the enteric nervous system were hyperresponsive to the Avpr1a agonist arginine-vasopressin, suggesting a role for enteric neurons in the pathology underlying VH. Taken together, these findings implicate differential regulation of Avpr1a as a novel mechanism of VH susceptibility as well as a potential therapeutic target specific to VH. PERSPECTIVE: This article presents evidence of Avpr1a as a novel candidate gene for VH in a mouse model of IBS. Avpr1a genotype and/or tissue-specific expression represents a potential biomarker for chronic abdominal pain susceptibility.
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Affiliation(s)
- Leena Kader
- Department of Anesthesiology, Pain, and Perioperative Medicine, KU Medical Center, Kansas City, Kansas; Neuroscience Graduate Program, KU Medical Center, Kansas City, Kansas
| | - Adam B Willits
- Department of Anesthesiology, Pain, and Perioperative Medicine, KU Medical Center, Kansas City, Kansas; Neuroscience Graduate Program, KU Medical Center, Kansas City, Kansas
| | - Sebastian Meriano
- Department of Anesthesiology, Pain, and Perioperative Medicine, KU Medical Center, Kansas City, Kansas; Department of Cell Biology and Physiology, KU Medical Center, Kansas City, Kansas
| | - Julie A Christianson
- Department of Cell Biology and Physiology, KU Medical Center, Kansas City, Kansas
| | - Jun-Ho La
- Department of Neurobiology, University of University of Texas Medical Branch, Galveston, Texas
| | - Bin Feng
- Biomedical Engineering Department, University of Connecticut, Storrs, Connecticut
| | - Brittany Knight
- Department of Neuroscience, University of Connecticut Health Center, Farmington, Connecticut
| | - Gulum Kosova
- Division of Statistical Genetics,TenSixteen Bio, Suffolk, Massachusetts
| | - Jennifer J Deberry
- Department of Anesthesiology & Perioperative Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Matthew D Coates
- Department of Medicine, Division of Gastroenterology & Hepatology, Penn State College of Medicine, Hershey, Pennsylvania
| | - Jeffrey S Hyams
- Department of Gastroenterology, Connecticut Children's Medical Center, Hartford, Connecticut
| | - Kyle M Baumbauer
- Department of Anesthesiology, Pain, and Perioperative Medicine, KU Medical Center, Kansas City, Kansas; Department of Cell Biology and Physiology, KU Medical Center, Kansas City, Kansas
| | - Erin E Young
- Department of Anesthesiology, Pain, and Perioperative Medicine, KU Medical Center, Kansas City, Kansas; Neuroscience Graduate Program, KU Medical Center, Kansas City, Kansas; Department of Cell Biology and Physiology, KU Medical Center, Kansas City, Kansas.
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Gervason S, Meleine M, Lolignier S, Meynier M, Daugey V, Birer A, Aissouni Y, Berthon JY, Ardid D, Filaire E, Carvalho FA. Antihyperalgesic properties of gut microbiota: Parabacteroides distasonis as a new probiotic strategy to alleviate chronic abdominal pain. Pain 2024; 165:e39-e54. [PMID: 37756665 DOI: 10.1097/j.pain.0000000000003075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 08/08/2023] [Indexed: 09/29/2023]
Abstract
ABSTRACT The potential role of gut microbiota in pain modulation is arousing an emerging interest since recent years. This study investigated neuromodulatory properties of gut microbiota to identify next-generation probiotics to propose alternative therapies for visceral pain management. Neuromodulation ability of 10 bacterial strains isolated from a healthy donor was assessed both on ND7/23 immortalized cell line and primary neuronal cells from rat dorsal root ganglia. This screening highlighted the neuroinhibitory property of Parabacteroides distasonis (F1-2) strain, supported both by its intracellular content and membrane fraction, which was further investigated in visceral pain mouse models. Oral administration of F1-2 resulted in a significant decrease of colonic hypersensitivity (CHS) in dextran sulfate sodium (0.5%) model associated with low-grade inflammation and a significant decrease of CHS in Citrobacter rodentium postinfectious models. No effect of F1-2 oral administration on CHS was observed in a neonatal maternal separation stress model. Antihyperalgesic effect unlikely involved modulation of inflammatory processes or restoration of intestinal barrier. Exploration of direct dialogue mechanisms between this strain and nervous system, assessed by calcium imaging experiments, revealed that F1-2 interacts directly with nociceptors by reducing activation level on capsaicin, inflammatory soup, and bradykinin stimulations. Our study provides new insights about bacteria-host interaction and places P distasonis as a potential therapeutic strategy in the treatment of visceral pain observed in leaky gut-associated pathologies.
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Affiliation(s)
- Sandie Gervason
- NeuroDol, UMR 1107 INSERM, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Mathieu Meleine
- NeuroDol, UMR 1107 INSERM, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Stéphane Lolignier
- NeuroDol, UMR 1107 INSERM, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Maëva Meynier
- NeuroDol, UMR 1107 INSERM, University of Clermont Auvergne, Clermont-Ferrand, France
- M2iSH, UMR 1071 INSERM, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Valentine Daugey
- NeuroDol, UMR 1107 INSERM, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Aurélien Birer
- M2iSH, UMR 1071 INSERM, University of Clermont Auvergne, Clermont-Ferrand, France
- Centre National de Référence de la Résisitance aux Antibiotiques, Service de Bactériologie, Clermont-Ferrand, France
| | - Youssef Aissouni
- NeuroDol, UMR 1107 INSERM, University of Clermont Auvergne, Clermont-Ferrand, France
| | | | - Denis Ardid
- NeuroDol, UMR 1107 INSERM, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Edith Filaire
- ECREIN Team, Human Nutrition Unit (UNH), UMR 1019 INRAE-UCA, University of Clermont-Auvergne, Clermont-Ferrand, France
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Omoloye A, Weisenburger S, Lehner MD, Gronier B. Menthacarin treatment attenuates nociception in models of visceral hypersensitivity. Neurogastroenterol Motil 2024; 36:e14760. [PMID: 38361164 DOI: 10.1111/nmo.14760] [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: 08/10/2023] [Revised: 12/14/2023] [Accepted: 01/30/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Chronic visceral hypersensitivity is closely associated with irritable bowel syndrome (IBS), a very common disorder which significantly impairs quality of life, characterized by abdominal pain, and distension. Imaging studies have found that IBS patients show higher metabolic activities and functional differences from normal controls in the anterior cingulate cortex (ACC), in response to visceral pain stimulation. Non-clinical data and clinical data suggest that medicinal products containing essential oils such as peppermint or caraway oil exert beneficial effects on IBS symptoms. METHODS We assessed acute and long-term treatment effects of a mixture of peppermint and caraway essential oils (Menthacarin) on brain electrophysiological markers of gut pain sensitivity in two rat models of visceral hypersensitivity. KEY RESULTS Chronic administration of corticosteroids and acute repeated mechanical hyperstimulation under anesthesia induced hyperalgesia and hypersensitivity, characterized by an increase in electrophysiological excitatory responses of ACC neurons to colorectal distension (CRD) and an increase in the proportion of neurons responding to otherwise subthreshold stimulation, respectively. Long-term, but not acute, oral administration of Menthacarin (60 mg kg-1 day-1) significantly reduced the net excitatory response to CRD in normally responsive control animals and counteracted the development of visceral hyperalgesia and hypersensitivity induced by repeated corticosterone administration and acute mechanical stimulation. CONCLUSIONS & INFERENCES The present study shows that, using the CRD method, chronic Menthacarin administration at a clinically relevant dose attenuates the neuronal discharge associated with visceral pain stimuli in the rat ACC, particularly in models of hypersensitivity, suggesting a potential for treating exaggerated visceral pain sensitivity.
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Affiliation(s)
- Adesina Omoloye
- Leicester Institute for Pharmaceutical Innovation, Leicester School of Pharmacy, De Montfort University, Leicester, UK
| | | | - Martin D Lehner
- Preclinical R&D, Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany
| | - Benjamin Gronier
- Leicester Institute for Pharmaceutical Innovation, Leicester School of Pharmacy, De Montfort University, Leicester, UK
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6
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Cantrell C, Reid C, Walker CS, Stallkamp Tidd SJ, Zhang R, Wilson R. Post-COVID postural orthostatic tachycardia syndrome (POTS): a new phenomenon. Front Neurol 2024; 15:1297964. [PMID: 38585346 PMCID: PMC10998446 DOI: 10.3389/fneur.2024.1297964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/12/2024] [Indexed: 04/09/2024] Open
Abstract
Background The impact of COVID-19 has been far-reaching, and the field of neurology is no exception. Due to the long-hauler effect, a variety of chronic health consequences have occurred for some post-COVID patients. A subset of these long-hauler patients experienced symptoms of autonomic dysfunction and tested positive for postural orthostatic tachycardia syndrome (POTS) via autonomic testing. Methods We conducted a chart review of a convenience sample from patients seen by neurologists at our tertiary care center for suspicion of post-COVID POTS. Patients included in our study had clearly defined POTS based on clinical criteria and positive tilt table test, were 81.25% female, and had an average age of approximately 36. Out of 16 patients, 12 had a confirmed positive COVID test result, with the remaining 4 having strong clinical suspicion for COVID infection. Our analysis examined the most bothersome 3 symptoms affecting each patient per the neurologist's note at their initial visit for post-COVID POTS, clinical presentation, comorbidities, neurological exam findings, autonomic testing results, and COMPASS-31 autonomic questionnaire and PROMIS fatigue survey results. Results Palpitations (68.75%) and fatigue (62.5%) were the most common of the impactful symptoms reported by patients in their initial Cleveland Clinic neurology visit. The most frequent comorbidities in our sample were chronic migraines (37.5%), irritable bowel syndrome (IBS) (18.75%), and Raynaud's (18.75%). Neurological exam findings and autonomic testing results other than tilt table yielded variable findings without clear trends. Survey results showed substantial autonomic symptom burden (COMPASS-31 autonomic questionnaire average score 44.45) and high levels of fatigue (PROMIS fatigue survey average score 64.64) in post-COVID POTS patients. Conclusion Our sample of post-COVID POTS patients are similar to the diagnosed POTS general population including in comorbidities and autonomic testing. Fatigue was identified by patients as a common and debilitating symptom. We hope that our study will be an early step toward further investigation of post-COVID POTS with focus on the trends identified in this chart review.
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Affiliation(s)
| | - Conor Reid
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, United States
| | - Claudia S. Walker
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, United States
| | | | - Ryan Zhang
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Robert Wilson
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, United States
- Department of Neuromuscular Medicine, Cleveland Clinic Foundation, Cleveland, OH, United States
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Aljahdli ES, Badroun F, Mushaeb HH, Aljohani R, Albisher S, Basalaim L, Baeisa S. Effects of irritable bowel syndrome on the health-related quality of life among the Saudi population. Saudi J Gastroenterol 2024; 30:37-44. [PMID: 37357494 PMCID: PMC10852141 DOI: 10.4103/sjg.sjg_107_23] [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: 03/15/2023] [Revised: 05/08/2023] [Accepted: 05/16/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a digestive system disorder. Patients with IBS have a significantly lower quality of life (QoL). In this study, we aimed to assess how IBS affects the Saudi Arabian population's health-related (HR)-QoL. METHODS A cross-sectional Web-based survey was conducted with a representative sample (n = 1346) of patients who met the Rome IV criteria for IBS from all regions of the country between February and May 2021. The questionnaire surveyed participants' socio-demographic data (nationality, sex, age, region, marital status, level of education, and occupation) and included 24 questions on IBS divided into four categories: (1) diagnosis; (2) symptoms; (3) impact on patients' lives; and (4) management methods. The HR-QoL score was calculated using a five-point Likert scale, with higher scores indicating worse QoL. RESULTS Most patients (83.3%) were diagnosed by a physician, and 66.7% had a family member or a friend with IBS. Mixed IBS was the most common type of IBS (26.4%). Factors associated with poor QoL and significantly associated with IBS included female sex, initial diagnosis by a general physician, intermittent symptoms, and being asymptomatic for weeks to months. CONCLUSIONS Greater attention to the QoL of patients with IBS is required to help them deal with IBS and create supportive environments to reduce its psychological effects.
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Affiliation(s)
- Emad S. Aljahdli
- Gastrointestinal Oncology Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- Gastroenterology Division, Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ftoon Badroun
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hanan H. Mushaeb
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Raghad Aljohani
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sara Albisher
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Leena Basalaim
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Salma Baeisa
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Kader L, Willits A, Meriano S, Christianson JA, La JH, Feng B, Knight B, Kosova G, Deberry J, Coates M, Hyams J, Baumbauer K, Young EE. Identification of arginine-vasopressin receptor 1a (Avpr1a/AVPR1A) as a novel candidate gene for chronic visceral pain. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.12.19.572390. [PMID: 38187732 PMCID: PMC10769202 DOI: 10.1101/2023.12.19.572390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Chronic abdominal pain in the absence of ongoing disease is the hallmark of disorders of gut-brain interaction (DGBIs), including irritable bowel syndrome (IBS). While the etiology of DGBIs remains poorly understood, there is evidence that both genetic and environmental factors play a role. In this study, we report the identification and validation of Avpr1a as a novel candidate gene for visceral hypersensitivity (VH), a primary peripheral mechanism underlying abdominal pain in DGBI/IBS. Comparing two C57BL/6 (BL/6) substrains (C57BL/6NTac and C57BL/6J) revealed differential susceptibility to the development of chronic VH following intrarectal zymosan (ZYM) instillation, a validated preclinical model for post-inflammatory IBS. Using whole genome sequencing, we identified a SNP differentiating the two strains in the 5' intergenic region upstream of Avpr1a, encoding the protein arginine-vasopressin receptor 1A (AVPR1A). We used behavioral, histological, and molecular approaches to identify distal colon-specific gene expression differences and neuronal hyperresponsiveness covarying with Avpr1a genotype and VH susceptibility. While the two BL/6 substrains did not differ across other gastrointestinal (GI) phenotypes (e.g., GI motility), VH-susceptible BL/6NTac mice had higher colonic Avpr1a mRNA and protein expression. Moreover, neurons of the enteric nervous system were hyperresponsive to the AVPR1A agonist AVP, suggesting a role for enteric neurons in the pathology underlying VH. These results parallel our findings that patients' colonic Avpr1a mRNA expression was higher in patients with higher pain ratings. Taken together, these findings implicate differential regulation of Avpr1a as a novel mechanism of VH-susceptibility as well as a potential therapeutic target specific to VH.
