Chemical and molecular factors in irritable bowel syndrome: current knowledge, challenges, and unanswered questions.
Several chemical and molecular factors in the intestine are reported to be altered and to have a potentially significant role in irritable bowel syndrome (IBS), particularly in IBS with diarrhea. These include bile acids; short-chain fatty acids; mucosal barrier proteins; mast cell products such as histamine, proteases, and tryptase; enteroendocrine cell products; and mucosal mRNAs, proteins, and microRNAs. This article reviews the current knowledge and unanswered questions in the pathobiology of the chemical and molecular factors in IBS. Evidence continues to point to significant roles in pathogenesis of these chemical and molecular mechanisms, which may therefore constitute potential targets for future research and therapy. However, it is still necessary to address the interaction between these factors in the gut and to appraise how they may influence hypervigilance in the central nervous system in patients with IBS.
Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic, Rochester, Minnesota camilleri.michael@mayo.edu.
Michael
M
Camilleri
Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic, Rochester, Minnesota.
Ibironke
I
Oduyebo
Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic, Rochester, Minnesota.
Houssam
H
Halawi
D001647:Bile Acids and Salts / Q000378:metabolism; D019858:Enteroendocrine Cells / Q000378:metabolism; D005232:Fatty Acids, Volatile / Q000378:metabolism; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism*; D043183:Irritable Bowel Syndrome / Q000378:metabolism*; D008407:Mast Cells / Q000378:metabolism
D001647:Bile Acids and Salts; D005232:Fatty Acids, Volatile
bile; histamine; mRNA; miRNA; mucosal expression; permeability; proteases; short-chain fatty acids; tryptase