Department of Gastroenterology, Digestive System Research Unit, Hospital Universitari Vall d'Hebron, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
Gut Liver. 2012 Jul;6(3):305-15. doi: 10.5009/gnl.2012.6.3.305. Epub 2012 Jul 12.
The etiopathogenesis of the irritable bowel syndrome (IBS), one of the most prevalent gastrointestinal disorders, is not well known. The most accepted hypothesis is that IBS is the result of the disturbance of the 'brain-gut axis.' Although the pathophysiological mechanisms of intestinal dysfunction are complex and not completely understood, stress, infections, gut flora, and altered immune response are thought to play a role in IBS development. The intestinal barrier, composed of a single-cell layer, forms a physical barrier that separates the intestinal lumen from the internal milieu. The loss of integrity of this barrier is related with mucosal immune activation and intestinal dysfunction in IBS. The number of mast cells and T lymphocytes is increased in the intestinal mucosa of certain IBS patients, and the mediators released by these cells could compromise the epithelial barrier function and alter nerve signaling within the enteric nervous system. The association of clinical symptoms to structural and functional abnormalities of the mucosal barrier in IBS patients highlights the importance of understanding the physiological role of the gut barrier in the pathogenesis of this disorder. This review summarizes the clinical and experimental evidences indicating the cellular and molecular mechanisms of IBS symptomatology, and its relevance for future translational research.
肠易激综合征（IBS）是最常见的胃肠道疾病之一，其发病机制尚不清楚。目前最被接受的假设是，IBS 是“脑-肠轴”紊乱的结果。尽管肠道功能障碍的病理生理机制复杂且尚未完全阐明，但应激、感染、肠道菌群和免疫反应改变被认为在 IBS 发病中起作用。肠道屏障由单层细胞组成，形成将肠腔与内部环境分开的物理屏障。这种屏障的完整性丧失与 IBS 中的黏膜免疫激活和肠道功能障碍有关。在某些 IBS 患者的肠道黏膜中，肥大细胞和 T 淋巴细胞的数量增加，这些细胞释放的介质可能会损害上皮屏障功能并改变肠神经系统内的神经信号。IBS 患者的临床症状与黏膜屏障的结构和功能异常相关，这突出表明了解肠道屏障在该疾病发病机制中的生理作用的重要性。本文综述了表明 IBS 症状的细胞和分子机制的临床和实验证据，及其对未来转化研究的相关性。