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Affiliation(s)
- Leena Kader
- Department of Anesthesiology, Pain, and Perioperative Medicine, KU Medical Center, Kansas City, KS, United States
- Neuroscience Graduate Program, KU Medical Center, Kansas City, KS, United States
| | - Adam Willits
- Department of Anesthesiology, Pain, and Perioperative Medicine, KU Medical Center, Kansas City, KS, United States
- Neuroscience Graduate Program, KU Medical Center, Kansas City, KS, United States
| | - Sebastian Meriano
- Department of Anesthesiology, Pain, and Perioperative Medicine, KU Medical Center, Kansas City, KS, United States
- Department of Cell Biology and Physiology, KU Medical Center, Kansas City, KS, United States
| | - Julie A. Christianson
- Department of Cell Biology and Physiology, KU Medical Center, Kansas City, KS, United States
| | - Jun-Ho La
- Department of Neurobiology, University of University of Texas Medical Branch, Galveston, TX
| | - Bin Feng
- Biomedical Engineering Department, University of Connecticut, Storrs, CT
| | - Brittany Knight
- Department of Neuroscience, University of Connecticut Health Center, Farmington, CT, United States
| | | | - Jennifer Deberry
- Department of Anesthesiology & Perioperative Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Matthew Coates
- Department of Medicine, Division of Gastroenterology & Hepatology, Penn State College of Medicine, Hershey, PA, United States
| | - Jeffrey Hyams
- Department of Gastroenterology, Connecticut Children’s Medical Center, Hartford, CT
| | - Kyle Baumbauer
- Department of Anesthesiology, Pain, and Perioperative Medicine, KU Medical Center, Kansas City, KS, United States
- Department of Cell Biology and Physiology, KU Medical Center, Kansas City, KS, United States
| | - Erin E. Young
- Department of Anesthesiology, Pain, and Perioperative Medicine, KU Medical Center, Kansas City, KS, United States
- Neuroscience Graduate Program, KU Medical Center, Kansas City, KS, United States
- Department of Cell Biology and Physiology, KU Medical Center, Kansas City, KS, United States
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Noor-Mohammadi E, Ligon CO, Mackenzie KD, Stratton J, Shnider SJ, Greenwood-Van Meerveld B. Antinociceptive Effects of an Anti-CGRP Antibody in Rat Models of Colon-Bladder Cross-Organ Sensitization. J Pharmacol Exp Ther 2023; 387:4-14. [PMID: 37164371 DOI: 10.1124/jpet.122.001480] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 04/10/2023] [Accepted: 04/22/2023] [Indexed: 05/12/2023] Open
Abstract
Irritable bowel syndrome (IBS) and bladder pain syndrome/interstitial cystitis (BPS/IC) are comorbid visceral pain disorders seen commonly in women with unknown etiology and limited treatment options and can involve visceral organ cross-sensitization. Calcitonin gene-related peptide (CGRP) is a mediator of nociceptive processing and may serve as a target for therapy. In three rodent models, we employed a monoclonal anti-CGRP F(ab')2 to investigate the hypothesis that visceral organ cross-sensitization is mediated by abnormal CGRP signaling. Visceral organ cross-sensitization was induced in adult female rats via transurethral infusion of protamine sulfate (PS) into the urinary bladder or infusion into the colon of trinitrobenzene sulfonic acid (TNBS). Colonic sensitivity was assessed via the visceromotor response to colorectal distension (CRD). Bladder sensitivity was assessed as the frequency of abdominal withdrawal reflexes to von Frey filaments applied to the suprapubic region. PS- or TNBS-induced changes in colonic and bladder permeability were investigated in vitro via quantification of transepithelial electrical resistance (TEER). Peripheral administration of an anti-CGRP F(ab')2 inhibited PS-induced visceral pain behaviors and colon hyperpermeability. Similarly, TNBS-induced pain behaviors and colon and bladder hyperpermeability were attenuated by anti-CGRP F(ab')2 treatment. PS into the bladder or TNBS into the colon significantly increased the visceromotor response to CRD and abdominal withdrawal reflexes to suprapubic stimulation and decreased bladder and colon TEER. These findings suggest an important role of peripheral CGRP in visceral nociception and organ cross-sensitization and support the evaluation of CGRP as a therapeutic target for visceral pain in patients with IBS and/or BPS/IC. SIGNIFICANCE STATEMENT: A monoclonal antibody against calcitonin gene-related peptide (CGRP) was found to reduce concomitant colonic and bladder hypersensitivity and hyperpermeability. The results of this study suggest that CGRP-targeting antibodies, in addition to migraine prevention, may provide a novel treatment strategy for multiorgan abdominopelvic pain following injury or inflammation.
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Affiliation(s)
- Ehsan Noor-Mohammadi
- Department of Physiology (E.N.-M., C.O.L., B.G.-V.M.), University of Oklahoma Health Science Center, Oklahoma City, Oklahoma; and TEVA Pharmaceuticals Ltd. (K.D.M., J.S., S.J.S.), Redwood City, California
| | - Casey O Ligon
- Department of Physiology (E.N.-M., C.O.L., B.G.-V.M.), University of Oklahoma Health Science Center, Oklahoma City, Oklahoma; and TEVA Pharmaceuticals Ltd. (K.D.M., J.S., S.J.S.), Redwood City, California
| | - Kimberly D Mackenzie
- Department of Physiology (E.N.-M., C.O.L., B.G.-V.M.), University of Oklahoma Health Science Center, Oklahoma City, Oklahoma; and TEVA Pharmaceuticals Ltd. (K.D.M., J.S., S.J.S.), Redwood City, California
| | - Jennifer Stratton
- Department of Physiology (E.N.-M., C.O.L., B.G.-V.M.), University of Oklahoma Health Science Center, Oklahoma City, Oklahoma; and TEVA Pharmaceuticals Ltd. (K.D.M., J.S., S.J.S.), Redwood City, California
| | - Sara J Shnider
- Department of Physiology (E.N.-M., C.O.L., B.G.-V.M.), University of Oklahoma Health Science Center, Oklahoma City, Oklahoma; and TEVA Pharmaceuticals Ltd. (K.D.M., J.S., S.J.S.), Redwood City, California
| | - Beverley Greenwood-Van Meerveld
- Department of Physiology (E.N.-M., C.O.L., B.G.-V.M.), University of Oklahoma Health Science Center, Oklahoma City, Oklahoma; and TEVA Pharmaceuticals Ltd. (K.D.M., J.S., S.J.S.), Redwood City, California
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10
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Yang Q, Zhao Y, Zhao X, Sun S, Chen Y, Chen J, Zou D, Zhang L. Exploring the potential targets of Biling Weitong Granules on visceral hypersensitivity through integration of network pharmacology and in vivo analysis. JOURNAL OF ETHNOPHARMACOLOGY 2023:116701. [PMID: 37257703 DOI: 10.1016/j.jep.2023.116701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/13/2023] [Accepted: 05/28/2023] [Indexed: 06/02/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Biling Weitong Granules(BLWTG) are a newly developed traditional Chinese medicine prescription based on the ancient prescription Jinlingzi San and Zuojin Wan. It is used for the treatment of functional gastrointestinal disorders (FGIDs) featured as visceral hypersensitivity(VH). However, its active ingredients and protein targets involved still remain unknown. AIM OF THE STUDY To explore the potential targets of BLWTG for the treatment of visceral hypersensitivity. MATERIALS AND METHODS Active components and their protein targets of BLWTG were screened from TCMSP database and the component-target network were constructed with Cytoscape software. Irritable bowel syndrome (IBS) was the representative disease in this study and information on its linked pathways was obtained from NCBI, Drugbank and Genecard. Target pathways of BLWTG were analyzed through KEGG to verify the correlation with IBS related pathways.Then, the VH mouse models was induced by maternal separation(MS), randomly divided into normal saline(NS),BLWTG1(low-dosage) and BLWTG2(high-dosage) group. After intervention, threshold intensity of colorectal distension (CRD) and body weight were measured to evaluate relief of IBS symptoms. Elisa was performed to evaluate 5-HT concentration changes of colon tissues. Flow cytometry was performed to assess changes of colon eosinophils and mast cells proportion. Transcriptome sequencing was employed to analyze changes of pathways and differential genes. RESULTS 199 protein targets and 132 active components of BLWTG were identified. KEGG analysis revealed the overlap between BLWTG target pathways and IBS related pathways such as neuroactive ligand-receptor interaction, tryptophan metabolism and inflammatory reaction. 34 genes were not only BLWTG target proteins but also recognized targets for treating IBS. After maternal separation(MS), the mice showed a significant decrease in threshold intensity of CRD, a progressive decrease in body weight and an increase of 5-HT concentration of colon tissue. The proportion of mast cells and eosinophils in the colon increased. Differential genes including Hp,Ido1 and Aqp7 were significantly increased in MS mice group and IBS-related pathways were upregulated. After treatment of BLWTG, threshold intensity of CRD and body weight were significantly improved and IBS related pathways were downregulated. In addition, among BLWTG protein targets, Il1b,Tnf,Adrb1 and Nos2 were found upregulated in MS + NS mice and downregulated after BLWTG intervention through combination of transcriptome sequencing. CONCLUSIONS In maternal separation-induced mouse models, BLWTG could alleviate visceral hypersensitivity, possibly through downregulation of 5-HT concentration and eosinophils and mast cells proportion in colon and critical pathways such as neuroactive ligand-receptor pathway. Potential targets of BLWTG including Il1b,Tnf,Adrb1 and Nos2 were found through integration of network pharmacology database and transcriptome sequencing, providing evidence for further study on mechanisms underlying visceral hypersensitivity.
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Affiliation(s)
- Qidi Yang
- Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.197, Rui Jin Er Road, Shanghai, 200025, China.
| | - Yizhou Zhao
- Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.197, Rui Jin Er Road, Shanghai, 200025, China.
| | - Xiangyu Zhao
- Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.197, Rui Jin Er Road, Shanghai, 200025, China.
| | - Sishen Sun
- Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.197, Rui Jin Er Road, Shanghai, 200025, China.
| | - Yifei Chen
- Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.197, Rui Jin Er Road, Shanghai, 200025, China.
| | - Jiayin Chen
- Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.197, Rui Jin Er Road, Shanghai, 200025, China.
| | - Duowu Zou
- Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.197, Rui Jin Er Road, Shanghai, 200025, China.
| | - Ling Zhang
- Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.197, Rui Jin Er Road, Shanghai, 200025, China.
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11
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Hafiz TA, Alhemayed TS, Mandorah RH, Alshanqiti AA, Almohaimeed RA, Noor OM. Irritable Bowel Syndrome: Prevalence and Determinants Among Adults in the Makkah Region, Saudi Arabia. Cureus 2023; 15:e39568. [PMID: 37378098 PMCID: PMC10292633 DOI: 10.7759/cureus.39568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is among the most prevalent gut-brain interaction disorders and one of the most expensive in terms of money and health. Despite their widespread occurrence in society, these disorders have only recently been subjected to rigorous scientific inquiry, classification, and treatment. Although IBS does not lead to future complications, such as bowel cancer, it can impact work productivity and health-related quality of life and increase medical costs. Both young and older people with IBS have worse general health than the general population. AIMS To determine the prevalence of IBS among adults aged 25 to 55 years in the Makkah region, as well as the risk factors that may contribute to it. METHODOLOGY A cross-sectional web-based survey with a representative sample (n = 936) of individuals in the Makkah region was carried out from November 21, 2022, to May 3, 2023. RESULTS In Makkah, 420 out of 936 persons have IBS, making it 44.9% common. Most of the IBS patients in the study were women, aged 25 to 35 years, married, and suffering from mixed IBS. Age, gender, marital status, and occupation were found to be associated with IBS. It was discovered that there is an association between IBS and insomnia, medication use, food allergies, chronic diseases, anemia, arthritis, gastrointestinal surgery, and a family history of IBS. CONCLUSION The study highlights the importance of addressing the risk factors of IBS and developing supportive environments to alleviate its effects in Makkah. The researchers hope the findings inspire further research and action to improve the lives of people with IBS.
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Affiliation(s)
- Tamara A Hafiz
- Health Education & Health Promotion, Faculty of Public Health & Health Informatics, Umm Al-Qura University, Makkah, SAU
| | - Tala S Alhemayed
- Health Education & Health Promotion, Faculty of Public Health & Health Informatics, Umm Al-Qura University, Makkah, SAU
| | - Renaad H Mandorah
- Health Education & Health Promotion, Faculty of Public Health & Health Informatics, Umm Al-Qura University, Makkah, SAU
| | - Aeshah A Alshanqiti
- Health Education & Health Promotion, Faculty of Public Health & Health Informatics, Umm Al-Qura University, Makkah, SAU
| | - Raneem A Almohaimeed
- Health Education & Health Promotion, Faculty of Public Health & Health Informatics, Umm Al-Qura University, Makkah, SAU
| | - Osama M Noor
- Family Medicine, Faculty of Public Health & Health Informatics, Umm Al-Qura University, Makkah, SAU
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12
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Zhou Q, Yang L, Verne ML, Zhang BB, Fields J, Verne GN. Catechol-O-Methyltransferase Loss Drives Cell-Specific Nociceptive Signaling via the Enteric Catechol-O-Methyltransferase/microRNA-155/Tumor Necrosis Factor α Axis. Gastroenterology 2023; 164:630-641.e34. [PMID: 36623778 PMCID: PMC10038873 DOI: 10.1053/j.gastro.2022.12.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND & AIMS The etiology of abdominal pain in postinfectious, diarrhea-predominant irritable bowel syndrome (PI-IBS-D) is unknown, and few treatment options exist. Catechol-O-methyltransferase (COMT), an enzyme that inactivates and degrades biologically active catecholamines, plays an important role in numerous physiologic processes, including modulation of pain perception. Our objective was to determine the mechanism(s) of how decreased colonic COMT in PI-IBS-D patients contributes to the chronic abdominal pain phenotype after enteric infections. METHODS Colon neurons, epithelial cells, and macrophages were procured with laser capture microdissection from PI-IBS-D patients to evaluate cell-specific colonic COMT, microRNA-155 (miR-155), and tumor necrosis factor (TNF) α expression levels compared to recovered patients (infection cleared: did not develop PI-IBS-D) and control individuals. COMT-/-, colon-specific COMT-/-, and miR-155-/- mice and human colonoids were used to model phenotypic expression of COMT in PI-IBS-D patients and to investigate signaling pathways linking abdominal pain. Citrobacter rodentium and trinitrobenzene sulfonic acid animal models were used to model postinflammatory changes seen in PI-IBS-D patients. RESULTS Colonic COMT levels were significantly decreased and correlated with increased visual analog scale abdominal pain ratings in PI-IBS-D patients compared to recovered patients and control individuals. Colonic miR-155 and TNF-α were increased in PI-IBS-D patients with diminished colonic COMT. COMT-/- mice had significantly increased expression of miR-155 and TNF-α in both colon tissues and dorsal root ganglia. Introduction of cV1q antibody (anti-TNF-α) into mice reversed visceral hypersensitivity after C rodentium and trinitrobenzene sulfonic acid. CONCLUSIONS Decreased colonic COMT in PI-IBS-D patients drives abdominal pain phenotypes via the COMT/miR-155/TNF-α axis. These important findings will allow new treatment paradigms and more targeted and personalized medicine approaches for gastrointestinal disorders after enteric infections.
