Tsang S W, Auyeung K K W, Bian Z X, Ko J K S
Center for Cancer and Inflammation Research, School of Chinese Medicine, Hong Kong Baptist University, 7 Baptist University Road, Kowloon Tong, Hong Kong SAR, China.
Curr Neuropharmacol. 2016;14(8):842-856. doi: 10.2174/1570159x14666160324144154.
Although the precise pathophysiology of irritable bowel syndrome (IBS) remains unknown, it is generally considered to be a disorder of the brain-gut axis, representing the disruption of communication between the brain and the digestive system. The present review describes advances in understanding the pathophysiology and experimental approaches in studying IBS, as well as providing an update of the therapies targeting brain-gut axis in the treatment of the disease.
Causal factors of IBS are reviewed. Following this, the preclinical experimental models of IBS will be introduced. Besides, both current and future therapeutic approaches of IBS will be discussed.
When signal of the brain-gut axis becomes misinterpreted, it may lead to dysregulation of both central and enteric nervous systems, altered intestinal motility, increased visceral sensitivity and consequently contributing to the development of IBS. Interference of the brain-gut axis can be modulated by various psychological and environmental factors. Although there is no existing animal experiment that can represent this complex multifactorial disease, these in vivo models are clinically relevant readouts of gastrointestinal functions being essential to the identification of effective treatments of IBS symptoms as well as their molecular targets. Understanding the brain-gut axis is essential in developing the effective therapy for IBS. Therapies include improvement of GI motor functions, relief of visceral hypersensitivity and pain, attenuation of autonomic dysfunctions and suppression of mucosal immune activation.
Target-oriented therapies that provide symptomatic, psychological and physiological benefits could surely help to improve the quality of life of IBS patients.
尽管肠易激综合征（IBS）的确切病理生理学仍不清楚，但一般认为它是一种脑-肠轴紊乱疾病，表现为大脑与消化系统之间的沟通中断。本综述描述了在理解IBS病理生理学和研究IBS的实验方法方面取得的进展，并提供了针对脑-肠轴治疗该疾病的疗法的最新情况。
对IBS的病因进行综述。在此之后，将介绍IBS的临床前实验模型。此外，还将讨论IBS当前和未来的治疗方法。
当脑-肠轴信号被错误解读时，可能会导致中枢和肠神经系统失调、肠道运动改变、内脏敏感性增加，从而促成IBS的发展。脑-肠轴的干扰可由各种心理和环境因素调节。虽然目前没有能代表这种复杂多因素疾病的动物实验，但这些体内模型是胃肠道功能的临床相关读数，对于确定IBS症状的有效治疗方法及其分子靶点至关重要。了解脑-肠轴对于开发IBS的有效治疗方法至关重要。治疗方法包括改善胃肠运动功能、缓解内脏超敏反应和疼痛、减轻自主神经功能障碍以及抑制黏膜免疫激活。
提供症状、心理和生理益处的靶向治疗肯定有助于改善IBS患者的生活质量。
