title: Brain-gut microbiome interactions and functional bowel disorders.
abstract: Alterations in the bidirectional interactions between the intestine and the nervous system have important roles in the pathogenesis of irritable bowel syndrome (IBS). A body of largely preclinical evidence suggests that the gut microbiota can modulate these interactions. A small and poorly defined role for dysbiosis in the development of IBS symptoms has been established through characterization of altered intestinal microbiota in IBS patients and reported improvement of subjective symptoms after its manipulation with prebiotics, probiotics, or antibiotics. It remains to be determined whether IBS symptoms are caused by alterations in brain signaling from the intestine to the microbiota or primary disruption of the microbiota, and whether they are involved in altered interactions between the brain and intestine during development. We review the potential mechanisms involved in the pathogenesis of IBS in different groups of patients. Studies are needed to better characterize alterations to the intestinal microbiome in large cohorts of well-phenotyped patients, and to correlate intestinal metabolites with specific abnormalities in gut-brain interactions.
authors.affiliation: Oppenheimer Center for Neurobiology of Stress, Division of Digestive Diseases, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California. Electronic address: emayer@ucla.edu.
authors.forename: Emeran A
authors.initials: EA
authors.lastname: Mayer
authors.affiliation: Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas; Texas Children's Microbiome Center, Department of Pathology, Houston, Texas; Texas Children's Hospital, Houston, Texas.
authors.forename: Tor
authors.initials: T
authors.lastname: Savidge
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, Texas; Children's Nutrition Research Center, Houston, Texas; Texas Children's Hospital, Houston, Texas.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Shulman
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001419:Bacteria / Q000145:classification / Q000187:drug effects / Q000378:metabolism*; D001921:Brain / Q000378:metabolism* / Q000503:physiopathology; D064806:Dysbiosis; D054884:Host-Pathogen Interactions; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000378:metabolism / Q000382:microbiology* / Q000503:physiopathology / Q000628:therapy; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000187:drug effects / Q000294:innervation* / Q000382:microbiology*; D064307:Microbiota / Q000187:drug effects; D009434:Neural Pathways / Q000378:metabolism; D019936:Probiotics / Q000627:therapeutic use; D015398:Signal Transduction
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents
keywords: Dysbiosis; Irritable Bowel Syndrome; Probiotics