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Affiliation(s)
- QiQi Zhou
- Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; Memphis Veterans Affairs Medical Center, Research Service, Memphis, Tennessee
| | - Liuqing Yang
- Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Meghan L Verne
- Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Benjamin B Zhang
- Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Jeremy Fields
- Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - George Nicholas Verne
- Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; Memphis Veterans Affairs Medical Center, Research Service, Memphis, Tennessee.
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13
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Hu C, Yan C, Wu Y, Tao E, Guo R, Zhu Z, Chen X, Fang M, Jiang M. Low FODMAP Diet Relieves Visceral Hypersensitivity and Is Associated with Changes in Colonic Microcirculation in Water Avoidance Mice Model. Nutrients 2023; 15:nu15051155. [PMID: 36904154 PMCID: PMC10004816 DOI: 10.3390/nu15051155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/02/2023] Open
Abstract
(1) Background: Irritable bowel syndrome (IBS) is a global public health problem, the pathogenesis of which has not been fully explored. Limiting fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) can relieve symptoms in some patients with IBS. Studies have shown that normal microcirculation perfusion is necessary to maintain the primary function of the gastrointestinal system. Here, we hypothesized that IBS pathogenesis might be related to abnormalities in colonic microcirculation. A low-FODMAP diet could alleviate visceral hypersensitivity (VH) by improving colonic microcirculation; (2) Methods: C57BL/6 mice were raised to establish an IBS-like rodent model using water avoidance (WA) stress or SHAM-WA as a control, one hour per day for ten days. The mice in the WA group were administered different levels of the FODMAP diet: 2.1% regular FODMAP (WA-RF), 10% high FODMAP diet (WA-HF), 5% medium FODMAP diet (WA-MF), and 0% low FODMAP diet (WA-LF) for the following 14 days. The body weight and food consumption of the mice were recorded. Visceral sensitivity was measured as colorectal distention (CRD) using the abdominal withdrawal reflex (AWR) score. Colonic microcirculation was assessed using laser speckle contrast imaging (LCSI). Vascular endothelial-derived growth factor (VEGF) was detected using immunofluorescence staining; (3) Results: The threshold values of CRD pressure in the WA-RF, WA-HF, and WA-MF groups were significantly lower than those in the SHAM-WA group. Moreover, we observed that colonic microcirculation perfusion decreased, and the expression of VEGF protein increased in these three groups of mice. Interestingly, a low-FODMAP dietary intervention could reverse this situation. Specifically, a low-FODMAP diet increased colonic microcirculation perfusion, reduced VEGF protein expression in mice, and increased the threshold of VH. There was a significant positive correlation between colonic microcirculation and threshold for VH; (4) Conclusions: These results demonstrate that a low-FODMAP diet can alter VH by affecting colonic microcirculation. Changes in intestinal microcirculation may be related to VEGF expression.
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Affiliation(s)
- Chenmin Hu
- Endoscopy Center and Gastrointestinal Laboratory, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou 310052, China
- Department of Pediatrics, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Chenxi Yan
- Endoscopy Center and Gastrointestinal Laboratory, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou 310052, China
| | - Yuhao Wu
- Endoscopy Center and Gastrointestinal Laboratory, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou 310052, China
| | - Enfu Tao
- Endoscopy Center and Gastrointestinal Laboratory, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou 310052, China
| | - Rui Guo
- Endoscopy Center and Gastrointestinal Laboratory, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou 310052, China
| | - Zhenya Zhu
- Endoscopy Center and Gastrointestinal Laboratory, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou 310052, China
| | - Xiaolong Chen
- Endoscopy Center and Gastrointestinal Laboratory, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou 310052, China
| | - Marong Fang
- Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
- Institute of System Medicine, Zhejiang University School of Medicine, Hangzhou 310058, China
- Correspondence: (M.F.); (M.J.)
| | - Mizu Jiang
- Endoscopy Center and Gastrointestinal Laboratory, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou 310052, China
- Department of Gastroenterology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou 310052, China
- Correspondence: (M.F.); (M.J.)
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14
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Sex differences in pain-related behaviors and clinical progression of disease in mouse models of colonic pain. Pain 2023; 164:197-215. [PMID: 35559931 PMCID: PMC9756435 DOI: 10.1097/j.pain.0000000000002683] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/28/2022] [Indexed: 01/09/2023]
Abstract
ABSTRACT Previous studies have reported sex differences in patients with irritable bowel syndrome and inflammatory bowel disease, including differences in visceral pain perception. Despite this, sex differences in behavioral manifestations of visceral pain and underlying pathology of the gastrointestinal tract have been largely understudied in preclinical research. In this study, we evaluated potential sex differences in spontaneous nociceptive responses, referred abdominal hypersensitivity, disease progression, and bowel pathology in mouse models of acute and persistent colon inflammation. Our experiments show that females exhibit more nociceptive responses and referred abdominal hypersensitivity than males in the context of acute but not persistent colon inflammation. We further demonstrate that, after acute and persistent colon inflammation, pain-related behavioral responses in females and males are distinct, with increases in licking of the abdomen only observed in females and increases in abdominal contractions only seen in males. During persistent colon inflammation, males exhibit worse disease progression than females, which is manifested as worse physical appearance and higher weight loss. However, no measurable sex differences were observed in persistent inflammation-induced bowel pathology, stool consistency, or fecal blood. Overall, our findings demonstrate sex differences in pain-related behaviors and disease progression in the context of acute and persistent colon inflammation, highlighting the importance of considering sex as a biological variable in future mechanistic studies of visceral pain as well as in the development of diagnostics and therapeutic options for chronic gastrointestinal diseases.
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15
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Verne ZT, Fields JZ, Zhang BB, Zhou Q. Autonomic dysfunction and gastroparesis in Gulf War veterans. J Investig Med 2023; 71:7-10. [PMID: 35798472 DOI: 10.1136/jim-2021-002291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2022] [Indexed: 01/25/2023]
Abstract
Over 25% of veterans with Gulf War illness developed chronic gastrointestinal (GI) symptoms of unknown etiology after they returned from deployment to the Persian Gulf. To determine the prevalence of delayed gastric emptying and its association with autonomic dysfunction in returning Gulf War (GW) veterans with chronic GI symptoms, we prospectively studied 35 veterans who were deployed to the Persian Gulf and developed chronic nausea, vomiting, postprandial abdominal pain, and bloating during their tour of duty and 15 asymptomatic controls. All veterans underwent 5 standardized cardiovascular tests to assess autonomic function. Each test was scored from 0 (normal) to 5 (severe disease) and the mean was calculated. A composite score >1.5 was considered abnormal, with 5 representing severe autonomic dysfunction. A standardized gastric emptying test with a solid phase was performed in each veteran. A gastric retention of >50% at 100 minutes was considered abnormal. The composite autonomic score was 3.7 in veterans with GI symptoms (vs 1.3 in controls) (p<0.01). The mean solid phase retention at 100 minutes was 72.6% in the symptomatic veterans versus 24.6% in controls (p<0.001). Our results suggest that autonomic dysfunction and delayed gastric emptying are common in returning GW veterans with GI symptoms. Autonomic dysfunction was positively correlated with the severity of delayed gastric emptying and may account for the GI symptoms of nausea, vomiting, postprandial abdominal pain, and bloating. These new findings are important for an increasing number of veterans who are serving in the Persian Gulf and are at a high risk of developing GI disorders while deployed.
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Affiliation(s)
| | - Jeremy Z Fields
- Department of Medicine, The University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA
| | - Benjamin Buyi Zhang
- Department of Medicine, The University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA
| | - QiQi Zhou
- Department of Medicine, The University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA.,Memphis VA Medical Center, Memphis, Tennessee, USA
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16
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Abdominophrenic Dyssynergia: A Narrative Review. Am J Gastroenterol 2023; 118:41-45. [PMID: 36191283 PMCID: PMC9810002 DOI: 10.14309/ajg.0000000000002044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 08/16/2022] [Indexed: 11/07/2022]
Abstract
Chronic bloating and abdominal distension are common and highly bothersome gastrointestinal symptoms. Although the differential diagnoses for bloating and distension are broad, these symptoms are frequently associated with disorders of the gut-brain interaction. Functional abdominal bloating may be a result of visceral hypersensitivity, whereas abdominal distension seems to be a somatic behavioral response associated with abdominophrenic dyssynergia, featuring diaphragmatic contraction and abdominal wall relaxation. We review the available literature regarding abdominophrenic dyssynergia and comment on its epidemiology, diagnosis, treatment, and avenues to address in the near future.
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17
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Tian S, Zhang H, Chen S, Wu P, Chen M. Global research progress of visceral hypersensitivity and irritable bowel syndrome: bibliometrics and visualized analysis. Front Pharmacol 2023; 14:1175057. [PMID: 37201020 PMCID: PMC10185792 DOI: 10.3389/fphar.2023.1175057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/18/2023] [Indexed: 05/20/2023] Open
Abstract
Background: Irritable bowel syndrome (IBS) is a group of functional intestinal disorders characterized by abdominal pain, bloating, and changes in bowel habits, and/or stool characteristics. Recent studies have shown that there has been a significant advancement in the study of visceral hypersensitivity in IBS. Through the use of bibliometrics, this study aims to provide a comprehensive overview of the knowledge structure and research hotpots of visceral hypersensitivity in IBS. Methods: Publications related to visceral hypersensitivity in IBS from 2012 to 2022 were searched on the web of science core collection (WoSCC) database. CiteSpace.6.1. R2 and Vosviewer 1.6.17 were used to perform bibliometric analysis. Results: A total of 974 articles led by China and the United States from 52 countries were included. Over the past decade, the number of articles on visceral hypersensitivity and IBS has steadily increased year by year. China, the United States, and Belgium are the main countries in this field. Univ Oklahoma, Univ Gothenburg, and Zhejiang University are the main research institutions. Simren, Magnus, Greenwood-van meerveld, Beverley, and Tack, Jan are the most published authors in this research field. The research on the causes, genes, and pathways involved in visceral hypersensitivity in IBS and the mechanism of IBS are the main topics and hotspots in this field. This study also found that gut microbiota may be related to the occurrence of visceral hypersensitivity, and probiotics may be a new method for the treatment of visceral hypersensitivity and pain, which may become a new direction for research in this field. Conclusion: This is the first bibliometric study to comprehensively summarize the research trends and developments of visceral hypersensitivity in IBS. This information provides the research frontier and hot topics in this field in recent years, which will provide a reference for scholars studying this field.
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Affiliation(s)
- Siyu Tian
- School of Clinical Medicine, Chengdu University of TCM, Chengdu, China
| | - Hang Zhang
- School of Clinical Medicine, Chengdu University of TCM, Chengdu, China
| | - Siqi Chen
- School of Clinical Medicine, Chengdu University of TCM, Chengdu, China
| | - Pengning Wu
- School of Clinical Medicine, Chengdu University of TCM, Chengdu, China
| | - Min Chen
- Department of Colorectal Diseases, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Min Chen,
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Maalouf E, Grover M. Editorial: repurposed linaclotide and the quest for abdominal pain management in irritable bowel syndrome. Aliment Pharmacol Ther 2023; 57:261-262. [PMID: 36565004 DOI: 10.1111/apt.17304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Elisia Maalouf
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Madhusudan Grover
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
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19
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Lin W, Liu Y, Zhou Y, Lin M, Liu C, Tang Y, Wu B, Lin C. Methyltransferase-like 3 modulates visceral hypersensitivity through regulating the nuclear export of circKcnk9 in YTHDC1-dependent manner. Mol Pain 2022; 18:17448069221144540. [PMID: 36443649 PMCID: PMC9730012 DOI: 10.1177/17448069221144540] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Accumulating evidence shows that N6-methyladenosine (m6A) modulators contribute to the process of chronic pain. However, the exact mechanisms of m6A writers involved in visceral hypersensitivity of Irritable bowel syndrome (IBS) remain unclear. This article aimed to reveal a new mechanism for the progression of IBS. Methods: The IBS-like model was established by neonatal colorectal distention (CRD). The relationship between m6A and circKcnk9 was analyzed by bioinformatics, immunofluorescence and RNA fluorescence in situ hybridization (FISH) assays. Visceral hypersensitivity was assessed based on the electromyography (EMG) response of the abdominal external oblique muscle to CRD. In vivo and in vitro studies (including EMG stereotactic infusion, Western blot and qRT-PCR) were utilized to explore the biological functions of related indicators. The bioinformatics, RIP experiments and RNA pull-down assays were used to explore the potential molecular mechanisms. Results: We identified that neonatal CRD increased the level of the m6A via methyltransferase-like 3 (METTL3) in the hippocampal neurons. Subsequently, knockdown of METTL3 could alleviate visceral hypersensitivity in IBS-like rats. By contrast, overexpression of METTL3 could induce visceral hypersensitivity and activate hippocampal neurons in control rats. Moreover, YTHDC1, the only m6A-associated protein predicted by bioinformatics to bind to circKcnk9, modulated visceral hypersensitivity through regulating the nuclear export of circKcnk9 in an m6A-dependent manner. Notably, FISH data suggested that the increased nuclear staining of circKcnk9 caused by siYTHDC1 could be recovered by overexpression of YTHDC1 wild type (WT) but not YTHDC1 negative control (NC) in PC12 cells. Conclusions: Our findings reveal a new regulatory mechanism in progress of IBS, that is, METTL3 modulates visceral hypersensitivity through regulating the nuclear export of circKcnk9 in YTHDC1-dependent manner.
