The brainegut pathway in functional gastrointestinal disorders is bidirectional: a 12-year prospective population-based study. (English)
In: Gut, Jg. 61 (2012-09-01), Heft 9, S. 1284-1290
Online
academicJournal
Zugriff:
Objective Inflammatory bowel diseases (IBDs) feature multiple cellular stress responses, including endoplasmic reticulum (ER) unfolded protein responses (UPRs). UPRs represent autoregulatory pathways that adjust organelle capacity to cellular demand. A similar mechanism, mitochondrial UPR (mtUPR), has been described for mitochondria. ER UPR in intestinal epithelial cells (IECs) contributes to the development of intestinal inflammation, and since mitochondrial alterations and dysfunction are implicated in the pathogenesis of IBDs, the authors characterised mtUPR in the context of intestinal inflammation. Methods Truncated ornithine transcarbamylase was used to selectively induce mtUPR in a murine IEC line. Dextran sodium sulphate (DSS) was administered to PKR (double-stranded-RNA-activated protein kinase) knockout mice to induce IEC stress in vivo and to test for their susceptibility to DSS-induced colitis. Expression Objective Psychological factors are known to be associated with functional gastrointestinal disorders (FGIDs) including irritable bowel syndrome (IBS) and functional dyspepsia (FD). No prospective studies have evaluated whether it is the brain (eg, via anxiety) that drives gut symptoms, or whether gut dysfunction precipitates the central nervous system features such as anxiety. In a 12-year longitudinal, prospective, population-based study, we aimed to determine the directionality of the brainegut mechanism in FGIDs. Design Participants (n=1775) were a random population sample from Australia who responded to a survey on FGIDs in 1997 and agreed to be contacted for future research; 1002 completed the 12-year followup survey (response rate =60%), with 217, 82 and 45 people meeting Rome II for new onset FGIDs, IBS and FD, respectively. Anxiety and depression were measured using the Delusions Symptom States Inventory at baseline and follow-up. Results Among people free of a FGID at baseline, higher levels of anxiety (OR 1.11; 95% CI 1.03 to 1.19, p=0.006) but not depression at baseline was a significant independent predictor of developing new onset FGIDs 12 years later. Among people who did not have elevated levels of anxiety and depression at baseline, those with a FGID at baseline had significantly higher levels of anxiety and depression at follow-up (mean difference coefficient 0.76, p<0.001 and 0.30, p=0.01 for anxiety and depression, respectively). In IBS higher levels of anxiety and depression at baseline were predictive of IBS at follow-up, while only depression was predictive of FD at follow-up. Conclusions The central nervous system and gut interact bidirectionally in FGIDs. [ABSTRACT FROM AUTHOR]
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Titel: |
The brainegut pathway in functional gastrointestinal disorders is bidirectional: a 12-year prospective population-based study. (English)
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Autor/in / Beteiligte Person: | Koloski, N. A. ; Jones, M. ; Kalantar, J. ; Weltman, M. ; Zaguirre, J. ; Talley, N. J. |
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Zeitschrift: | Gut, Jg. 61 (2012-09-01), Heft 9, S. 1284-1290 |
Veröffentlichung: | 2012 |
Medientyp: | academicJournal |
ISSN: | 0017-5749 (print) |
DOI: | 10.1136/gutjnl-2011-300474 |
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