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  • Review Article
  • Published:

Crosstalk at the mucosal border: importance of the gut microenvironment in IBS

Nature Reviews Gastroenterology & Hepatology volume 12, pages 36–49 (2015)Cite this article

Subjects

Key Points

  • Altered gut microbiota composition, aberrant expression pattern and function of enterochromaffin cells, abnormal gut permeability and dysregulated immune activity have been found in at least subgroups of patients with IBS

  • The complex interaction between these systems has been demonstrated in different animal models of IBS

  • The association between these abnormalities and the symptom profile in patients with IBS has been demonstrated

  • Targeting these alterations in the development of new therapies for IBS seems promising

Abstract

The aetiology and pathology of IBS, a functional bowel disorder thought to lack an organic cause, is largely unknown. However, studies suggest that various features, such as altered composition of the gut microbiota, together with increased intestinal permeability, a changed balance in the enteroendocrine system and a dysregulated immune system in the gut, most likely have an important role in IBS. Exactly how these entities act together and give rise to symptoms is still unknown, but an altered gut microbiota composition could lead to dysregulation of the intestinal barrier as well as the enteroendocrine and the immune systems, which (through interactions with the nervous system) might generate symptoms. This Review highlights the crosstalk between the gut microbiota, the enteroendocrine system, the immune system and the role of intestinal permeability in patients with IBS.

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Figure 1: Peripheral factors involved in the pathophysiology of IBS.
Figure 2: Different structural abnormalities can interact with each other and contribute to the generation of symptoms in IBS.

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  1. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 41345, Sweden

    Lena Öhman, Hans Törnblom & Magnus Simrén

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L.O. has received an unrestricted research grant from AstraZeneca, served as an Advisory Board member for Genetic Analysis AS, and has received speaker honoraria from Abbvie and Takeda. H.T. has received unrestricted research support from Tillotts Pharma, and served as a Consultant and/or Advisory Board member for Almirall, Danone and Shire. M.S. has received unrestricted research grants from AstraZeneca and Danone, and served as a consultant and/or Advisory Board member for Albireo, Almirall, Danone, Chr Hansen, Novartis and Shire.

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Öhman, L., Törnblom, H. & Simrén, M. Crosstalk at the mucosal border: importance of the gut microenvironment in IBS. Nat Rev Gastroenterol Hepatol 12, 36–49 (2015). https://doi.org/10.1038/nrgastro.2014.200

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