Intestinal Barrier in Post- Irritable Bowel Syndrome.

BACKGROUND

() is one of the most common causes of bacterial gastroenteritis worldwide. One sequela of this infection is the development of post-infectious irritable bowel syndrome (PI-IBS). It has been suggested that a dysfunctional intestinal barrier may promote IBS development. We aimed to test this hypothesis against the background of the leaky gut concept for low-grade inflammation in PI-IBS.

METHODS

We identified patients with persistent PI-IBS symptoms after infection. During sigmoidoscopy, forceps biopsies were obtained for electrophysiological measurements of epithelial transport and barrier function in miniaturized Ussing devices. absence was checked by PCR and cytokine production with immunohistochemistry.

RESULTS

In PI-IBS, the epithelial resistance of the colon epithelium was unaltered, reflecting an intact paracellular pathway. In contrast, temperature-dependent horseradish peroxidase (HRP, 44 kDa) permeation increased. Short-circuit current (Isc) reflecting active anion secretion and ENaC-dependent electrogenic sodium absorption was unaffected. Early endosome antigen-1 (EEA1) and IL-4 levels increased. is not incorporated into the resident microbiota of the colon mucosa in PI-IBS.

CONCLUSIONS

In PI-IBS after infection, macromolecule uptake via endocytosis was enhanced, leading to low-grade inflammation with pro-inflammatory cytokine release. The findings will allow -induced pathomechanisms to be targeted during infection and, thereafter to reduce sequelae such as PI-IBS.