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Affiliation(s)
- Wei Lin
- Pain Research Institute, Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Yuan Liu
- Pain Research Institute, Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China,Cancer Research Center Nantong, the Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Yifei Zhou
- Pain Research Institute, Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Mengying Lin
- Pain Research Institute, Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Congxu Liu
- Pain Research Institute, Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Ying Tang
- Pain Research Institute, Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China,Ying Tang, Pain Research Institute, Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Fujian Medical University, Fuzhou 350122, China.
| | - Bin Wu
- Department of Pediatrics, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China,Bin Wu, Department of Pediatrics, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China.
| | - Chun Lin
- Pain Research Institute, Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China,Chun Lin, Pain Research Institute, Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Fujian Medical University, Fuzhou 350122, China.
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20
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Hou Y, Dong L, Lu X, Shi H, Xu B, Zhong W, Ma L, Wang S, Yang C, He X, Zhao Y, Wang S. Distinctions Between Fecal and Intestinal Mucosal Microbiota in Subgroups of Irritable Bowel Syndrome. Dig Dis Sci 2022; 67:5580-5592. [PMID: 35879512 DOI: 10.1007/s10620-022-07588-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 04/14/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND AIMS Recent studies have shown that changes in the intestinal microbiota contribute to the pathogenesis of irritable bowel syndrome (IBS). This study aimed to investigate the characteristics of the fecal and intestinal mucosal microbiota in IBS patients, and the correlation between microbiota and clinical manifestations. METHODS Fecal and intestinal mucosal samples were collected from 14 constipation-predominant IBS (IBS-C) patients, 20 diarrhea-predominant IBS (IBS-D) patients, and 20 healthy controls (HCs). 16S rRNA gene sequencing and fluorescence in situ hybridization were used for the analysis of samples. RESULTS Community richness and diversity of the fecal microbiota in IBS patients were significantly reduced compared with the HCs. The mucosal samples in IBS patients showed decreased Bifidobacterium and increased Bacteroides caccae compared with HCs; Eubacterium and Roseburia were decreased in IBS-C patients and increased in IBS-D patients. A comparison of the fecal and mucosal microbiota in IBS patients showed significantly increased Bifidobacterium in fecal samples and a decrease in mucosal samples in IBS-C patients; Bacteroides caccae and Roseburia were significantly reduced in fecal samples and increased in mucosal samples of IBS patients. A correlation between microbiota and clinical manifestations in IBS patients showed that Bacteroides caccae and Roseburia in fecal samples and Bifidobacterium and Eubacterium in mucosal samples were associated with abdominal pain and distention. CONCLUSIONS Distinct differences exist between the fecal and intestinal mucosal microbiota in IBS patients, with the changes in the latter appearing more consistent with the pathophysiology of IBS. Changes in intestinal microbiota were associated with the clinical manifestations in IBS.
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Affiliation(s)
- Yangfan Hou
- Department of Gastroenterology, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China.,Pulmonary and Critical Care Medicine, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China
| | - Lei Dong
- Department of Gastroenterology, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China
| | - Xiaolan Lu
- Department of Gastroenterology, Shanghai Pudong Hospital, Shanghai, 201399, China
| | - Haitao Shi
- Department of Gastroenterology, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China
| | - Bing Xu
- Department of Gastroenterology, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China
| | - Wenting Zhong
- International Medical Ward, Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, 710061, China
| | - Lin Ma
- Department of Gastroenterology, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China
| | - Shuhui Wang
- Department of Gastroenterology, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China
| | - Caifeng Yang
- Departments of Gastroenterology, Xi'an City First Hospital, Xi'an, 710002, China
| | - Xinyi He
- Department of Gastroenterology, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China
| | - Yidi Zhao
- Emergency Department, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China
| | - Shenhao Wang
- Department of Gastroenterology, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China.
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21
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Zhang L, Yu C, Chen B, Chao Y, Zhang H, Zhao Q, Yang K, Zhang Y, Chen S. Modulation of colonic function in irritable bowel syndrome rats by electroacupuncture at ST25 and the neurobiological links between ST25 and the colon. Front Neurosci 2022; 16:930489. [PMID: 36507334 PMCID: PMC9731770 DOI: 10.3389/fnins.2022.930489] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 11/01/2022] [Indexed: 11/25/2022] Open
Abstract
Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disease characterized by abdominal pain and defecation disorders. Acupuncture therapy positively affects IBS, with ST25 being the main point. However, ST25 has mostly been used in conjunction with other acupoints. This study aimed to observe the therapeutic effect of electroacupuncture at ST25 alone in IBS and the neurobiological mechanism of ST25 associated with the colon. First, we observed the effect of electroacupuncture at ST25 on the visceral pain threshold and slow-wave discharge of the colon in IBS model rats. Second, we explored the neurobiological mechanism of ST25 associated with the colon using a neural tracer technique. The results showed that (1) electroacupuncture at ST25 alone can alleviate visceral hypersensitivity and restore normal slow-wave frequency and rhythm of the colon in IBS rats; (2) there is a close neuroanatomical connection between ST25 and the colon, i.e., in the dorsal root ganglion (DRG), ST25 is similar in innervation to the colon, mainly in the T8-L1 segment, while the presence of double-labeled positive neurons is present in a part of the DRG; retrogradely labeled motor neurons associated with ST25 were observed in the anterior horn of the spinal cord, and retrogradely labeled sympathetic postganglionic neurons associated with ST25 were observed in the sympathetic nerve chain. These findings suggested that the DRGs and the dorsal horn of the spinal cord are important targets for electroacupuncture at ST25 to reduce visceral hypersensitivity in IBS rats. The sympathetic ganglia may be an important site for ST25 to regulate intestinal motility. The neurobiological mechanism of ST25 action in IBS rats should be further investigated in the future by combining related techniques, such as pseudorabies virus, optogenetics, calcium imaging, and electrophysiology.
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Affiliation(s)
- Lili Zhang
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Cheng Yu
- Department of Traditional Chinese Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Biwei Chen
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yuqiao Chao
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Haiyan Zhang
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Qinyu Zhao
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Kaiwei Yang
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yujiao Zhang
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China,Yujiao Zhang,
| | - Shaozong Chen
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China,*Correspondence: Shaozong Chen,
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22
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Zhou Q, Verne GN. Epigenetic modulation of visceral nociception. Neurogastroenterol Motil 2022; 34:e14443. [PMID: 35950237 PMCID: PMC9787514 DOI: 10.1111/nmo.14443] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 12/30/2022]
Abstract
Epigenetics is a process that alters gene activity or phenotype without any changes in the underlying DNA sequence or genotype. These biological changes may have deleterious effects and can lead to various human diseases. Ongoing research is continuing to illuminate the role of epigenetics in a variety of pathophysiologic processes. Several categories of epigenetic mechanisms have been studied including chromatin remodeling, DNA methylation, histone modification, and non-coding RNA mechanisms. These epigenetic changes can have a long-term effect on gene expression without any underlying changes in the DNA sequences. The underlying pathophysiology of disorders of brain-gut interaction and stress-induced visceral pain are not fully understood and the role of epigenetic mechanisms in these disorders are starting to be better understood. Current work is underway to determine how epigenetics plays a role in the neurobiology of patients with chronic visceral pain and heightened visceral nociception. More recently, both animal models and human studies have shown how epigenetic regulation modulates stress-induced visceral pain. While much more work is needed to fully delineate the mechanistic role of epigenetics in the neurobiology of chronic visceral nociception, the current study by Louwies et al., in Neurogastroenterology and Motility provides additional evidence supporting the involvement of epigenetic alterations in the central nucleus of the amygdala in stress-induced visceral hypersensitivity in rodents.
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Affiliation(s)
- QiQi Zhou
- Department of MedicineUniversity of Tennessee College of MedicineMemphisTennesseeUSA
- Memphis VA Medical CenterResearch ServiceMemphisTennesseeUSA
| | - George Nicholas Verne
- Department of MedicineUniversity of Tennessee College of MedicineMemphisTennesseeUSA
- Memphis VA Medical CenterResearch ServiceMemphisTennesseeUSA
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23
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Willits AB, Grossi V, Glidden NC, Hyams JS, Young EE. Identification of a Pain-Specific Gene Expression Profile for Pediatric Recurrent Abdominal Pain. FRONTIERS IN PAIN RESEARCH 2022; 2:759634. [PMID: 35295473 PMCID: PMC8915586 DOI: 10.3389/fpain.2021.759634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Functional Abdominal Pain (FAP) and Irritable Bowel Syndrome (IBS) are common recurrent abdominal pain diagnoses with the hallmark, lack of inflammation. To identify a biological signature for IBS/FAP in the colon, this study used genetic profiling to uncover gene expression changes associated with IBS/FAP and abdominal pain. Methods: Patients (8 to 17 years) newly diagnosed with IBS or FAP were enrolled in the study. At diagnostic colonoscopy, three rectal biopsies were collected, and gene expression analysis was performed using a Qiagen PCR Array. Relative fold difference in gene expression for 84 pain-associated genes was calculated using the 2-ΔΔ Cq method compared with pain-free controls. Factors affecting pain burden (Pain Burden Interview; PBI) were analyzed, including age, sex, rectal inflammation, and gene expression. Data were analyzed using multiple stepwise linear regression and 2-tailed t tests (P ≤ 0.05). Results: Of the 22 total patients in the study, 19 were diagnosed with either IBS-Constipation (frequency of 5.26%), IBS-Diarrhea (47.37%), IBS-Mixed (10.53%), or FAP (36.84%). IBS/FAP patients reported significantly higher pain burden at the time of diagnosis compared to pain-free controls (p < 0.001), as well as significantly higher abdominal pain (p = 0.01). Of the 84 genes, expression of GRIN1 (p = 0.02), MAPK3 (p = 0.04), P2X4 (p = 0.04), and PTGES3 (p = 0.02) were all significantly associated with PBI score. Discussion: Abdominal pain associated with IBS/FAP in pediatric patients may be linked to the expression of GRIN1, MAPK3, P2X4, and PTGES3, pointing to potential novel therapeutic targets for management of recurring abdominal pain.
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Affiliation(s)
- Adam B Willits
- Neuroscience Program, KU Medical Center, Kansas City, KS, United States
| | - Victoria Grossi
- Division of Digestive Diseases, Hepatology, and Nutrition, Connecticut Children's Medical Center, Hartford, CT, United States
| | - Nicole C Glidden
- Genetics and Genome Sciences, University of Connecticut School of Medicine, Farmington, CT, United States
| | - Jeffrey S Hyams
- Division of Digestive Diseases, Hepatology, and Nutrition, Connecticut Children's Medical Center, Hartford, CT, United States
| | - Erin E Young
- Neuroscience Program, KU Medical Center, Kansas City, KS, United States.,Genetics and Genome Sciences, University of Connecticut School of Medicine, Farmington, CT, United States.,Department of Anesthesiology, KU Medical Center, Kansas City, KS, United States
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24
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Choi C, Abougergi M, Peluso H, Weiss SH, Nasir U, Pyrsopoulos N. Cannabis Use is Associated With Reduced 30-Day All-cause Readmission Among Hospitalized Patients With Irritable Bowel Syndrome: A Nationwide Analysis. J Clin Gastroenterol 2022; 56:257-265. [PMID: 33471483 DOI: 10.1097/mcg.0000000000001498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 12/13/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Cannabinoid receptors are potential therapeutic targets in a variety of gastrointestinal tract disorders. The authors hypothesize that the use of cannabis use is associated with better control of symptoms associated with irritable bowel syndrome (IBS). This study aimed to examine the utilization of inpatient services by patients with IBS who did and did not report the use of cannabis. METHODS This is a retrospective cohort study that utilized the 2016 Nationwide Readmissions Database. Inclusion criteria included a principal diagnosis of IBS. The primary outcome was 30-day hospital readmission rates for IBS-specific causes. Secondary outcomes included the 30-day hospital readmission rates for all causes, resource utilization, and the 5 most common principal diagnoses and independent risk factors associated with readmission. RESULTS Of the 7163 patients with IBS identified in the National Readmission Database, 357 reported the use of cannabis. The 30-day IBS-specific readmission rates were 1.5% in patients who reported cannabis use and 1.1% in those who did not report cannabis use (P=0.53). Among the cannabis users, none of the variables evaluated served as a significant predictor of IBS-specific readmission; median income was a predictor for readmission among those who did not report cannabis use (odds ratio, 2.77; 95% confidence interval, 1.15-6.67; P=0.02). The 30-day readmission rates for all causes were 8.1% and 12.7% for patients who did and did not report cannabis use, respectively. After adjusting for confounders, the odds of 30-day readmission for all causes were lower among patients who reported cannabis use compared with those who did not (adjusted odds ratio, 0.53; 95% confidence interval, 0.28-0.99; P=0.04). The 5 most frequent diagnoses at readmission among patients who did not report cannabis use were enterocolitis because of Clostridioides difficile, IBS without diarrhea, sepsis, noninfective gastroenteritis and colitis, and acute kidney failure. By contrast, the 5 most frequent readmission diagnoses for cannabis users were cyclical vomiting, IBS with diarrhea, endometriosis, right upper quadrant abdominal pain, and nausea with vomiting. A discharge disposition of "against medical advice" was identified as an independent risk factor for 30-day hospital readmission for all causes among patients who reported cannabis use. By contrast, higher comorbidity scores and discharges with home health care were independent predictors of 30-day hospital readmission for all causes among patients who did not report cannabis use. Private insurance was an independent factor associated with lower rates of readmission for all causes among those who did not report cannabis use. CONCLUSION Our review of the National Readmission Database revealed no statistically significant differences in 30-day readmission rates for IBS-specific causes when comparing patients who reported cannabis use with those who did not. However, the authors found that cannabis use was associated with reduced 30-day hospital readmission rates for all causes.
