Irritable Bowel Syndrome, Depression, and Neurodegeneration: A Bidirectional Communication from Gut to Brain.
Patients with irritable bowel syndrome (IBS) are increasingly presenting with a wide range of neuropsychiatric symptoms, such as deterioration in gastroenteric physiology, including visceral hypersensitivity, altered intestinal membrane permeability, and gastrointestinal motor dysfunction. Functional imaging of IBS patients has revealed several abnormalities in various brain regions, such as significant activation of amygdala, thinning of insular and anterior cingulate cortex, and increase in hypothalamic gray matter, which results in poor psychiatric and cognitive outcomes. Interrelations between the enteric and central events in IBS-related gastrointestinal, neurological, and psychiatric pathologies have compelled researchers to study the gut-brain axis-a bidirectional communication that maintains the homeostasis of the gastrointestinal and central nervous system with gut microbiota as the protagonist. Thus, it can be disrupted by any alteration owing to the gut dysbiosis or loss of diversity in microbial composition. Available evidence indicates that the use of probiotics as a part of a balanced diet is effective in the management of IBS and IBS-associated neurodegenerative and psychiatric comorbidities. In this review, we delineate the pathogenesis and complications of IBS from gastrointestinal and neuropsychiatric standpoints while also discussing the neurodegenerative events in enteric and central nervous systems of IBS patients and the therapeutic potential of gut microbiota-based therapy established on clinical and preclinical data.
['Aziz|Muhammad Nazirul Mubin|MNM|', 'Kumar|Jaya|J|', 'Muhammad Nawawi|Khairul Najmi|KN|0000-0002-5309-5301', 'Raja Ali|Raja Affendi|RA|', 'Mokhtar|Norfilza M|NM|0000-0002-4863-100X']
D001921:Brain D002490:Central Nervous System D003071:Cognition D003142:Communication D015897:Comorbidity D003863:Depression D064806:Dysbiosis D005260:Female D000069196:Gastrointestinal Microbiome D006801:Humans D043183:Irritable Bowel Syndrome D008297:Male D019636:Neurodegenerative Diseases D019936:Probiotics
irritable bowel syndrome depression neurodegeneration gut dysbiosis microbiota-gut-immune-glia axis