Taché Yvette, Million Mulugeta, Nelson Allyson G, Lamy Christophe, Wang Lixin
Center for Neurovisceral Sciences and Women's Health, and CURE: Digestive Diseases Research Center, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
Gend Med. 2005 Sep;2(3):146-54. doi: 10.1016/s1550-8579(05)80043-9.
Clinical reports have shown that irritable bowel syndrome (IBS) is comorbid with anxiety/depression and stress-related events, and that the disorder is more prevalent among women than among men. In rodents, colorectal distention (CRD) induces abdominal contractions, and this visceromotor response is used to assess visceral pain. The activation of brain corticotropin-releasing factor (CRF) pathways has a key role in the behavioral and visceral responses to stress.
In this review of experimental studies that delineate the underlying mechanisms of the stress response, we focused on CRF signaling pathways and sex hormones in modulating visceral hypersensitivity induced by CRD in rodents.
The findings of our recent research on the development of an experimental model of visceral pain in female rats and the modulation of the hyperalgesic response to CRD by CRF antagonists were integrated with those of the published literature. A MEDLINE search of the years 1981 to 2005 was conducted using the key words stress, CRF, CRH, CRF1 receptor, IBS, CRD, female rat, visceral pain, estrogen, and anxiety.
CRF and other related mammalian peptides (urocortins) interact with the distinct CRF subtype 1 and 2 receptors. Well-documented preclinical studies have established the role of brain CRF1 receptors in mediating stress-related anxiogenic and visceral (stimulation of colonic motor function and sensitization to repeated CRD) responses in male rodents, whereas more limited studies have been performed in female rats. Our recent study indicated that the CRF1 antagonist antalarmin prevents visceral hypersensitivity induced by 2 sets of CRD in female rats. In several models of visceral pain induced by CRD, sex differences and a sensitization action of estrogen were reported. Our preliminary evidence indicated a potentiating interaction between CRF-CRF1 pathways and estrogen in the stimulation of colonic motor responses that may take place within the enteric neurons of the colon, where both CRF1 and estrogen receptors are present.
The results of this review suggest that overactivity of CRF1 signaling in the brain and the gut may have relevance in understanding the comorbidity of anxiety/depression and IBS in diarrhea-predominant female patients. Targeting these mechanisms with CRF1 antagonists may provide a novel therapeutic strategy.
临床报告显示,肠易激综合征(IBS)与焦虑/抑郁及应激相关事件共病,且该疾病在女性中比在男性中更为普遍。在啮齿动物中,结肠扩张(CRD)会诱发腹部收缩,这种内脏运动反应用于评估内脏痛。脑促肾上腺皮质激素释放因子(CRF)通路的激活在对应激的行为和内脏反应中起关键作用。
在这篇阐述应激反应潜在机制的实验研究综述中,我们聚焦于CRF信号通路和性激素在调节啮齿动物中由CRD诱发的内脏超敏反应中的作用。
我们近期关于雌性大鼠内脏痛实验模型的建立以及CRF拮抗剂对CRD所致痛觉过敏反应调节的研究结果,与已发表文献的研究结果相结合。使用关键词应激、CRF、CRH、CRF1受体、IBS、CRD、雌性大鼠、内脏痛、雌激素和焦虑,对1981年至2005年的MEDLINE数据库进行了检索。
CRF和其他相关的哺乳动物肽(尿皮质素)与不同的CRF 1型和2型受体相互作用。充分记录的临床前研究已证实脑CRF1受体在介导雄性啮齿动物应激相关的致焦虑和内脏(刺激结肠运动功能及对重复CRD敏感)反应中的作用,而在雌性大鼠中进行的研究较少。我们近期的研究表明,CRF1拮抗剂安他拉明可预防雌性大鼠由两组CRD诱发的内脏超敏反应。在几种由CRD诱发的内脏痛模型中,报告了性别差异以及雌激素的致敏作用。我们的初步证据表明,CRF - CRF1通路与雌激素在刺激结肠运动反应方面存在增强性相互作用,这种相互作用可能发生在结肠的肠神经元内,CRF1和雌激素受体在该部位均有表达。
这篇综述的结果表明,脑和肠道中CRF1信号的过度活跃可能与理解腹泻为主型女性患者焦虑/抑郁与IBS的共病有关。用CRF1拮抗剂靶向这些机制可能提供一种新的治疗策略。