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The trace aminergic system: a gender-sensitive therapeutic target for IBS?
Pretorius, L, Smith, C
Journal of biomedical science. 2020;(1):95
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Abstract
Due to a lack of specific or sensitive biomarkers, drug discovery advances have been limited for individuals suffering from irritable bowel syndrome (IBS). While current therapies provide symptomatic relief, inflammation itself is relatively neglected, despite the presence of chronic immune activation and innate immune system dysfunction. Moreover, considering the microgenderome concept, gender is a significant aetiological risk factor. We believe that we have pinpointed a "missing link" that connects gender, dysbiosis, diet, and inflammation in the context of IBS, which may be manipulated as therapeutic target. The trace aminergic system is conveniently positioned at the interface of the gut microbiome, dietary nutrients and by-products, and mucosal immunity. Almost all leukocyte populations express trace amine associated receptors and significant amounts of trace amines originate from both food and the gut microbiota. Additionally, although IBS-specific data are sparse, existing data supports an interpretation in favour of a gender dependence in trace aminergic signalling. As such, trace aminergic signalling may be altered by fluctuations of especially female reproductive hormones. Utilizing a multidisciplinary approach, this review discusses potential mechanisms of actions, which include hyperreactivity of the immune system and aberrant serotonin signalling, and links outcomes to the symptomology clinically prevalent in IBS. Taken together, it is feasible that the additional level of regulation by the trace aminergic system in IBS has been overlooked, until now. As such, we suggest that components of the trace aminergic system be considered targets for future therapeutic action, with the specific focus of reducing oxidative stress and inflammation.
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Personality traits and emotional patterns in irritable bowel syndrome.
Muscatello, MR, Bruno, A, Mento, C, Pandolfo, G, Zoccali, RA
World journal of gastroenterology. 2016;(28):6402-15
Abstract
The review focuses on those personality traits (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness), constructs (alexithymia and distressed - Type D personality) and emotional patterns (negative and positive) that are of particular concern in health psychology, with the aim to highlight their potential role on the pathogenesis, onset, symptom clusters, clinical course, and outcome of irritable bowel syndrome (IBS). Personality traits and emotional patterns play key roles in affecting autonomic, immune, inflammatory, and endocrine functions, thus contributing not only to IBS clinical expression and symptomatic burden, but also to disease physiopathology. In this sense, psychological treatments should address those personality traits and emotional features that are constitutive of, and integral to IBS. The biopsychosocial model of illness applied to IBS acknowledges the interaction between biological, psychological, environmental, and social factors in relation to pain and functional disability. A holistic approach to IBS should take into account the heterogeneous nature of the disorder, and differentiate treatments for different types of IBS, also considering the marked individual differences in prevalent personality traits and emotional patterns. Beyond medications, and lifestyle/dietary interventions, psychological and educational treatments may provide the optimal chance of addressing clinical symptoms, comorbid conditions, and quality of life in IBS patients.
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Effect of probiotic species on irritable bowel syndrome symptoms: A bring up to date meta-analysis.
Ortiz-Lucas, M, Tobías, A, Saz, P, Sebastián, JJ
Revista espanola de enfermedades digestivas. 2013;(1):19-36
Abstract
BACKGROUND AND OBJECTIVES immune system alteration in irritable bowel syndrome (IBS) patients may be modulated by probiotics. We assessed the efficacy of some probiotic species in alleviating characteristic IBS symptoms. MATERIAL AND METHODS a meta-analysis of all identified randomized controlled trials comparing probiotics with placebo in treating IBS symptoms was performed with continuous data summarized using standardized mean differences (SMDs) with 95% confidence intervals (95% CIs), where appropriate. The random-effects model was employed in cases of heterogeneity; otherwise, fixed-effects models were used. RESULTS meta-analysis was performed with 10 of 24 studies identified as suitable for inclusion. Probiotics improved pain scores if they contained Bifidobacterium breve (SMD, - 0.34; 95% CI, - 0.66; -0.02), Bifidobacterium longum (SMD, -0.48; 95% CI, - 0.91; -0.06), or Lactobacillus acidophilus (SMD, -0.31; 95% CI, -0.61; -0.01) species. Distension scores were improved by probiotics containing B. breve (SMD, -0.45; 95% CI, -0.77; -0.13), Bifidobacterium infantis, Lactobacillus casei, or Lactobacillus plantarum (SMD, -0.53; 95% CI, -1.00; -0.06) species. All probiotic species tested improved flatulence: B. breve (SMD, -0.42; 95% CI, -0.75;- 0.10), B. infantis, L. casei, L. plantarum (SMD, -0.60; 95% CI, -1.07; -0.13), B. longum, L. acidophilus, Lactobacillus bulgaricus, and Streptococcus salivarius ssp. thermophilus (SMD, -0.61; 95% CI, -1.01; -0.21). There was not a clear positive effect of probiotics concerning the quality of life. CONCLUSIONS some probiotics are an effective therapeutic option for IBS patients, and the effects on each IBS symptom are likely species-specific. Future studies must focus on the role of probiotics in modulating intestinal microbiota and the immune system while considering individual patient symptom profiles.
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Review article: Probiotics in gastrointestinal and liver diseases.
Jonkers, D, Stockbrügger, R
Alimentary pharmacology & therapeutics. 2007;:133-48
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Abstract
BACKGROUND Probiotics, defined as live micro-organisms with beneficial effects for the host, are widely applied in gastrointestinal and liver diseases. AIM AND METHOD To review the available evidence of clinical trials on probiotics in gastrointestinal and liver diseases, with a major focus on irritable bowel syndrome, inflammatory bowel disease, pancreatitis and chronic liver diseases. RESULTS Evidence for the therapeutic or preventive application of particular probiotic strains is available for antibiotic-associated diarrhoea, rota-virus-associated diarrhoea and pouchitis. Results are encouraging for irritable bowel syndrome, ulcerative colitis and for reducing side effects by Helicobacter pylori eradication therapies, but are less clear for Crohn's disease, lactose intolerance and constipation. In general, for most of these patient groups, more placebo-controlled methodologically well-designed studies that pay attention to both clinical outcome and mechanistic aspects are required. The application in liver disease and pancreatitis is promising, but more human trials have to be awaited. Possible mechanisms of probiotics include modulation of the intestinal microbiota and the immune system, but different bacterial may have different effects. CONCLUSION Further insight into disease entities and the functioning of probiotic strains is required to be able to select disease-specific strains, which have to be tested in well-designed placebo-controlled studies.