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Understanding neuroimmune interactions in disorders of gut–brain interaction: from functional to immune-mediated disorders

Functional gastrointestinal disorders—recently renamed into disorders of gut–brain interaction—such as irritable bowel syndrome and functional dyspepsia are highly prevalent conditions with bothersome abdominal symptoms in the absence of structural abnormalities. While traditionally considered as mo...

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Detalles Bibliográficos
Autores principales: Vanuytsel, Tim, Bercik, Premysl, Boeckxstaens, Guy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10086308/
https://www.ncbi.nlm.nih.gov/pubmed/36657961
http://dx.doi.org/10.1136/gutjnl-2020-320633
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author Vanuytsel, Tim
Bercik, Premysl
Boeckxstaens, Guy
author_facet Vanuytsel, Tim
Bercik, Premysl
Boeckxstaens, Guy
author_sort Vanuytsel, Tim
collection PubMed
description Functional gastrointestinal disorders—recently renamed into disorders of gut–brain interaction—such as irritable bowel syndrome and functional dyspepsia are highly prevalent conditions with bothersome abdominal symptoms in the absence of structural abnormalities. While traditionally considered as motility disorders or even psychosomatic conditions, our understanding of the pathophysiology has evolved significantly over the last two decades. Initial observations of subtle mucosal infiltration with immune cells, especially mast cells and eosinophils, are since recently being backed up by mechanistic evidence demonstrating increased release of nociceptive mediators by immune cells and the intestinal epithelium. These mediators can activate sensitised neurons leading to visceral hypersensitivity with bothersome symptoms. The interaction between immune activation and an impaired barrier function of the gut is most likely a bidirectional one with alterations in the microbiota, psychological stress and food components as upstream players in the pathophysiology. Only few immune-targeting treatments are currently available, but an improved understanding through a multidisciplinary scientific approach will hopefully identify novel, more precise treatment targets with ultimately better outcomes.
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spelling pubmed-100863082023-04-12 Understanding neuroimmune interactions in disorders of gut–brain interaction: from functional to immune-mediated disorders Vanuytsel, Tim Bercik, Premysl Boeckxstaens, Guy Gut Recent Advances in Clinical Practice Functional gastrointestinal disorders—recently renamed into disorders of gut–brain interaction—such as irritable bowel syndrome and functional dyspepsia are highly prevalent conditions with bothersome abdominal symptoms in the absence of structural abnormalities. While traditionally considered as motility disorders or even psychosomatic conditions, our understanding of the pathophysiology has evolved significantly over the last two decades. Initial observations of subtle mucosal infiltration with immune cells, especially mast cells and eosinophils, are since recently being backed up by mechanistic evidence demonstrating increased release of nociceptive mediators by immune cells and the intestinal epithelium. These mediators can activate sensitised neurons leading to visceral hypersensitivity with bothersome symptoms. The interaction between immune activation and an impaired barrier function of the gut is most likely a bidirectional one with alterations in the microbiota, psychological stress and food components as upstream players in the pathophysiology. Only few immune-targeting treatments are currently available, but an improved understanding through a multidisciplinary scientific approach will hopefully identify novel, more precise treatment targets with ultimately better outcomes. BMJ Publishing Group 2023-04 2023-01-19 /pmc/articles/PMC10086308/ /pubmed/36657961 http://dx.doi.org/10.1136/gutjnl-2020-320633 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Recent Advances in Clinical Practice
Vanuytsel, Tim
Bercik, Premysl
Boeckxstaens, Guy
Understanding neuroimmune interactions in disorders of gut–brain interaction: from functional to immune-mediated disorders
title Understanding neuroimmune interactions in disorders of gut–brain interaction: from functional to immune-mediated disorders
title_full Understanding neuroimmune interactions in disorders of gut–brain interaction: from functional to immune-mediated disorders
title_fullStr Understanding neuroimmune interactions in disorders of gut–brain interaction: from functional to immune-mediated disorders
title_full_unstemmed Understanding neuroimmune interactions in disorders of gut–brain interaction: from functional to immune-mediated disorders
title_short Understanding neuroimmune interactions in disorders of gut–brain interaction: from functional to immune-mediated disorders
title_sort understanding neuroimmune interactions in disorders of gut–brain interaction: from functional to immune-mediated disorders
topic Recent Advances in Clinical Practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10086308/
https://www.ncbi.nlm.nih.gov/pubmed/36657961
http://dx.doi.org/10.1136/gutjnl-2020-320633
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