Zhou Guo Qiong, Huang Meng Jie, Yu Xin, Zhang Na Na, Tao Shan, Zhang Ming
Department of General Practice, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
Front Pediatr. 2023 Sep 5;11:1241801. doi: 10.3389/fped.2023.1241801. eCollection 2023.
Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder worldwide. Extensive research has identified multiple factors contributing to its development, including genetic predisposition, chronic infection, gut dysbiosis, aberrant serotonin metabolism, and brain dysfunction. Recent studies have emphasized the critical role of the early life stage as a susceptibility window for IBS. Current evidence suggests that diet can heighten the risk of IBS in offspring by influencing the microbiota composition, intestinal epithelium structure, gene expression, and brain-gut axis. The use of antibiotics during pregnancy and the neonatal period disrupts the normal gut microbiota structure, aligning it with the characteristics observed in IBS patients. Additionally, early life stress impacts susceptibility to IBS by modulating TLR4, NK1, and the hypothalamic-pituitary-adrenal (HPA) axis while compromising the offspring's immune system. Formula feeding facilitates the colonization of pathogenic bacteria in the intestines, concurrently reducing the presence of probiotics. This disruption of the Th1 and Th2 cell balance in the immune system weakens the intestinal epithelial barrier. Furthermore, studies suggest that delivery mode influences the occurrence of IBS by altering the composition of gut microbes. This review aims to provide a comprehensive summary of the existing evidence regarding the impact of adverse early life exposures on IBS during pregnancy, intrapartum, and neonatal period. By consolidating this knowledge, the review enhances our understanding of the direct and indirect mechanisms underlying early life-related IBS and offers new insights and research directions from childhood to adulthood.
肠易激综合征（IBS）是一种在全球范围内普遍存在的功能性胃肠疾病。广泛的研究已经确定了多种导致其发病的因素，包括遗传易感性、慢性感染、肠道菌群失调、血清素代谢异常以及脑功能障碍。最近的研究强调了生命早期阶段作为IBS易感窗口的关键作用。目前的证据表明，饮食可通过影响微生物群组成、肠上皮结构、基因表达和脑-肠轴来增加后代患IBS的风险。孕期和新生儿期使用抗生素会破坏正常的肠道微生物群结构，使其与IBS患者所观察到的特征相符。此外，生命早期的压力通过调节Toll样受体4（TLR4）、神经激肽1（NK1）和下丘脑-垂体-肾上腺（HPA）轴，同时损害后代的免疫系统，从而影响对IBS的易感性。配方奶喂养促进了肠道中病原菌的定植，同时减少了益生菌的存在。免疫系统中Th1和Th2细胞平衡的这种破坏削弱了肠上皮屏障。此外，研究表明分娩方式通过改变肠道微生物的组成来影响IBS的发生。本综述旨在全面总结现有证据，阐述孕期、分娩期和新生儿期不良生命早期暴露对IBS的影响。通过整合这些知识，本综述加深了我们对与生命早期相关的IBS潜在直接和间接机制的理解，并提供了从儿童期到成年期的新见解和研究方向。
