Bashashati M, Rezaei N, Shafieyoun A, McKernan D P, Chang L, Öhman L, Quigley E M, Schmulson M, Sharkey K A, Simrén M
Department of Physiology and Pharmacology, Snyder Institute for Chronic Diseases and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
Neurogastroenterol Motil. 2014 Jul;26(7):1036-48. doi: 10.1111/nmo.12358. Epub 2014 May 5.
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder of unknown etiology; although infection and inflammation have recently been considered as important etiologic agents. A recent meta-analysis showed correlations between cytokine [interleukin-10 (IL-10) and tumor necrosis factor (TNF)] gene polymorphisms and IBS; however, it is still unknown whether patients with IBS have different cytokine profiles compared to healthy population.
To determine the relationships between serum/plasma levels or mucosal expression of IL-10/TNF-α and IBS, we conducted a systematic review and meta-analysis based on case-control studies retrieved from PubMed and EMBASE search through August 2013. Standardized mean difference (SMD) was generated by using the inverse variance method. Heterogeneity was assessed based on I(2) values.
Serum/plasma levels of TNF-α tended to be higher in IBS vs controls (p = 0.09); this reached significance in IBS subtypes vs controls and in female patients with IBS. However, serum/plasma levels of IL-10 were not significantly different in IBS patients vs controls. Further analysis of serum/plasma IL-10 levels in IBS subtypes did not show any difference; however, analysis based on gender showed a significantly lower serum/plasma IL-10 levels in male patients with IBS vs male controls (p = 0.02). Colonic IL-10 mRNA had a significantly lower expression in IBS vs control (p = 0.001).
CONCLUSIONS & INFERENCES: There is an imbalance of proinflammatory TNF-α, and anti-inflammatory IL-10, cytokines in IBS. Stratifying IBS patients based on cytokine profile may represent an opportunity for personalized treatment of this condition.
肠易激综合征（IBS）是一种病因不明的功能性胃肠疾病；尽管感染和炎症最近被认为是重要的病因。最近的一项荟萃分析显示细胞因子[白细胞介素-10（IL-10）和肿瘤坏死因子（TNF）]基因多态性与IBS之间存在相关性；然而，与健康人群相比，IBS患者是否具有不同的细胞因子谱仍不清楚。
为了确定IL-10/TNF-α的血清/血浆水平或黏膜表达与IBS之间的关系，我们基于从PubMed和EMBASE检索到的截至2013年8月的病例对照研究进行了系统评价和荟萃分析。采用逆方差法生成标准化均数差（SMD）。基于I(2)值评估异质性。
与对照组相比，IBS患者的TNF-α血清/血浆水平有升高趋势（p = 0.09）；在IBS亚型与对照组以及女性IBS患者中这一差异具有统计学意义。然而，IBS患者与对照组的IL-10血清/血浆水平无显著差异。对IBS亚型的血清/血浆IL-10水平进行进一步分析未显示出任何差异；然而，基于性别的分析显示，男性IBS患者的血清/血浆IL-10水平显著低于男性对照组（p = 0.02）。与对照组相比，IBS患者结肠IL-10 mRNA表达显著降低（p = 0.001）。
IBS中促炎细胞因子TNF-α和抗炎细胞因子IL-10之间存在失衡。根据细胞因子谱对IBS患者进行分层可能为该疾病的个性化治疗提供契机。
