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

Content Provider	Europe PMC
Author	Vanuytsel, Tim Bercik, Premysl Boeckxstaens, Guy
Copyright Year	2023
Abstract	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.
ISSN	00175749
Journal	Gut
Volume Number	72
PubMed Central reference number	PMC10086308
Issue Number	4
PubMed reference number	36657961
e-ISSN	14683288
DOI	10.1136/gutjnl-2020-320633
Language	English
Publisher	BMJ
Publisher Date	2023-01-19
Publisher Place	BMA House, Tavistock Square, London, WC1H 9JR
Access Restriction	Open
Rights License	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/. © 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.
Subject Keyword	FUNCTIONAL BOWEL DISORDER FUNCTIONAL DYSPEPSIA IRRITABLE BOWEL SYNDROME INTESTINAL MAST CELLS Intestinal eosinophils
Content Type	Text
Resource Type	Article
Subject	Gastroenterology