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Affiliation(s)
| | - Marwan Abougergi
- Division of Gastroenterology, Department of Internal Medicine, University of South Carolina School of Medicine, Columbia
- Catalyst Medical Consulting, Simpsonville
| | - Heather Peluso
- Department of Surgery, Prisma Health Upstate, Greenville, SC
| | | | | | - Nikolaos Pyrsopoulos
- Department of Medicine
- Division of Gastroenterology and Hepatology, Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ
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25
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Electroacupuncture Alleviates Visceral Hypersensitivity in IBS-D Rats by Inhibiting EGCs Activity through Regulating BDNF/TrkB Signaling Pathway. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2497430. [PMID: 35198032 PMCID: PMC8860523 DOI: 10.1155/2022/2497430] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/17/2022] [Indexed: 02/05/2023]
Abstract
Objective To determine whether electroacupuncture (EA) could alleviate visceral hypersensitivity in diarrhea-predominant irritable bowel syndrome (IBS-D) rats by inhibiting EGCs activity via the BDNF/TrkB signaling pathway. Methods Sprague Dawley rats were randomly divided to a control group (n = 8) and a model preparation group (n = 32), which received Senna solution by gavage and CUMS (chronic unpredictable mild stress) for 14 consecutive days and was further divided to a Model group, an EA group (only electroacupuncture), an EA + TrkB agonist group (electroacupuncture and TrkB), and an EA + DMSO group (electroacupuncture and DMSO, n = 8 for each). Rats in the three EA groups were acupunctured at ST25, ST36, and LR3 for 20 min every day for 14 days. Abdominal withdrawal reflex (AWR) was used to quantify visceral sensitivity; reverse transcription polymerase chain reaction (RT-PCR) and double immunofluorescent staining were used to detect the colocalized expression of GFAP/BDNF and GFAP/TrkB. Western Blot (WB) was used to detect the expression of PLC and SP in the colon. Flow cytometry was used to detect the expression of Ca2+. Results EA effectively alleviated visceral hypersensitivity in IBS-D rats (P < 0.05). Compared to the control group, the expression of BDNF, TrkB, PLC, SP, and Ca2+ and the colocalized expression of GFAP/BDNF and GFAP/TrkB increased in the Model group (P < 0.05), while all these parameters decreased in the EA group following EA intervention (P < 0.05). In addition, no significant difference was found between the EA + TrkB agonist group and the control group (P > 0.05). Conclusions EA alleviates visceral hypersensitivity of IBS-D rats possibly by inhibiting the activity of EGCs through the BDNF/TrkB-PLC-Ca2+ signaling pathway in the colon.
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26
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Guo J, Chen L, Wang YH, Song YF, Zhao ZH, Zhao TT, Lin ZY, Gu DM, Liu YQ, Peng YJ, Pei LX, Sun JH. Electroacupuncture Attenuates Post-Inflammatory IBS-Associated Visceral and Somatic Hypersensitivity and Correlates With the Regulatory Mechanism of Epac1-Piezo2 Axis. Front Endocrinol (Lausanne) 2022; 13:918652. [PMID: 35865309 PMCID: PMC9294163 DOI: 10.3389/fendo.2022.918652] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/20/2022] [Indexed: 12/12/2022] Open
Abstract
Electroacupuncture (EA) is considered to have a therapeutic effect in the relief of irritable bowel syndrome (IBS)-associated visceral hypersensitivity via the reduction of the level of 5-hydroxytryptamine (5-HT) and 5-HT3 receptors (5-HT3R). However, whether Epac1/Piezo2, as the upstream of 5-HT, is involved in this process remains unclear. We investigated whether EA at the ST36 and ST37 acupoints alleviated visceral and somatic hypersensitivity in a post-inflammatory IBS (PI-IBS) model mice via the Epac1-Piezo2 axis. In this study, we used 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced PI-IBS as a mouse model. Visceral sensitivity was assessed by the abdominal withdrawal reflex test. Somatic sensitivity was evaluated by the hind paw withdrawal threshold. Quantitative real-time PCR, immunofluorescence staining, ELISA, and Western blotting were performed to examine the expressions of Epac1, Piezo2, 5-HT, and 5-HT3R from the mouse distal colon/L5-S2 dorsal root ganglia (DRG). Our results showed that EA improved the increased visceral sensation and peripheral mechanical hyperalgesia in PI-IBS model mice, and the effects of EA were superior to the sham EA. EA significantly decreased the protein and mRNA levels of Epac1 and Piezo2, and reduced 5-HT and 5-HT3R expressions in the distal colon. Knockdown of colonic Piezo2 eliminated the effect of EA on somatic hypersensitivity. Combined knockdown of colonic Epac1 and Piezo2 synergized with EA in relieving visceral hypersensitivity and blocked the effect of EA on somatic hypersensitivity. Additionally, protein levels of Epac1 and Piezo2 were also found to be decreased in the L5-S2 DRGs after EA treatment. Taken together, our study suggested that EA at ST36 and ST37 can alleviate visceral and somatic hypersensitivity in PI-IBS model mice, which is closely related to the regulation of the Epac1-Piezo2 axis.
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Affiliation(s)
- Jing Guo
- Department of Acupuncture and Rehabilitation, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Acupuncture and Massage College, Health and Rehabilitation College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Lu Chen
- Department of Acupuncture and Rehabilitation, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yu-hang Wang
- Acupuncture and Massage College, Health and Rehabilitation College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ya-fang Song
- Acupuncture and Massage College, Health and Rehabilitation College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhan-hao Zhao
- Department of Massage, Danyang Hospital of Traditional Chinese Medicine, Danyang, China
| | - Ting-ting Zhao
- Department of Acupuncture and Rehabilitation, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhi-ying Lin
- Department of Acupuncture and Rehabilitation, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Dong-mei Gu
- Department of Acupuncture, Nantong Hospital of Traditional Chinese Medicine, Nantong, China
| | - Yun-qi Liu
- Nanjing Foreign Language School, Nanjing, China
| | - Yong-jun Peng
- Department of Acupuncture and Rehabilitation, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- *Correspondence: Yong-jun Peng, ; Li-xia Pei, ; Jian-hua Sun,
| | - Li-xia Pei
- Department of Acupuncture and Rehabilitation, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- *Correspondence: Yong-jun Peng, ; Li-xia Pei, ; Jian-hua Sun,
| | - Jian-hua Sun
- Department of Acupuncture and Rehabilitation, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- *Correspondence: Yong-jun Peng, ; Li-xia Pei, ; Jian-hua Sun,
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27
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Choudhary A, Fikree A, Aziz Q. Overlap between irritable bowel syndrome and hypermobile Ehlers-Danlos syndrome: An unexplored clinical phenotype? AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2021; 187:561-569. [PMID: 34741491 DOI: 10.1002/ajmg.c.31938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 12/11/2022]
Abstract
Irritable bowel syndrome (IBS) is common, but its cause remains unknown. IBS patients present with gastrointestinal (GI) symptoms such as abdominal pain with altered bowel habits; however, some patients also have non-GI symptoms including muscle and joint pains. It is thus plausible that within large IBS cohorts, subgroups exist with distinct clinical phenotypes. Yet, these subgroups have not been clearly identified or characterized. Due to lack of segmentation, treatment-focused symptomatic management is similar for all with IBS and follows indiscriminate algorithms regardless of possible differing clinical phenotype. This universal approach to IBS management may account for the reported lack of efficacy of treatment. One emerging subgroup receiving increasing attention is that with overlap IBS and the underlying heritable connective tissue disorder, hypermobile Ehlers-Danlos syndrome (hEDS). Current evidence suggests that up to 62% of patients with hEDS suffer from IBS. However, despite recognition of the presence of IBS in hEDS, this overlap IBS/hEDS group has not been characterized and these patients are managed in a similar way to those with IBS alone. Future studies are required to characterize and deep phenotype in this overlap IBS/hEDS group.
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Affiliation(s)
- Anisa Choudhary
- Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Wingate Institute of Neurogastroenterology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Asma Fikree
- Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Wingate Institute of Neurogastroenterology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Qasim Aziz
- Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Wingate Institute of Neurogastroenterology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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28
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Abstract
Glia, the non-neuronal cells of the nervous system, were long considered secondary cells only necessary for supporting the functions of their more important neuronal neighbors. Work by many groups over the past two decades has completely overturned this notion, revealing the myriad and vital functions of glia in nervous system development, plasticity, and health. The largest population of glia outside the brain is in the enteric nervous system, a division of the autonomic nervous system that constitutes a key node of the gut-brain axis. Here, we review the latest in the understanding of these enteric glia in mammals with a focus on their putative roles in human health and disease.
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Affiliation(s)
- Harry J. Rosenberg
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
- Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Meenakshi Rao
- Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115, USA
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29
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Dhingra R, Bascom R, Thompson E, Francomano CA, Schubart JR. Gastrointestinal medication burden among persons with the Ehlers-Danlos syndromes. Neurogastroenterol Motil 2021; 33:e14077. [PMID: 33393191 DOI: 10.1111/nmo.14077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/04/2020] [Accepted: 12/14/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND The Ehlers-Danlos syndromes (EDSs) are a group of heritable disorders of connective tissue associated with an increased prevalence of both structural and functional GI conditions. METHODS We used 10 years (2005-2014) of administrative claims data comprised of 4294 people with clinician-diagnosed EDS, aged 5-62 years, and compared their frequency of GI drug prescription claims to their age-, sex-, state of residence-, and earliest claim date-matched controls. We categorized the GI medications into the following groups: acid suppressants, anti-emetics, irritable bowel syndrome drugs, and visceral hypersensitivity (VHS) medications. KEY RESULTS Compared to controls, a significantly higher proportion of persons with EDS had prescription claims for at least one GI drug group, as well as for drugs in each of the four GI drug groups included in our study. By age-group, 25.7% children and 45.1% adults with EDS had prescription claims for at least one GI drug group compared with only 7.4% and 21.0% of controls, respectively (p < 0.0001). By gender, 44.0% of women and 25.3% of men with EDS had prescription claims for at least one class of GI drugs compared with 19.2% and 9.6% of controls, respectively (p < 0.0001). CONCLUSIONS AND KEY INFERENCES Predominant medication burden occurs among women with EDS, beginning peri-pubertally for anti-emetics and VHS drugs. High GI medication burden underscores previous evidence that GI dysmotility is common among persons with EDS.
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Affiliation(s)
- Radha Dhingra
- Department of Public Health Sciences, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Rebecca Bascom
- Department of Public Health Sciences, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA.,Department of Medicine, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Elizabeth Thompson
- Department of Medicine, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Clair A Francomano
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jane R Schubart
- Department of Public Health Sciences, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA.,Department of Surgery, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
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30
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Lajoie F, Rousseau G, Blanquet-Diot S, Etienne-Mesmin L. [Irritable bowel syndrome: Role of gut microbiota]. Med Sci (Paris) 2021; 37:593-600. [PMID: 34180818 DOI: 10.1051/medsci/2021095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Irritable Bowel Syndrome (IBS) is a functional disorder of the gastrointestinal tract with high prevalence. IBS, in particular the diarrheic subtype, is associated with alterations in gut microbiota composition and functionality, called dysbiosis. However, the treatment of this disease mainly relies on the patient's symptoms without considering the gut microbiota perturbations. In this review, we present epidemiological data about IBS-D. Then, we describe the main pathophysiological mechanisms associated with this disease, by focusing on gut microbiota alterations. We end up discussing the current therapies now available.
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Affiliation(s)
- Frédérique Lajoie
- Département de pharmacologie et physiologie, Faculté de médecine, université de Montréal, CP 6128 - Succursale Centre-ville, H3C 3J7 Montréal (Québec), Canada
| | - Guy Rousseau
- Département de pharmacologie et physiologie, Faculté de médecine, université de Montréal, CP 6128 - Succursale Centre-ville, H3C 3J7 Montréal (Québec), Canada
| | - Stéphanie Blanquet-Diot
- Université Clermont Auvergne, INRAe, UMR454 MEDIS (microbiologie, environnement digestif et santé), 28 place Henri-Dunant, 63000, Clermont-Ferrand, France
| | - Lucie Etienne-Mesmin
- Université Clermont Auvergne, INRAe, UMR454 MEDIS (microbiologie, environnement digestif et santé), 28 place Henri-Dunant, 63000, Clermont-Ferrand, France
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Evidence for Somatic Hypersensitivity in Veterans With Gulf War Illness and Gastrointestinal Symptoms. Clin J Pain 2019; 34:944-949. [PMID: 29570102 DOI: 10.1097/ajp.0000000000000611] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Over 25% of Persian Gulf War (PGW) veterans with Gulf War Illness (GWI) (chronic health symptoms of undetermined etiology) developed gastrointestinal (GI) (diarrhea and abdominal pain) and other somatic symptoms. OBJECTIVES Our study objective was to determine if veterans with GWI and GI symptoms exhibit heightened patterns of somatic pain perception (hypersensitivity) across nociceptive stimuli modalities. METHODS Participants were previously deployed GW Veterans with GWI and GI symptoms (n=53); veterans with GWI without GI symptom (n=47); and veteran controls (n=38). We determined pain thresholds for contact thermal, cold pressor, and ischemic stimuli. RESULTS Veterans with GWI and GI symptoms showed lower pain thresholds (P<0.001) for each stimulus. There was also overlap of somatic hypersensitivities among veterans with GI symptoms with 20% having hypersensitivity to all 3 somatic stimuli. Veterans with GWI and GI symptoms also showed a significant correlation between mechanical visual analog scale abdominal pain ratings and heat pain threshold, cold pressor threshold, and ischemic pain threshold/tolerance. DISCUSSION Our findings show that there is widespread somatic hypersensitivity in veterans with GWI/GI symptoms that is positively correlated with abdominal pain ratings. In addition, veterans with somatic hypersensitivity that overlap have the greatest number of extraintestinal symptoms. These findings may have a translational benefit: strategies for developing more effective therapeutic agents that can reduce and/or prevent somatic and GI symptoms in veterans deployed to future military conflicts.
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Abstract
BACKGROUND Well over 700,000 United States military personnel participated in the Persian Gulf War in which they developed chronic health disorders of undetermined etiology. Up to 25% of Veterans had persistent and chronic gastrointestinal (GI) symptoms, which they suspected were related to their military service in the Gulf. AIM The overall aim of the current study was to evaluate intestinal permeability in previously deployed Gulf War Veterans who developed chronic GI symptoms during their tour in the Persian Gulf. METHODS To accomplish this, we evaluated intestinal permeability (IP) using the urinary lactulose/mannitol test. Measurements of intestinal permeability were then correlated with mean ratings of daily abdominal pain, frequency of bowel movements, and consistency of bowel movements on the Bristol Stool Scale in all Veterans. RESULTS A total of 73 veterans had documented chronic GI symptoms (diarrhea, abdominal pain) and were included in the study. A total of 29/73 (39%) of veterans has increased IP and had a higher average daily stool frequency (P<0.05); increased liquid stools as indicated by a higher Bristol Stool Scale (P<0.01); and a higher mean M-VAS abdominal pain rating (P<0.01). Pearson correlation coefficients revealed that there was a positive correlation between increased IP and stool frequency, Bristol Stool Scale, and M-VAS abdominal pain rating. CONCLUSIONS Our study demonstrates that deployed Gulf War Veterans with persistent GI symptoms commonly have increased intestinal permeability that potentiates the severity of abdominal pain, diarrhea, and stool consistency. These new findings in our study are important as they may lead to novel diagnostic biomarkers for returning Gulf War Veterans who suffer from chronic functional gastrointestinal disorders. These advances are also important for an increasing number of veterans who are now serving in the Persian Gulf and are at a high risk of developing these chronic pain disorders.
