Review article: the psychoneuroimmunology of irritable bowel syndrome – an exploration of interactions between psychological, neurological and immunological observations
Article first published online: 10 JUL 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 28, Issue 7, pages 830–840, October 2008
How to Cite
AREBI, N., GURMANY, S., BULLAS, D., HOBSON, A., STAGG, A. and KAMM, M. (2008), Review article: the psychoneuroimmunology of irritable bowel syndrome – an exploration of interactions between psychological, neurological and immunological observations. Alimentary Pharmacology & Therapeutics, 28: 830–840. doi: 10.1111/j.1365-2036.2008.03801.x
- Issue published online: 1 SEP 2008
- Article first published online: 10 JUL 2008
- Publication data Submitted 20 March 2008 First decision 22 April 2008 Resubmitted 1 July 2008; 4 July 2008 Accepted 7 July 2008 Epub Accepted Aritcle 10 July 2008
Background The pathogenesis of irritable bowel syndrome (IBS) is founded on interactive mechanisms. Disentangling these processes is a prerequisite for the development of effective drug therapy.
Aim To identify the interaction between the various factors implicated in IBS.
Methods Articles pertaining to IBS pathogenesis focusing on psychoneuroimmunology were identified using following search terms: IBS, animal models, microbiota, probiotics, immunology, visceral hypersensitivity, imaging, psychology and visceral pain.
Results Cerebral imaging using MRI and proton emission tomography scanning has revealed differential regional cerebral activation, whereas stimuli induced activation has been captured by both MRI and cortical evoked potentials. At the peripheral neurological level, the concept of visceral hypersensitivity has been challenged as perhaps representing psychological traits with symptom over-reporting or hyper-vigilance. Gut mucosal immunology is thought to be relevant with immunological changes reflected as peripheral blood cytokine level changes. Molecular technology advances suggest a role for microbiota by activating the gut immunological system. These interactions have been examined in IBS animal models.
Conclusions Translation of animal model findings to humans is needed to link the various psychological, neurological and immunological changes noted in IBS. This analysis may identify patient sub-groups, which will ultimately be critical for drug testing to be focused accordingly.