Wan Xuemeng, Wang Liyuan, Wang Zhiling, Wan Chaomin
Department of Pediatrics, West China Second University Hospital of Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, China.
Front Immunol. 2024 Dec 19;15:1490653. doi: 10.3389/fimmu.2024.1490653. eCollection 2024.
Irritable bowel syndrome (IBS) is a common gastrointestinal disease. Recently, an increasing number of studies have shown that Toll-like receptor 4 (TLR4), widely distributed on the surface of a variety of epithelial cells (ECs) and immune sentinel cells in the gut, plays a vital role in developing IBS.
We sought to synthesize the existing literature on TLR4 in IBS and inform further study.
We conducted a systematic search of the PubMed, Embase (Ovid), Scopus, Web of Science, MEDLINE, and Cochrane Library databases on June 8, 2024, and screened relevant literature. Critical information was extracted, including clinical significance, relevant molecular mechanisms, and therapeutic approaches targeting TLR4 and its pathways.
Clinical data showed that aberrant TLR4 expression is associated with clinical manifestations such as pain and diarrhea in IBS. Aberrant expression of TLR4 is involved in pathological processes such as intestinal inflammation, barrier damage, visceral sensitization, and dysbiosis, which may be related to TLR4, NF-κB, pro-inflammatory effects, and CRF. Several studies have shown that many promising therapeutic options (i.e., acupuncture, herbs, probiotics, hormones, etc.) have been able to improve intestinal inflammation, visceral sensitization, intestinal barrier function, intestinal flora, defecation abnormalities, and depression by inhibiting TLR4 expression and related pathways.
TLR4 plays a crucial role in the development of IBS. Many promising therapeutic approaches alleviate IBS through TLR4 and its pathways. Strategies for targeting TLR4 in the future may provide new ideas for treating IBS.
肠易激综合征（IBS）是一种常见的胃肠道疾病。最近，越来越多的研究表明，广泛分布于各种上皮细胞（ECs）表面和肠道免疫哨兵细胞上的Toll样受体4（TLR4）在IBS的发生发展中起着至关重要的作用。
我们试图综合现有的关于IBS中TLR4的文献，并为进一步研究提供信息。
我们于2024年6月8日对PubMed、Embase（Ovid）、Scopus、Web of Science、MEDLINE和Cochrane图书馆数据库进行了系统检索，并筛选了相关文献。提取了关键信息，包括临床意义、相关分子机制以及针对TLR4及其信号通路的治疗方法。
临床数据表明，TLR4的异常表达与IBS中的疼痛和腹泻等临床表现相关。TLR4的异常表达参与了肠道炎症、屏障损伤、内脏高敏反应和菌群失调等病理过程，这可能与TLR4、核因子-κB（NF-κB）、促炎作用和促肾上腺皮质激素释放因子（CRF）有关。几项研究表明，许多有前景的治疗选择（即针灸、草药、益生菌、激素等）能够通过抑制TLR4表达及其相关信号通路来改善肠道炎症、内脏高敏反应、肠道屏障功能、肠道菌群、排便异常和抑郁。
TLR4在IBS的发生发展中起关键作用。许多有前景的治疗方法通过TLR4及其信号通路缓解IBS。未来针对TLR4的策略可能为治疗IBS提供新思路。