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Smith-Edwards KM, Najjar SA, Edwards BS, Howard MJ, Albers KM, Davis BM. Extrinsic Primary Afferent Neurons Link Visceral Pain to Colon Motility Through a Spinal Reflex in Mice. Gastroenterology 2019; 157:522-536.e2. [PMID: 31075226 PMCID: PMC6995031 DOI: 10.1053/j.gastro.2019.04.034] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/08/2019] [Accepted: 04/22/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND & AIMS Proper colon function requires signals from extrinsic primary afferent neurons (ExPANs) located in spinal ganglia. Most ExPANs express the vanilloid receptor TRPV1, and a dense plexus of TRPV1-positive fibers is found around myenteric neurons. Capsaicin, a TRPV1 agonist, can initiate activity in myenteric neurons and produce muscle contraction. ExPANs might therefore form motility-regulating synapses onto myenteric neurons. ExPANs mediate visceral pain, and myenteric neurons mediate colon motility, so we investigated communication between ExPANs and myenteric neurons and the circuits by which ExPANs modulate colon function. METHODS In live mice and colon tissues that express a transgene encoding the calcium indicator GCaMP, we visualized levels of activity in myenteric neurons during smooth muscle contractions induced by application of capsaicin, direct colon stimulation, stimulation of ExPANs, or stimulation of preganglionic parasympathetic neuron (PPN) axons. To localize central targets of ExPANs, we optogenetically activated TRPV1-expressing ExPANs in live mice and then quantified Fos immunoreactivity to identify activated spinal neurons. RESULTS Focal electrical stimulation of mouse colon produced phased-locked calcium signals in myenteric neurons and produced colon contractions. Stimulation of the L6 ventral root, which contains PPN axons, also produced myenteric activation and contractions that were comparable to those of direct colon stimulation. Surprisingly, capsaicin application to the isolated L6 dorsal root ganglia, which produced robust calcium signals in neurons throughout the ganglion, did not activate myenteric neurons. Electrical activation of the ganglia, which activated even more neurons than capsaicin, did not produce myenteric activation or contractions unless the spinal cord was intact, indicating that a complete afferent-to-efferent (PPN) circuit was necessary for ExPANs to regulate myenteric neurons. In TRPV1-channel rhodopsin-2 mice, light activation of ExPANs induced a pain-like visceromotor response and expression of Fos in spinal PPN neurons. CONCLUSIONS In mice, ExPANs regulate myenteric neuron activity and smooth muscle contraction via a parasympathetic spinal circuit, linking sensation and pain to motility.
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Affiliation(s)
- Kristen M. Smith-Edwards
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania,Pittsburgh Center for Pain Research, University of Pittsburgh, Pittsburgh, Pennsylvania,Center for Neuroscience at the University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sarah A. Najjar
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania,Pittsburgh Center for Pain Research, University of Pittsburgh, Pittsburgh, Pennsylvania,Center for Neuroscience at the University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Brian S. Edwards
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania,Pittsburgh Center for Pain Research, University of Pittsburgh, Pittsburgh, Pennsylvania,Center for Neuroscience at the University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Kathryn M. Albers
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania,Pittsburgh Center for Pain Research, University of Pittsburgh, Pittsburgh, Pennsylvania,Center for Neuroscience at the University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Brian M. Davis
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania,Pittsburgh Center for Pain Research, University of Pittsburgh, Pittsburgh, Pennsylvania,Center for Neuroscience at the University of Pittsburgh, Pittsburgh, Pennsylvania
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Zhou Q, Verne ML, Fields JZ, Lefante JJ, Basra S, Salameh H, Verne GN. Randomised placebo-controlled trial of dietary glutamine supplements for postinfectious irritable bowel syndrome. Gut 2019; 68:996-1002. [PMID: 30108163 PMCID: PMC9549483 DOI: 10.1136/gutjnl-2017-315136] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 07/19/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND More effective treatments are needed for patients with postinfectious, diarrhoea-predominant, irritable bowel syndrome (IBS-D). Accordingly, we conducted a randomised, double-blind, placebo-controlled, 8-week-long trial to assess the efficacy and safety of oral glutamine therapy in patients who developed IBS-D with increased intestinal permeability following an enteric infection. METHODS Eligible adults were randomised to glutamine (5 g/t.i.d.) or placebo for 8 weeks. The primary end point was a reduction of ≥50 points on the Irritable Bowel Syndrome Severity Scoring System (IBS-SS). Secondary endpoints included: raw IBS-SS scores, changes in daily bowel movement frequency, stool form (Bristol Stool Scale) and intestinal permeability. RESULTS Fifty-four glutamine and 52 placebo subjects completed the 8-week study. The primary endpoint occurred in 43 (79.6%) in the glutamine group and 3 (5.8%) in the placebo group (a 14-fold difference). Glutamine also reduced all secondary endpoint means: IBS-SS score at 8 weeks (301 vs 181, p<0.0001), daily bowel movement frequency (5.4 vs 2.9±1.0, p<0.0001), Bristol Stool Scale (6.5 vs 3.9, p<0.0001) and intestinal permeability (0.11 vs 0.05; p<0.0001). 'Intestinal hyperpermeability' (elevated urinary lactulose/mannitol ratios) was normalised in the glutamine but not the control group. Adverse events and rates of study-drug discontinuation were low and similar in the two groups. No serious adverse events were observed. CONCLUSIONS In patients with IBS-D with intestinal hyperpermeability following an enteric infection, oral dietary glutamine supplements dramatically and safely reduced all major IBS-related endpoints. Large randomised clinical trials (RCTs) should now be done to validate these findings, assess quality of life benefits and explore pharmacological mechanisms. TRIAL REGISTRATION NUMBER NCT01414244; Results.
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Affiliation(s)
- QiQi Zhou
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA,Department of Veteran Affairs, Malcom Randall VAMC, Gainesville, FL
| | | | - Jeremy Z. Fields
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA
| | - John J. Lefante
- Department of Global Biostatistics and Data Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Sarpreet Basra
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA
| | - Habeeb Salameh
- Department of Medicine, University of Texas Medical Branch, Galveston, TX
| | - G. Nicholas Verne
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA
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Abstract
Beyond their well-known role in embryonic development of the central and peripheral nervous system, neurotrophins, particularly nerve growth factor and brain-derived neurotrophic factor, exert an essential role in pain production and sensitization. This has mainly been studied within the framework of somatic pain, and even antibodies (tanezumab and fasinumab) have recently been developed for their use in chronic somatic painful conditions, such as osteoarthritis or low back pain. However, data suggest that neurotrophins also exert an important role in the occurrence of visceral pain and visceral sensitization. Visceral pain is a distressing symptom that prompts many consultations and is typically encountered in both 'organic' (generally inflammatory) and 'functional' (displaying no obvious structural changes in routine clinical evaluations) disorders of the gut, such as inflammatory bowel disease and irritable bowel syndrome, respectively. The present review provides a summary of neurotrophins as a molecular family and their role in pain in general and addresses recent investigations of the involvement of nerve growth factor and brain-derived neurotrophic factor in visceral pain, particularly that associated with inflammatory bowel disease and irritable bowel syndrome.
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Zhu H, Xiao X, Chai Y, Li D, Yan X, Tang H. MiRNA-29a modulates visceral hyperalgesia in irritable bowel syndrome by targeting HTR7. Biochem Biophys Res Commun 2019; 511:671-678. [DOI: 10.1016/j.bbrc.2019.02.126] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 02/23/2019] [Indexed: 02/06/2023]
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Siri S, Maier F, Chen L, Santos S, Pierce DM, Feng B. Differential biomechanical properties of mouse distal colon and rectum innervated by the splanchnic and pelvic afferents. Am J Physiol Gastrointest Liver Physiol 2019; 316:G473-G481. [PMID: 30702901 PMCID: PMC6483024 DOI: 10.1152/ajpgi.00324.2018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Visceral pain is one of the principal complaints of patients with irritable bowel syndrome, and this pain is reliably evoked by mechanical distension and stretch of distal colon and rectum (colorectum). This study focuses on the biomechanics of the colorectum that could play critical roles in mechanical neural encoding. We harvested the distal 30 mm of the colorectum from mice, divided evenly into three 10-mm-long segments (colonic, intermediate and rectal), and conducted biaxial mechanical stretch tests and opening-angle measurements for each tissue segment. In addition, we determined the collagen fiber orientations and contents across the thickness of the colorectal wall by nonlinear imaging via second harmonic generation (SHG). Our results reveal a progressive increase in tissue compliance and prestress from colonic to rectal segments, which supports prior electrophysiological findings of distinct mechanical neural encodings by afferents in the lumbar splanchnic nerves (LSN) and pelvic nerves (PN) that dominate colonic and rectal innervations, respectively. The colorectum is significantly more viscoelastic in the circumferential direction than in the axial direction. In addition, our SHG results reveal a rich collagen network in the submucosa and orients approximately ±30° to the axial direction, consistent with the biaxial test results presenting almost twice the stiffness in axial direction versus the circumferential direction. Results from current biomechanical study strongly indicate the prominent roles of local tissue biomechanics in determining the differential mechanical neural encoding functions in different regions of the colorectum. NEW & NOTEWORTHY Mechanical distension and stretch-not heat, cutting, or pinching-reliably evoke pain from distal colon and rectum. We report different local mechanics along the longitudinal length of the colorectum, which is consistent with the existing literature on distinct mechanotransduction of afferents innervating proximal and distal regions of the colorectum. This study draws attention to local mechanics as a potential determinant factor for mechanical neural encoding of the colorectum, which is crucial in visceral nociception.
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Affiliation(s)
- Saeed Siri
- 1Department of Biomedical Engineering, University of Connecticut, Storrs, Connecticut
| | - Franz Maier
- 2Department of Mechanical Engineering, University of Connecticut, Storrs, Connecticut
| | - Longtu Chen
- 1Department of Biomedical Engineering, University of Connecticut, Storrs, Connecticut
| | - Stephany Santos
- 2Department of Mechanical Engineering, University of Connecticut, Storrs, Connecticut
| | - David M. Pierce
- 1Department of Biomedical Engineering, University of Connecticut, Storrs, Connecticut,2Department of Mechanical Engineering, University of Connecticut, Storrs, Connecticut
| | - Bin Feng
- 1Department of Biomedical Engineering, University of Connecticut, Storrs, Connecticut
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Zhang Y, Qin G, Liu DR, Wang Y, Yao SK. Increased expression of brain-derived neurotrophic factor is correlated with visceral hypersensitivity in patients with diarrhea-predominant irritable bowel syndrome. World J Gastroenterol 2019; 25:269-281. [PMID: 30670915 PMCID: PMC6337018 DOI: 10.3748/wjg.v25.i2.269] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 12/03/2018] [Accepted: 12/13/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Visceral hypersensitivity is considered to play a vital role in the pathogenesis of irritable bowel syndrome (IBS). Neurotrophins have drawn much attention in IBS recently. Brain-derived neurotrophic factor (BDNF) was found to mediate visceral hypersensitivity via facilitating sensory nerve growth in pre-clinical studies. We hypothesized that BDNF might play a role in the pathogenesis of diarrhea-predominant IBS (IBS-D).
AIM To investigate BDNF levels in IBS-D patients and its role in IBS-D pathophysiology.
METHODS Thirty-one IBS-D patients meeting the Rome IV diagnostic criteria and 20 age- and sex-matched healthy controls were recruited. Clinical and psychological assessments were first conducted using standardized questionnaires. Visceral sensitivity to rectal distension was tested using a high-resolution manometry system. Colonoscopic examination was performed and four mucosal pinch biopsies were taken from the rectosigmoid junction. Mucosal BDNF expression and nerve fiber density were analyzed using immunohistochemistry. Mucosal BDNF mRNA levels were quantified by quantitative real-time polymerase chain reaction. Correlations between these parameters were examined.
RESULTS The patients had a higher anxiety score [median (interquartile range), 6.0 (2.0-10.0) vs 3.0 (1.0-4.0), P = 0.003] and visceral sensitivity index score [54.0 (44.0-61.0) vs 21.0 (17.3-30.0), P < 0.001] than controls. The defecating sensation threshold [60.0 (44.0-80.0) vs 80.0 (61.0-100.0), P = 0.009], maximum tolerable threshold [103.0 (90.0-128.0) vs 182.0 (142.5-209.3), P < 0.001] and rectoanal inhibitory reflex threshold [30.0 (20.0-30.0) vs 30.0 (30.0-47.5), P = 0.032] were significantly lower in IBS-D patients. Intestinal mucosal BDNF protein [3.46E-2 (3.06E-2-4.44E-2) vs 3.07E-2 (2.91E-2-3.48E-2), P = 0.031] and mRNA [1.57 (1.31-2.61) vs 1.09 (0.74-1.42), P = 0.001] expression and nerve fiber density [4.12E-2 (3.07E-2-7.46E-2) vs 1.98E-2 (1.21E-2-4.25E-2), P = 0.002] were significantly elevated in the patients. Increased BDNF expression was positively correlated with abdominal pain and disease severity and negatively correlated with visceral sensitivity parameters.
CONCLUSION Elevated mucosal BDNF may participate in the pathogenesis of IBS-D via facilitating mucosal nerve growth and increasing visceral sensitivity.
