Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, S-41345 Gothenburg, Sweden.
Nat Rev Gastroenterol Hepatol. 2010 Mar;7(3):163-73. doi: 10.1038/nrgastro.2010.4. Epub 2010 Jan 26.
IBS is one of the most common functional gastrointestinal disorders worldwide and is thought to be the result of disturbed neural function along the brain-gut axis. The mechanisms behind this disturbance are not clear, but important roles for low-grade inflammation and immunological alterations in the development of symptoms compatible with IBS have become evident. The development of long-standing gastrointestinal symptoms after infectious gastroenteritis and patients with IBD in remission frequently having functional gastrointestinal symptoms support this hypothesis. An increased innate immune activity in the intestinal mucosa and in blood is found in subpopulations of patients with IBS. Mast cells and monocytes seem to be particularly important. In addition, studies have demonstrated that IBS may be associated with an activated adaptive immune response. Increased epithelial barrier permeability and an abnormal gut flora might lead to increased activation of the intestinal immune system. Functional and anatomical evidence for abnormal neuroimmune interactions has been found in patients with IBS. The link between immune alterations and severity of gastrointestinal symptoms and the positive effect of anti-inflammatory treatments in IBS further highlight the relevance of neuroimmune interactions in this condition.
肠易激综合征（IBS）是全世界最常见的功能性胃肠道疾病之一，被认为是沿脑-肠轴的神经功能紊乱的结果。这种紊乱的机制尚不清楚，但低水平炎症和免疫改变在与 IBS 症状相符的发展中起着重要作用。感染性胃肠炎后长期存在胃肠道症状和缓解期炎症性肠病患者经常出现功能性胃肠道症状支持这一假说。在 IBS 患者的亚群中发现肠道黏膜和血液中的固有免疫活性增加。肥大细胞和单核细胞似乎尤为重要。此外，研究表明 IBS 可能与适应性免疫反应的激活有关。上皮屏障通透性增加和肠道菌群异常可能导致肠道免疫系统的过度激活。在 IBS 患者中发现了异常神经免疫相互作用的功能和解剖学证据。免疫改变与胃肠道症状严重程度之间的联系以及抗炎治疗对 IBS 的积极作用进一步强调了神经免疫相互作用在这种情况下的相关性。
