肠易激综合征与肠道内分泌细胞

肠易激综合征(irritable bowel syndrome,IBS)是指腹痛或腹部不适,同时伴有排便习惯异常或大便性状异常的一组功能性肠病。目前一般认为IBS缺乏形态学或实验检查异常。IBS的发病机制尚不清楚,已经提出的有肠道动力异常、内脏感觉异常、脑肠相互作用、炎症、肠道神经免疫内分泌网络调控失常等。肠道内分泌在肠道的运动、感觉、分泌等方面具有重要的作用,其在IBS发病机制中的作用也倍受关注,对两者关系的研究可追溯到20年前。本文就近年来肠道内分泌细胞与IBS可能关系的研究进行概述。     

神经-免疫-内分泌网络与肠易激综合征

肠易激综合征(IBS)与神经-免疫-内分泌网络调节紊乱之间的联系尚未明确。此文分别从肠道神经控制、神经-免疫调节、神经-内分泌调节三个方面介绍该网络在IBS发病机制中的重要作用。     

肠易激综合征与神经-内分泌-免疫网络关系

肠易激综合征(irritable bowel syndrome,IBS)是最常见的功能性胃肠障碍,在亚洲国家患病率为2.9％～15.6％,与西方国家相似,影响多达20.0％的成年人[1].IBS发病机制尚未完全阐明,以往提出的内脏感觉过敏、脑肠作用、免疫等机制均难以全面解释.近年随着对IBS从单一生物模式向生物-心理-社会模式认识的转变,越来越多研究显示神经-内分泌-免疫网络调控异常在IBS发病中有重要作用,本文研究整理了相关国内外文献,从神经-内分泌-免疫网络角度探讨IBS发病机制.     

肠易激综合征与肠黏膜异常

肠易激综合征（irritable bowel syndrome，IBS）是以腹痛或腹部不适，伴有大便性状改变和排便习惯改变为特征的功能性肠道疾病，是消化科常见的疾病之一。目前，IBS的发病机制尚不明确。肠道黏膜是机体接触外环境最大的部位，拥有丰富的神经、免疫、内分泌等感觉细胞，IBS患者肠道黏膜的变化对研究IBS的发病机制具有独特的意义。本文对近年IBS与肠黏膜异常的研究进展做一综述。     

感染后肠易激综合征肠道局部免疫-神经-内分泌网络功能的变化

肠易激综合征(IBS)是临床上最常见的功能性胃肠病之一。近年来肠道炎症,特别是急性肠道感染后遗留的肠道黏膜低度炎症在IBS中的作用越来越受到重视,此文就肠道黏膜低度炎症和肠道局部免疫变化、肠道神经-内分泌网络变化在IBS发病中的作用作一综述。     

肠黏膜分泌物调节肠易激综合征发病机制的研究进展

肠易激综合征(IBS)是一种以腹部不适或腹痛伴排便习惯改变为主要特征的功能性胃肠病。IBS的发病机制与胃肠动力学异常,内脏感觉异常、感染、精神心理因素等有关。其病理生理学机制尚不清楚,现认为脑肠轴神经免疫内分泌功能紊乱参与其中。近年来,研究发现肠黏膜的免疫炎性反应、内分泌功能紊乱以及神经营养因子分泌异常参与调节IBS脑肠轴功能紊乱并且导致肠黏膜异常分泌多种物质。此文主要阐述这些异常分泌的肠黏膜分泌物在IBS发病机制中的重要作用,并为IBS治疗提供一个广阔的前景。     

肠易激综合征与神经免疫内分泌网络调控异常

肠易激综合征（IBS）与神经免疫内分泌网络调节之间的联系尚未明确。此文分别从神经系统异常、免疫系统异常、内分泌系统异常三个方面介绍该网络在IBS发病机制中的重要作用。     

脑-肠轴失调在肠易激综合征发病中作用的研究进展

肠易激综合征(IBS)的发生是多因素共同作用的结果,其发病机制尚未明确。近年来,以脑-肠轴为基础的生物-心理-社会医学模式参与IBS发病的观念被广泛接受。由神经-内分泌-免疫网络介导的脑-肠双向调节通路,在维持中枢神经系统与肠道局部稳态中发挥重要调节作用,其中任一环节异常,都可能导致稳态平衡破坏而诱发IBS。本文就脑-肠轴失调在IBS发生、发展中作用的研究进展作一综述。     