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Affiliation(s)
- Yu Zhang
- Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Geng Qin
- Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
| | - De-Rong Liu
- Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Yan Wang
- Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
- Beijing Key Laboratory for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing 100029, China
| | - Shu-Kun Yao
- Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
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Goichon A, Bahlouli W, Ghouzali I, Chan P, Vaudry D, Déchelotte P, Ducrotté P, Coëffier M. Colonic Proteome Signature in Immunoproteasome-Deficient Stressed Mice and Its Relevance for Irritable Bowel Syndrome. J Proteome Res 2018; 18:478-492. [DOI: 10.1021/acs.jproteome.8b00793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Alexis Goichon
- INSERM unit 1073, Normandie University, UNIROUEN, 22 boulevard Gambetta, Rouen, F-76183, France
- Institute for Research and Innovation in Biomedicine (IRIB), Normandie University, UNIROUEN, Rouen, F-76183, France
| | - Wafa Bahlouli
- INSERM unit 1073, Normandie University, UNIROUEN, 22 boulevard Gambetta, Rouen, F-76183, France
- Institute for Research and Innovation in Biomedicine (IRIB), Normandie University, UNIROUEN, Rouen, F-76183, France
| | - Ibtissem Ghouzali
- INSERM unit 1073, Normandie University, UNIROUEN, 22 boulevard Gambetta, Rouen, F-76183, France
- Institute for Research and Innovation in Biomedicine (IRIB), Normandie University, UNIROUEN, Rouen, F-76183, France
| | - Philippe Chan
- Institute for Research and Innovation in Biomedicine (IRIB), Normandie University, UNIROUEN, Rouen, F-76183, France
- Platform in proteomics PISSARO, Normandie University, UNIROUEN, Rouen, F-76821, France
| | - David Vaudry
- Institute for Research and Innovation in Biomedicine (IRIB), Normandie University, UNIROUEN, Rouen, F-76183, France
- Platform in proteomics PISSARO, Normandie University, UNIROUEN, Rouen, F-76821, France
- INSERM unit 1239, Normandie University, UNIROUEN, Rouen, F-76821, France
| | - Pierre Déchelotte
- INSERM unit 1073, Normandie University, UNIROUEN, 22 boulevard Gambetta, Rouen, F-76183, France
- Institute for Research and Innovation in Biomedicine (IRIB), Normandie University, UNIROUEN, Rouen, F-76183, France
- Nutrition Department, Rouen University Hospital, Rouen, F-76031, France
| | - Philippe Ducrotté
- INSERM unit 1073, Normandie University, UNIROUEN, 22 boulevard Gambetta, Rouen, F-76183, France
- Institute for Research and Innovation in Biomedicine (IRIB), Normandie University, UNIROUEN, Rouen, F-76183, France
- Gastroenterology Department, Rouen University Hospital, Rouen, F-76031, France
| | - Moïse Coëffier
- INSERM unit 1073, Normandie University, UNIROUEN, 22 boulevard Gambetta, Rouen, F-76183, France
- Institute for Research and Innovation in Biomedicine (IRIB), Normandie University, UNIROUEN, Rouen, F-76183, France
- Nutrition Department, Rouen University Hospital, Rouen, F-76031, France
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Fifi AC, Axelrod CH, Chakraborty P, Saps M. Herbs and Spices in the Treatment of Functional Gastrointestinal Disorders: A Review of Clinical Trials. Nutrients 2018; 10:nu10111715. [PMID: 30423929 PMCID: PMC6266883 DOI: 10.3390/nu10111715] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 10/29/2018] [Accepted: 11/01/2018] [Indexed: 02/08/2023] Open
Abstract
More than fifty percent of all new patient visits to pediatric gastroenterology clinics consult for functional abdominal pain disorders (FAPDs). In 2005, a technical report of the American Academy of Pediatrics and the North American Pediatric Gastroenterology, Hepatology and Nutrition society (NASPGHAN) found limited or inconclusive evidence for most therapeutic interventions for this group of disorders. The report did not include studies on herbs and spices. Since then, there has been an increasing interest in the use of complementary and alternative medicine (CAM) for the treatment of chronic pain disorders in children. About 40% of parents of pediatric gastroenterology patients have utilized CAM. This review evaluated the published literature on the effectiveness of CAM, specifically the use of herbs and spices, for the treatment of FAPDs. We found little evidence for most of the commonly used herbs and spices. Despite its common use, research on the efficacy, safety, and optimal dosage remains limited. There is evidence to suggest the benefit of peppermint oil and STW 5 for the treatment of FAPDs in children. The paucity of data on most therapies underscores the need for large clinical trials to assess their efficacy.
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Affiliation(s)
- Amanda C Fifi
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Miami Miller School of Medicine, Miami, FL 33137, USA.
| | - Cara Hannah Axelrod
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Miami Miller School of Medicine, Miami, FL 33137, USA.
| | - Partha Chakraborty
- Jackson Memorial Pediatric Residency Program/University of Miami Miller School of Medicine, Miami, FL 33136, USA.
| | - Miguel Saps
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Miami Miller School of Medicine, Miami, FL 33137, USA.
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Lin MJ, Yu BP. Role of High-affinity Choline Transporter 1 in Colonic Hypermotility in a Rat Model of Irritable Bowel Syndrome. J Neurogastroenterol Motil 2018; 24:643-655. [PMID: 30347940 PMCID: PMC6175564 DOI: 10.5056/jnm18040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 07/13/2018] [Accepted: 07/31/2018] [Indexed: 12/13/2022] Open
Abstract
Background/Aims Irritable bowel syndrome (IBS) is a common disease characterized by intestinal dysmotility, the mechanism of which remains elusive. We aim to determine whether the high-affinity choline transporter 1 (CHT1), a determinant of cholinergic signaling capacity, modulates intestinal motility associated with stress-induced IBS. Methods A rat IBS model was established using chronic water avoidance stress (WAS). Colonic pathological alterations were evaluated histologically and intestinal motility was assessed by intestinal transit time and fecal water content (FWC). Visceral sensitivity was determined by visceromotor response to colorectal distension. RT-PCR, western blotting, and immunostaining were performed to identify colonic CHT1 expression. Contractility of colonic muscle strips was measured using isometric transducers. enzyme-linked immunosorbent assay was used to measure acetylcholine (ACh). We examined the effects of MKC-231, a choline uptake enhancer, on colonic motility. Results After 10 days of WAS, intestinal transit time was decreased and fecal water content increased. Visceromotor response magnitude in WAS rats in response to colorectal distension was significantly enhanced. Protein and mRNA CHT1 levels in the colon were markedly elevated after WAS. The density of CHT1-positive intramuscular interstitial cells of Cajal and myenteric plexus neurons in WAS rats was higher than in controls. Ammonium pyrrolidine dithiocarbamate partly reversed CHT1 upregulation and alleviated colonic hypermotility in WAS rats. Pharmacological enhancement of CHT1 activity by MKC-231 enhanced colonic motility in control rats via upregulation of CHT1 and elevation of ACh production. Conclusion Upregulation of CHT1 in intramuscular interstitial cells of Cajal and myenteric plexus neurons is implicated in chronic stress-induced colonic hypermotility by modulation of ACh synthesis via nuclear factor-kappa B signaling.
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Affiliation(s)
- Meng-Juan Lin
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.,Key Laboratory of Hubei Province for Digestive System Diseases, Wuhan, Hubei, China
| | - Bao-Ping Yu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.,Key Laboratory of Hubei Province for Digestive System Diseases, Wuhan, Hubei, China
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Chao G, Wang Y, Ye F, Zhang S. Regulation of Colonic Mucosal MicroRNA Expression via Multiple Targets in Visceral Hypersensitivity Rats by Tongxieyaofang. Yonsei Med J 2018; 59:945-950. [PMID: 30187701 PMCID: PMC6127421 DOI: 10.3349/ymj.2018.59.8.945] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/30/2018] [Accepted: 08/02/2018] [Indexed: 02/07/2023] Open
Abstract
PURPOSE This study aimed to screen for differentially expressed microRNAs (miRNAs) in the colons of rats with visceral hypersensitivity to build the expression profiles of miRNAs therein and to determine the mechanism of Tongxieyaofang use in the treatment of irritable bowel syndrome (IBS). MATERIALS AND METHODS Forty Sprague-Dawley rats were divided randomly into four groups: control group, model control group (induced by rectum stimulus and evaluated by abdominal withdraw reaction), treatment control group (normal saline), and Tongxieyaofang group (treated with Tongxieyaofang). We screened for differential expression of colonic mucosal miRNAs using liquid chip technology and verified the expression thereof using reverse transcription-PCR. RESULTS The visceral hypersensitivity rat model was successfully established. We found the expression of let-7f, let-7i, miR-130b, miR-29a, miR-132, miR-21, and miR-375 to be up-regulated (p<0.05), while the expression of miR-24, miR-31a, miR-192, miR-221, and miR-223 was down-regulated (p<0.05) in the visceral hypersensitivity rats. After treatment with Tongxieyaofang, the expression of let-7f, let-7i, miR-130b, miR-29a, miR-132, miR-21, and miR-375 was reduced (p<0.05), whereas the expression of miR-24, miR-31a, miR-192, miR-221, miR-223 was increased, compared to the treatment control group (p<0.05). CONCLUSION MiRNAs play a pivotal role in visceral hypersensitivity and might be targets in the treatment of IBS by Tongxieyaofang.
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Affiliation(s)
- Guanqun Chao
- Department of Family Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Yingying Wang
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Fangxu Ye
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Shuo Zhang
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China.
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Lin MJ, Yu BP. Upregulation of the high-affinity choline transporter in colon relieves stress-induced hyperalgesia. J Pain Res 2018; 11:1971-1982. [PMID: 30288092 PMCID: PMC6160269 DOI: 10.2147/jpr.s164186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Irritable bowel syndrome (IBS) is a common disease with hyperalgesia, the mechanisms of which remain elusive. The cholinergic system is known to be involved in pain inhibitory pathways in multiple diseases, and its involvement in IBS is unknown. Objective We aimed to determine whether high-affinity choline transporter CHT1, a major determinant of the cholinergic signaling capacity, is involved in regulating intestinal sensations associated with stress-induced visceral pain. Materials and methods An IBS rat model was established by chronic water avoidance stress (WAS). Colonic pathologic alterations were detected by H&E staining. Visceral sensations were determined by scoring the abdominal withdrawal reflex (AWR) and visceromotor response (VMR) magnitude of the electromyogram in response to colorectal distension (CRD). Abdominal mechanical hyperalgesia was assessed by counting the number of withdrawal events evoked by applying von Frey filaments. Real-time PCR, Western blot, and immunostaining were performed to identify CHT1 expression in the colon. Acetylcholine (ACh) secretion was determined by ELISA. Effects of MKC-231, a choline uptake enhancer, on visceral pain were examined. Results After 10 days of WAS exposure, AWR score and VMR magnitude in response to CRD were significantly enhanced and the number of withdrawal events was elevated. Protein and mRNA levels of CHT1 were considerably increased in the colon after WAS. CHT1 upregulation in the WAS-exposed group was largely abolished by ammonium pyrrolidinedithiocarbamate. The density of CHT1-positive intramuscular cells and enteric neurons in the myenteric plexus was enhanced in WAS-exposed rats. Pharmacologic enhancement of CHT1 activity by MKC-231 gavage could relieve the visceral pain of WAS rats by upregulating CHT1 protein expression and enhancing ACh production. Conclusion CHT1 may exert an antinociceptive effect in stress-induced visceral pain by modulating ACh synthesis through nuclear factor kappa B signaling. MKC-231 could be used as a potential drug to treat disorders with hyperalgesia.
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Affiliation(s)
- Meng-Juan Lin
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China, .,Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, Hubei, China,
| | - Bao-Ping Yu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China, .,Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, Hubei, China,
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Mohammadi EN, Ligon CO, Silos-Santiago A, Ge P, Kurtz C, Higgins C, Hannig G, Greenwood-Van Meerveld B. Linaclotide Attenuates Visceral Organ Crosstalk: Role of Guanylate Cyclase-C Activation in Reversing Bladder-Colon Cross-Sensitization. J Pharmacol Exp Ther 2018; 366:274-281. [PMID: 29784661 DOI: 10.1124/jpet.118.248567] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 03/21/2018] [Indexed: 12/15/2022] Open
Abstract
Bladder pain syndrome (BPS) is poorly understood; however, there is a female predominance and comorbidity with irritable bowel syndrome (IBS). Here we test the hypothesis that linaclotide, a guanylate cyclase-C (GC-C) agonist approved for the treatment of IBS with constipation (IBS-C), may represent a novel therapeutic for BPS acting through a mechanism involving an inhibition of visceral organ cross-sensitization. We showed previously that infusion of dilute protamine sulfate (PS) into the bladder increased sensitivity and permeability in the bladder and colon. PS was infused into the bladder of female rats; sensitivity was assessed via application of von Frey filaments applied to the suprapubic area and the frequency of withdrawal responses was recorded. Colonic sensitivity was measured via visceromotor behavioral response to graded pressures of colorectal distension (CRD). Permeability was measured in vitro via transepithelial electrical resistance (TEER) and conductance (G). Linaclotide (3 µg/kg, p.o.) or vehicle was administered daily for 7 days prior to experiments. Rats treated with PS bladder infusion exhibited visceral hyperalgesia, as shown by a significantly higher response frequency to individual von Frey filaments and increased behavioral responses to CRD. Linaclotide attenuated bladder and colonic hyperalgesia to control levels. PS infusion into the bladder increased bladder and colon permeability measured as a decrease in TEER and increased G. Linaclotide significantly inhibited PS-induced colonic hyperpermeability while having no effect on bladder hyperpermeability. Our findings suggest a novel treatment paradigm for GC-C agonism in IBS-C and BPS mediated through a mechanism involving visceral organ crosstalk.
