促肾上腺皮质激素释放因子1型和2型受体在肠易激综合征中的相互作用

Corticotropin-releasing factor receptor type 1 and type 2 interaction in irritable bowel syndrome.

作者信息

Nozu Tsukasa, Okumura Toshikatsu

机构信息

Department of Regional Medicine and Education, Asahikawa Medical University, Midorigaoka Higashi 2-1-1-1, Asahikawa, 078-8510, Japan,

出版信息

J Gastroenterol. 2015 Aug;50(8):819-30. doi: 10.1007/s00535-015-1086-8. Epub 2015 May 12.

Abstract

Irritable bowel syndrome (IBS) displays chronic abdominal pain or discomfort with altered defecation, and stress-induced altered gut motility and visceral sensation play an important role in the pathophysiology. Corticotropin-releasing factor (CRF) is a main mediator of stress responses and mediates these gastrointestinal functional changes. CRF in brain and periphery acts through two subtype receptors such as CRF receptor type 1 (CRF1) and type 2 (CRF2), and activating CRF1 exclusively stimulates colonic motor function and induces visceral hypersensitivity. Meanwhile, several recent studies have demonstrated that CRF2 has a counter regulatory action against CRF1, which may imply that CRF2 inhibits stress response induced by CRF1 in order to prevent it from going into an overdrive state. Colonic contractility and sensation may be explained by the state of the intensity of CRF1 signaling. CRF2 signaling may play a role in CRF1-triggered enhanced colonic functions through modulation of CRF1 activity. Blocking CRF2 further enhances CRF-induced stimulation of colonic contractility and activating CRF2 inhibits stress-induced visceral sensitization. Therefore, we proposed the hypothesis, i.e., balance theory of CRF1 and CRF2 signaling as follows. Both CRF receptors may be activated simultaneously and the signaling balance of CRF1 and CRF2 may determine the functional changes of gastrointestinal tract induced by stress. CRF signaling balance might be abnormally shifted toward CRF1, leading to enhanced colonic motility and visceral sensitization in IBS. This theory may lead to understanding the pathophysiology and provide the novel therapeutic options targeting altered signaling balance of CRF1 and CRF2 in IBS.

摘要

肠易激综合征(IBS)表现为慢性腹痛或不适并伴有排便习惯改变,应激诱导的肠道动力改变和内脏感觉在其病理生理学中起重要作用。促肾上腺皮质激素释放因子(CRF)是应激反应的主要介质,介导这些胃肠道功能变化。脑和外周的CRF通过两种亚型受体发挥作用,如1型CRF受体(CRF1)和2型CRF受体(CRF2),仅激活CRF1会刺激结肠运动功能并诱导内脏超敏反应。同时,最近的几项研究表明,CRF2对CRF1具有反调节作用,这可能意味着CRF2抑制CRF1诱导的应激反应,以防止其进入过度激活状态。结肠收缩性和感觉可以通过CRF1信号强度的状态来解释。CRF2信号可能通过调节CRF1活性在CRF1触发的结肠功能增强中发挥作用。阻断CRF2会进一步增强CRF诱导的结肠收缩刺激,而激活CRF2会抑制应激诱导的内脏致敏。因此,我们提出了如下假设,即CRF1和CRF2信号平衡理论。两种CRF受体可能同时被激活,CRF1和CRF2的信号平衡可能决定应激诱导的胃肠道功能变化。CRF信号平衡可能异常地向CRF1偏移,导致IBS患者结肠动力增强和内脏致敏。该理论可能有助于理解其病理生理学,并为针对IBS中CRF1和CRF2信号平衡改变的新型治疗选择提供依据。

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