Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 28, 2015; 21(24): 7362-7366
Published online Jun 28, 2015. doi: 10.3748/wjg.v21.i24.7362
Immunomodulation of enteric neural function in irritable bowel syndrome
Dervla O’Malley
Dervla O’Malley, Department of Physiology and Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland
Author contributions: O’Malley D solely contributed to this paper.
Conflict-of-interest: The author has no financial, professional or personal conflicts relating to this publication.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is 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 and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Dervla O’Malley, Department of Physiology and Alimentary Pharmabiotic Centre, University College Cork, 4.23 Western Gateway Building, Cork, Ireland. d.omalley@ucc.ie
Telephone: +353-21-4205483 Fax: +353-21-4205370
Received: January 7, 2015
Peer-review started: January 8, 2015
First decision: January 22, 2015
Revised: February 3, 2015
Accepted: March 12, 2015
Article in press: March 12, 2015
Published online: June 28, 2015
Processing time: 172 Days and 20.4 Hours
Abstract

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder which is characterised by symptoms such as bloating, altered bowel habit and visceral pain. It’s generally accepted that miscommunication between the brain and gut underlies the changes in motility, absorpto-secretory function and pain sensitivity associated with IBS. However, partly due to the lack of disease-defining biomarkers, understanding the aetiology of this complex and multifactorial disease remains elusive. Anecdotally, IBS patients have noted that periods of stress can result in symptom flares and many patients exhibit co-morbid stress-related mood disorders such as anxiety and depression. However, in addition to psychosocial stressors, infection-related stress has also been linked with the initiation, persistence and severity of symptom flares. Indeed, prior gastrointestinal infection is one of the strongest predictors of developing IBS. Despite a lack of overt morphological inflammation, the importance of immune factors in the pathophysiology of IBS is gaining acceptance. Subtle changes in the numbers of mucosal immune cell infiltrates and elevated levels of circulating pro-inflammatory cytokines have been reproducibly demonstrated in IBS populations. Moreover, these immune mediators directly affect neural signalling. An exciting new area of research is the role of luminal microbiota in the modulation of neuro-immune signalling, resulting in local changes in gastrointestinal function and alterations in central neural functioning. Progress in this area has begun to unravel some of the complexities of neuroimmune and neuroendocrine interactions and how these molecular exchanges contribute to GI dysfunction

Keywords: Neuroimmune; Irritable bowel syndrome; Interleukin; Myenteric; Submucosal; Microbiota

Core tip: This article assesses the importance of neuroimmune modulation of gastrointestinal function in the functional bowel disorder, irritable bowel syndrome (IBS). Recent progress in understanding the molecular mechanisms underlying the pathophysiology of IBS reveals the neuromodulatory effects of mast cell mediators, cytokines and luminal microbiota.