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Affiliation(s)
- Ehsan N Mohammadi
- Oklahoma Center for Neuroscience (E.N.M., C.O.L., B.G.-V.M.), Department of Physiology (B.G.-V.M.), and Veterans Affairs Medical Center (B.G.-V.M.), University of Oklahoma Health Science Center, Oklahoma City, Oklahoma; and Ironwood Pharmaceuticals, Cambridge, Massachusetts (A.S.-S., P.G., C.K., C.H., G.H.)
| | - Casey O Ligon
- Oklahoma Center for Neuroscience (E.N.M., C.O.L., B.G.-V.M.), Department of Physiology (B.G.-V.M.), and Veterans Affairs Medical Center (B.G.-V.M.), University of Oklahoma Health Science Center, Oklahoma City, Oklahoma; and Ironwood Pharmaceuticals, Cambridge, Massachusetts (A.S.-S., P.G., C.K., C.H., G.H.)
| | - Ada Silos-Santiago
- Oklahoma Center for Neuroscience (E.N.M., C.O.L., B.G.-V.M.), Department of Physiology (B.G.-V.M.), and Veterans Affairs Medical Center (B.G.-V.M.), University of Oklahoma Health Science Center, Oklahoma City, Oklahoma; and Ironwood Pharmaceuticals, Cambridge, Massachusetts (A.S.-S., P.G., C.K., C.H., G.H.)
| | - Pei Ge
- Oklahoma Center for Neuroscience (E.N.M., C.O.L., B.G.-V.M.), Department of Physiology (B.G.-V.M.), and Veterans Affairs Medical Center (B.G.-V.M.), University of Oklahoma Health Science Center, Oklahoma City, Oklahoma; and Ironwood Pharmaceuticals, Cambridge, Massachusetts (A.S.-S., P.G., C.K., C.H., G.H.)
| | - Caroline Kurtz
- Oklahoma Center for Neuroscience (E.N.M., C.O.L., B.G.-V.M.), Department of Physiology (B.G.-V.M.), and Veterans Affairs Medical Center (B.G.-V.M.), University of Oklahoma Health Science Center, Oklahoma City, Oklahoma; and Ironwood Pharmaceuticals, Cambridge, Massachusetts (A.S.-S., P.G., C.K., C.H., G.H.)
| | - Carolyn Higgins
- Oklahoma Center for Neuroscience (E.N.M., C.O.L., B.G.-V.M.), Department of Physiology (B.G.-V.M.), and Veterans Affairs Medical Center (B.G.-V.M.), University of Oklahoma Health Science Center, Oklahoma City, Oklahoma; and Ironwood Pharmaceuticals, Cambridge, Massachusetts (A.S.-S., P.G., C.K., C.H., G.H.)
| | - Gerhard Hannig
- Oklahoma Center for Neuroscience (E.N.M., C.O.L., B.G.-V.M.), Department of Physiology (B.G.-V.M.), and Veterans Affairs Medical Center (B.G.-V.M.), University of Oklahoma Health Science Center, Oklahoma City, Oklahoma; and Ironwood Pharmaceuticals, Cambridge, Massachusetts (A.S.-S., P.G., C.K., C.H., G.H.)
| | - Beverley Greenwood-Van Meerveld
- Oklahoma Center for Neuroscience (E.N.M., C.O.L., B.G.-V.M.), Department of Physiology (B.G.-V.M.), and Veterans Affairs Medical Center (B.G.-V.M.), University of Oklahoma Health Science Center, Oklahoma City, Oklahoma; and Ironwood Pharmaceuticals, Cambridge, Massachusetts (A.S.-S., P.G., C.K., C.H., G.H.)
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Tuncalı B, Araz C, Çelebi A. Ambulatory colonoscopy under sedoanalgesia in adult patients with and without irritable bowel syndrome: A prospective, cross-sectional, and double-blind comparison. THE TURKISH JOURNAL OF GASTROENTEROLOGY : THE OFFICIAL JOURNAL OF TURKISH SOCIETY OF GASTROENTEROLOGY 2018; 29:335-341. [PMID: 29755018 PMCID: PMC6284661 DOI: 10.5152/tjg.2018.17590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 12/14/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND/AIMS It is unclear whether patients with irritable bowel syndrome (IBS) require a high dose of sedatives during colonoscopy. In this study, we investigated the pre-procedural anxiety levels, sedative consumption, procedure times, complications, and patient's satisfaction between patients with IBS and controls for ambulatory colonoscopy under sedation. MATERIALS AND METHODS Rome III criteria were used in the diagnosis of IBS. Anxiety levels were measured using Spielberger's State-Trait Anxiety Inventory (STAI) and Beck Anxiety Inventory (BAI). Patients received a fixed dose of midazolam (0.02 mg/kg), fentanyl (1 μg/kg), ketamine (0.3 mg/kg), and incremental doses of propofol under sedation protocol. Demographic data, heart rate, blood pressure, and oxygen saturation were measured. Procedure times, recovery and discharge times, drug doses used, complications associated with the sedation, and patient's satisfaction scores were also recorded. RESULTS The mean Trait (p=0.015), State (p=0.029), Beck anxiety scores (p=0.018), the incidence of disruptive movements (p=0.044), and the amount of propofol (p=0. 024) used were significantly higher in patients with IBS. There was a decline in mean systolic blood pressure at the 6th minute in patients with IBS (p=0.026). No association was found between the sedative requirement and the anxiety scores. CONCLUSION Patients with IBS who underwent elective colonoscopy procedures expressed higher pre-procedural anxiety scores, required more propofol consumption, and experienced more disruptive movements compared with controls. On the contrary, the increased propofol consumption was not associated with the increased pre-procedural anxiety scores.
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Affiliation(s)
- Bahattin Tuncalı
- Department of Anesthesiology, Başkent University Zübeyde Hanım Practice and Research Center, İzmir, Turkey
| | - Coşkun Araz
- Department of Anesthesiology, Başkent University School of Medicine, Ankara, Turkey
| | - Arzu Çelebi
- Department of Gastroenterology, Başkent University Zübeyde Hanım Practice and Research Center, İzmir, Turkey
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Blockage of High-Affinity Choline Transporter Increases Visceral Hypersensitivity in Rats with Chronic Stress. Gastroenterol Res Pract 2018; 2018:9252984. [PMID: 29849603 PMCID: PMC5904806 DOI: 10.1155/2018/9252984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 03/14/2018] [Indexed: 12/19/2022] Open
Abstract
Background Visceral hypersensitivity is a common feature of irritable bowel syndrome. Cholinergic system involves in the development of visceral hypersensitivity, and high-affinity choline transporter (CHT1) is of crucial importance in choline uptake system. However, involvement of CHT1 in visceral hypersensitivity remains unknown. The research aimed to study the CHT1 expression in dorsal root ganglions (DRGs) and the role of CHT1 in visceral hypersensitivity. Methods Repetitive water avoidance stress (WAS) was used to induce visceral hypersensitivity in rats. Colorectal distension (CRD) was determined, and the abdominal withdrawal reflex (AWR) and threshold intensity data were recorded to measure the visceral sensitivity. After intraperitoneal injection of hemicholinium-3 (HC-3), the specific inhibitor of CHT1, CRD data were also recorded. The CHT1 expression of DRGs was investigated by Western blotting, immunohistochemistry, and quantitative RT-PCR. Acetylcholine levels in the DRGs were detected by the assay kit. Results Repetitive WAS increased the AWR score of CRD at high distension pressure and decreased the mean threshold of rats. The CHT1 expression and acetylcholine concentration of DRG were significantly increased in WAS rats. After the administration of HC-3, the AWR score in WAS group was significantly increased at higher distension pressure while the threshold intensity was significantly reduced compared to the normal saline group. Acetylcholine concentration was significantly lower than the normal saline rats. Conclusion Our research firstly reports that CHT1 is overexpressed in noninflammatory visceral hypersensitivity, and blockage of CHT1 can enhance the visceral hypersensitivity. CHT1 may play an inhibitory role in visceral hypersensitivity.
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Long X, Li M, Li LX, Sun YY, Zhang WX, Zhao DY, Li YQ. Butyrate promotes visceral hypersensitivity in an IBS-like model via enteric glial cell-derived nerve growth factor. Neurogastroenterol Motil 2018; 30:e13227. [PMID: 29052293 DOI: 10.1111/nmo.13227] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 09/14/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Altered visceral sensation is common in irritable bowel syndrome (IBS) and nerve growth factor (NGF) participates in visceral pain development. Sodium butyrate (NaB) could induce colonic hypersensitivity via peripheral up-regulation of NGF in animals. Enteric glial cells (EGCs) appear to be an important source of NGF. Whether butyrate could induce visceral hypersensitivity via increased EGC-derived NGF is still unknown. METHODS CRL-2690 cells were used for transcriptome analyses after butyrate treatment. Rats received butyrate enemas to induce colonic hypersensitivity. Colorectal distention test was performed to assess visceral sensitivity. Immunofluorescence studies were used to evaluate the co-expression of glial fibrillary acidic protein (GFAP) and NGF or growth associated protein 43 in animal model. NGF expression in rat colon was also investigated. In vitro, CRL-2690 cells were stimulated with NaB or trichostatin A (TSA). NGF or GFAP expression was also examined. KEY RESULTS Transcriptome analyses showed that butyrate induced marked changes of genes expression related to neurotrophic signaling pathways. NaB-treated rats showed increased visceral sensitivity. An improved NGF expression level was observed in NaB-treated rats. Meanwhile, a 2.1-fold increase in co-expression of GFAP and NGF was also determined in rats received NaB enemas. In cultured cells, both NaB and TSA treatment could cause obvious NGF expression. Thus, butyrate might regulate EGC function via histone deacetylase inhibition. CONCLUSIONS & INFERENCES Butyrate-EGC interplay may play a pivotal role in regulation of NGF expression and the development of colonic hypersensitivity in IBS-like animal model.
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Affiliation(s)
- X Long
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, China.,Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
| | - M Li
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, China.,Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
| | - L-X Li
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, China.,Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
| | - Y-Y Sun
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, China.,Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
| | - W-X Zhang
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, China.,Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
| | - D-Y Zhao
- Department of Gastroenterology, General Hospital of Puyang Oilfield, Puyang, China
| | - Y-Q Li
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, China.,Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
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The Role of Diet in the Treatment of Irritable Bowel Syndrome: A Systematic Review. Gastroenterol Clin North Am 2018; 47:107-137. [PMID: 29413008 DOI: 10.1016/j.gtc.2017.10.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Irritable bowel syndrome (IBS) is a multifaceted illness involving maladaptive shifts in the gut microbiota that affect the enteric nervous and immune systems, mucosal barrier function, the balance of neurotransmitters and hormones, and emotional well-being. There is abundant evidence indicating that certain foods elicit symptoms in IBS. Numerous elimination-type diets have been shown to alleviate symptoms. However, among these, the most controversial is a group of foods called fructo, oligo-, di-, and monosaccharides and polyols (FODMAPs). This paper reviews the role of diet and systematically analyze the literature for the role of FODMAPs in IBS.
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Greenwood-Van Meerveld B, Johnson AC. Mechanisms of Stress-induced Visceral Pain. J Neurogastroenterol Motil 2018; 24:7-18. [PMID: 29291604 PMCID: PMC5753899 DOI: 10.5056/jnm17137] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 12/04/2017] [Indexed: 12/13/2022] Open
Abstract
Evidence suggests that long-term stress facilitates visceral pain through sensitization of pain pathways and promotes chronic visceral pain disorders such as the irritable bowel syndrome (IBS). This review will describe the importance of stress in exacerbating IBS-induced abdominal pain. Additionally, we will briefly review our understanding of the activation of the hypothalamic-pituitary-adrenal axis by both chronic adult stress and following early life stress in the pathogenesis of IBS. The review will focus on the glucocorticoid receptor and corticotropin-releasing hormone-mediated mechanisms in the amygdala involved in stress-induced visceral hypersensitivity. One potential mechanism underlying persistent effects of stress on visceral sensitivity could be epigenetic modulation of gene expression. While there are relatively few studies examining epigenetically mediated mechanisms involved in stress-induced visceral nociception, alterations in DNA methylation and histone acetylation patterns within the brain, have been linked to alterations in nociceptive signaling via increased expression of pro-nociceptive neurotransmitters. This review will discuss the latest studies investigating the long-term effects of stress on visceral sensitivity. Additionally, we will critically review the importance of experimental models of adult stress and early life stress in enhancing our understanding of the basic molecular mechanisms of nociceptive processing.
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Affiliation(s)
- Beverley Greenwood-Van Meerveld
- Oklahoma Center for Neuroscience, University of Oklahoma Health Science Center, Oklahoma City, OK,
USA
- Department of Physiology, University of Oklahoma Health Science Center, Oklahoma City, OK,
USA
- VA Medical Center, University of Oklahoma Health Science Center, Oklahoma City, OK,
USA
| | - Anthony C Johnson
- VA Medical Center, University of Oklahoma Health Science Center, Oklahoma City, OK,
USA
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Nozu T, Miyagishi S, Kumei S, Nozu R, Takakusaki K, Okumura T. Glucagon-like peptide-1 analog, liraglutide, improves visceral sensation and gut permeability in rats. J Gastroenterol Hepatol 2018; 33:232-239. [PMID: 28440889 DOI: 10.1111/jgh.13808] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 04/08/2017] [Accepted: 04/19/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM A glucagon-like peptide-1 analog, liraglutide, has been reported to block inflammatory somatic pain. We hypothesized that liraglutide attenuates lipopolysaccharide (LPS)-induced and repeated water avoidance stress (WAS)-induced visceral hypersensitivity and tested the hypothesis in rats. METHODS The threshold of the visceromotor response induced by colonic balloon distention was measured to assess visceral sensation. Colonic permeability was determined in vivo by quantifying the absorbed Evans blue spectrophotometrically, which was instilled in the proximal colon for 15 min. The interleukin-6 level in colonic mucosa was also quantified using ELISA. RESULTS Subcutaneously injected LPS (1 mg/kg) reduced the visceromotor response threshold after 3 h. Liraglutide (300 μg/kg subcutaneously) at 15 h and 30 min before injecting LPS eliminated LPS-induced allodynia. It also blocked the allodynia induced by repeated water avoidance stress for 1 h for three consecutive days. Neither vagotomy nor naloxone altered the antinociceptive effect of liraglutide, but NG -nitro-L-arginine methyl ester, a nitric oxide synthesis inhibitor, blocked it. LPS increased colonic permeability and the interleukin-6 level, and the analog significantly inhibited these responses. CONCLUSIONS This study suggests that liraglutide blocked LPS-induced visceral allodynia, which may be a nitric oxide-dependent response, and was probably mediated by inhibiting pro-inflammatory cytokine production and attenuating the increased gut permeability. Because the LPS-cytokine system is considered to contribute to altered visceral sensation in irritable bowel syndrome, these results indicate the possibility that liraglutide can be useful for treating this disease.
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Affiliation(s)
- Tsukasa Nozu
- Department of Regional Medicine and Education, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Saori Miyagishi
- Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Shima Kumei
- Department of General Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Rintaro Nozu
- Department of Regional Medicine and Education, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Kaoru Takakusaki
- Research Center for Brain Function and Medical Engineering, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Toshikatsu Okumura
- Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
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