肠易激综合征中医药治疗机制研究现状

肠易激综合征(irritable bowel syndrome,IBS)是一种肠道功能性疾病,为常见病、多发病.西医对IBS的发病机制目前尚未完全清楚,一般认为与胃肠动力、内脏敏感性、脑-肠轴、神经-内分泌-免疫网络等功能异常及肠道菌群失调、肠道感染等多种因素有关.目前对IBS的治疗,现代医学方面尚缺特效药物,而中医药却有独到之处.应用现代医学的方法研究中医药治疗IBS的作用机制日受重视,许多中医学者从多角度探索IBS不同中医证候物质基础的差异及中药干预的可能作用途径.本文将10年来IBS的中医证候物质基础、中医药治疗IBS作用机制的临床及实验研究文献综述如下.     

神经生长因子与肠易激综合征

肠易激综合征(irritable bowel syndrome,IBS)是一种原因不明的慢性肠功能紊乱性疾病,其发病机制尚不完全清楚。目前多数学者认为IBS为神经内分泌免疫网络失衡造成的。神经生长因子(nerve growth factor,NGF)是神经内分泌免疫网络的重要成员。NGF可能参与IBS的发病过程。     

肥大细胞在肠易激综合征发病机制中的研究进展

肠易激综合征(irritable bowel syndrome,IBS)是以腹痛、腹部不适伴排便习惯改变和/或大便性状异常为特征的常见功能性胃肠病.IBS全球患病率为2%-15%.本病病因及发病机制尚不十分明确,目前认为多与胃肠动力异常、内脏高敏、感染与炎症、神经-内分泌失调、精神心理、食物过敏等多种因素有关.近年来提出的"神经-免疫-内分泌网络"理论在IBS发病机制中占有重要地位.研究发现,胃肠道的肥大细胞(mast cells,MCs)在IBS的发病中发挥着重要作用.本文拟以MCs在IBS中的发病机制的最新研究进展作一综述.     

Regulation of the serotonin transporter in the pathogenesis of irritable bowel syndrome

Serotonin(5-HT) and the serotonin transporter(SERT) have earned a tremendous amount of attention regarding the pathogenesis of irritable bowel syndrome(IBS). Considering that enteric 5-HT is responsible for the secretion, motility and perception of the bowel, the involvement of altered enteric 5-HT metabolism in the pathogenesis of IBS has been elucidated. Higher 5-HT availability is commonly associated with depressed SERT mR NA in patients with IBS compared with healthy controls. The expression difference of SERT between IBS patients and healthy controls might suggest that SERT plays an essential role in IBS pathogenesis, and SERT was expected to be a novel therapeutic target for IBS. Progress in this area has begun to illuminate the complex regulatory mechanisms of SERT in the etiology of IBS. In this article, current insights regarding the regulation of SERT in IBS are provided, including aspects of SERT gene polymorphisms, microR NAs, immunity and inflammation, gut microbiota, growth factors, among others. Potential SERT-directed therapies for IBS are also described. The potential regulators of SERT are of clinical importance and are important for better understanding IBS pathophysiology and therapeutic strategies.     

小肠细菌过度生长在肠易激综合征中的研究进展

肠易激综合征(IBS)是一种常见的功能性胃肠病,其发病机制复杂。目前认为IBS与胃肠动力障碍、内脏高敏感、肠道感染、脑-肠轴功能紊乱、免疫活化等因素有关。最新研究表明小肠细菌过度生长(SIBO)在IBS的发病中亦起重要作用。本文就SIBO在IBS中的研究进展,包括病理生理机制、诊断、治疗等作一综述。     

食物敏感与肠易激综合征研究进展

肠易激综合征(irritable bowel syndrome,IBS)是一种以腹痛或腹部不适伴排便习惯改变为特征的功能性胃肠病,其症状反复,严重地影响了患者的生活质量.研究发现,食物可引发或加重IBS患者的症状,其实质即食物过敏和食物不耐受,但具体的发病机制尚未得到肯定,目前包括细菌"代谢‘毒物’假说"、"免疫或炎症反应假说"、"物理或化学刺激假说"等.因此食物因素在IBS发病中的作用越来越受到重视,成为当前研究IBS病因的热点之一,本文将对食物敏感及食物引发IBS的可能机制、检测方法及干预措施的研究进展作一综述.     

