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肠易激综合征病因学和病理生理学的新见解:新生儿应激模型的作用

New insights in the etiology and pathophysiology of irritable bowel syndrome: contribution of neonatal stress models.

作者信息

Barreau Frederick, Ferrier Laurent, Fioramonti Jean, Bueno Lionel

机构信息

INSERM U843, Inflammation intestinale chez l'enfant, Université Paris 7, Hôpital Robert Debré, F-75019 Paris, France.

出版信息

Pediatr Res. 2007 Sep;62(3):240-5. doi: 10.1203/PDR.0b013e3180db2949.

Abstract

Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders, characterized by abdominal pain and disturbed defecation that cannot be explained by structural abnormalities. Although IBS symptoms (visceral pain, increased gut permeability, motility alterations) are clearly established, the etiology of this pathology is loosely understood. Nevertheless, clinical studies have reported that some early abuse (physical and psychological) is often associated with IBS development. Thus, loss and separation in the family during childhood may contribute to the IBS development. The recent development of animal models has pointed out the importance of early traumatic experiences in favoring the occurrence of IBS in adult life. Among these different models, neonatal maternal deprivation (NMD), neonatal colonic irritation (inflammatory stimuli), and neonatal colonic pain (rectal distension) have been described to mimic some cardinal features of IBS. The purpose of this review is 3-fold. First, to present the different neonatal stress models. Second, to review the literature on the influence of these early traumatic experiences on the gastrointestinal tract disturbances observed in adult life. Finally, we will also present the mediators and mechanisms involved in gut dysfunction triggered by NMD and probably in IBS.

摘要

肠易激综合征(IBS)是最常见的胃肠道疾病之一,其特征为腹痛和排便紊乱,且无法用结构异常来解释。尽管肠易激综合征的症状(内脏疼痛、肠道通透性增加、动力改变)已明确,但该病症的病因仍了解甚少。然而,临床研究报告称,一些早期虐待(身体和心理方面)常与肠易激综合征的发生有关。因此,童年时期家庭中的丧失和分离可能会促使肠易激综合征的发生。动物模型的最新进展指出了早期创伤经历在成年后引发肠易激综合征中的重要性。在这些不同的模型中,新生动物母婴分离(NMD)、新生动物结肠刺激(炎症刺激)和新生动物结肠疼痛(直肠扩张)已被描述为可模拟肠易激综合征的一些主要特征。本综述的目的有三个方面。第一,介绍不同的新生动物应激模型。第二,回顾关于这些早期创伤经历对成年后观察到的胃肠道紊乱影响的文献。最后,我们还将介绍由新生动物母婴分离引发的肠道功能障碍以及可能在肠易激综合征中涉及的介质和机制。

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