title: Mechanisms by which Stress Affects the Experimental and Clinical Inflammatory Bowel Disease (IBD): Role of Brain-Gut Axis.
abstract: BACKGROUND
  Stress of different origin is known to alter so called "braingut axis" and contributes to a broad array of gastrointestinal disorders including inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and other functional gastrointestinal diseases. The stressful situations and various stressors including psychosocial events, heat, hypo- and hyperthermia may worsen the course of IBD via unknown mechanism. The aims of this paper were to provide an overview of experimental and clinical evidences that stress activates the brain-gut axis which results in a mucosal mast cells activation and an increase in the production of proinflammatory cytokines and other endocrine and humoral mediators.
  
  
  METHODS
  Research and online content related to effects of stress on lower bowel disorders are reviewed and most important mechanisms are delineated.
  
  
  RESULTS
  Brain conveys the neural, endocrine and circulatory messages to the gut via brain-gut axis reflecting changes in corticotrophin releasing hormone, mast cells activity, neurotransmission at the autonomic nerves system and intestinal barrier function all affecting the pathogenesis of animal colitis and human IBD. Stress triggers the hypothalamus-pituitary axis and the activation of the autonomic nervous system, an increase in cortisol levels and proinflammatory cytokines such as tumor necrosis factor-alpha, interleukin-8, interleukin-1beta and interleukin-6.
  
  
  CONCLUSIONS
  The acute or chronic stress enhances the intestinal permeability weakening of the tight junctions and increasing bacterial translocation into the intestinal wall. An increased microbial load in the colonic tissue, excessive cytokine release and a partially blunted immune reactivity in response to stress result in its negative impact on IBD.
authors.forename: Bartosz
authors.initials: B
authors.lastname: Brzozowski
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Mazur-Bialy
authors.forename: Robert
authors.initials: R
authors.lastname: Pajdo
authors.forename: Slawomir
authors.initials: S
authors.lastname: Kwiecien
authors.forename: Jan
authors.initials: J
authors.lastname: Bilski
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Zwolinska-Wcislo
authors.forename: Tomasz
authors.initials: T
authors.lastname: Mach
authors.affiliation: Department of Physiology, Jagiellonian University Medical College, 16 Grzegorzecka Street, 31-531 Cracow, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Brzozowski
mesh_terms: D000818:Animals; D001921:Brain / Q000503:physiopathology*; D000069196:Gastrointestinal Microbiome / Q000502:physiology; D041981:Gastrointestinal Tract / Q000503:physiopathology*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000503:physiopathology*; D013315:Stress, Psychological / Q000503:physiopathology*