精神心理因素在肠易激综合征中的作用

精神心理因素异常是肠易激综合征（IBS）的发病机制之一，但其具体机制尚未完全明了。多数研究发现IBS患者伴随不同程度和类型的精神心理异常，经历过更多的负性生活事件，表现出一些异常的行为特征，但各地的研究结论存有一定差异。目前的研究多集中于精神心理异常是如何改变脑一肠轴的功能，从而参与IBS的发生、发展。在IBS的治疗中，精神药物和心理疗法都表现出一定的作用，但不是决定性的，其疗效尚需更多的循证医学证据来证明。     

5-羟色胺转运体在肠道疾病中的研究进展

5-羟色胺(5-HT)是脑-肠轴中的重要神经递质,参与胃肠动力和感觉的调节过程。5-羟色胺转运体(SERT)可再摄取5-HT,并将其灭活、降解,是调控5-HT表达水平的重要物质。近年来诸多研究表明,SERT表达异常与肠易激综合征(IBS)、炎症性肠病(IBD)、慢传输型便秘等多种肠道疾病密切相关。本文就SERT在肠道疾病中的研究进展作一综述。     

Unraveling the ties between irritable bowel syndrome and intestinal microbiota

Irritable bowel syndrome(IBS)is the most prevalent functional gastrointestinal disorder.It is a multifactoria disorder.Intestinal microbiota may cause the pathogenesis of IBS by contributing to abnormal gastrointestina motility,low-grade inflammation,visceral hypersensitivity,communication in the gut-brain axis,and so on.Previous attempts to identify the intestinal microbiota composition in IBS patients have yielded inconsistent and occasionally contradictory results.This inconsistency may be due to the differences in the molecular techniques employed,the sample collection and handling methods,use of single samples that are not linked to fluctuating symptoms,or other factors such as patients diets and phenotypic characterizations.Despite these difficulties,previous studies found that the intestina microbiota in some IBS patients was completely different from that in healthy controls,and there does appear to be a consistent theme of Firmicutes enrichment and reduced abundance of Bacteroides.Based on the differences in intestinal microbiota composition,many studies have addressed the roles of microbiotatargeted treatments,such as antibiotics and probiotics,in alleviating certain symptoms of IBS.This review summarizes the current knowledge of the associations between intestinal microbiota and IBS as well as the possible modes of action of intestinal microbiota in the pathogenesis of IBS.Improving the current level of understanding of host-microbiota interactions in IBS is important not only for determining the role of intestinal microbiota in IBS pathogenesis but also for therapeutic modulation of the microbiota.     

Irritable bowel syndrome: Diagnosis and pathogenesis

Irritable bowel syndrome (IBS) is a common gastro-intestinal (GI) disorder that considerably reduces the quality of life. It further represents an economic burden on society due to the high consumption of healthcare resources and the non-productivity of IBS patients. The diagnosis of IBS is based on symptom assessment and the Rome Ⅲ criteria. A combination of the Rome Ⅲ criteria, a physical examination, blood tests, gastros-copy and colonoscopy with biopsies is believed to be necessary for diagnosis. Duodenal chromogranin A cell density is a promising biomarker for the diagnosis of IBS. The pathogenesis of IBS seems to be multifactorial, with the following factors playing a central role in the pathogenesis of IBS:heritability and genetics, dietary/intestinal microbiota, low-grade inflammation, and disturbances in the neuroendocrine system (NES) of the gut. One hypothesis proposes that the cause of IBS is an altered NES, which would cause abnormal GI motility, secretions and sensation. All of these abnormalities are characteristic of IBS. Alterations in the NES could be the result of one or more of the following:genetic factors, dietary intake, intestinal flora, or lowgrade inflammation. Post-infectious IBS (PI-IBS) and inflammatory bowel disease-associated IBS (IBD-IBS) represent a considerable subset of IBS cases. Patients with PI-and IBD-IBS exhibit low-grade mucosal inflammation, as well as abnormalities in the NES of the gut.     

肠易激综合征心理状态与去甲肾上腺素、酪氨酸羟化酶

肠易激综合征（IBS）为7种经典心身疾病之一,精神因素在发病中占据重要地位,80％以上的IBS患者症状加重与精神因素有明显关系。去甲肾上腺素（NE）能系统与情感、行为及意识状态有关,脑内NE功能异常可导致抑郁、焦虑类疾病并在某些应激状态下表现出来或恶化,肾上腺素能交感神经失调与部分IBS发病有关。酪氨酸羟化酶（TH）作为NE合成的限速酶,与抑郁症密切相关。研究脑-肠轴各层面中NE和TH的变化趋势有助于进一步了解IBS尤其是IBS伴焦虑、抑郁状态者的发病机制。