Functional Bowel Disorders Are Associated with a Central Immune Activation.

Per G Farup,Knut Hestad,Thor Ueland,Knut Rudi,Stian Lydersen

doi:10.1155/2017/1642912

Abstract

Background Subjects with depression and unexplained neurological symptoms have a high prevalence of gastrointestinal comorbidity probably related to the brain-gut communication. This study explored associations between functional gastrointestinal disorders (FGID) and inflammatory markers in subjects with these disorders. Methods The FGID, including irritable bowel syndrome (IBS), were classified according to the Rome III criteria, and degree of symptoms was assessed with IBS symptom severity score (IBS-SSS). A range of interleukins (IL), chemokines and growth factors, tryptophan, and kynurenine were analysed in serum and the cerebrospinal fluid (CSF), and short-chain fatty acids (SCFA) were analysed in the faeces. The results are reported as partial correlation (pc) and p values. Results Sixty-six subjects were included. IBS was associated with high levels of tryptophan (p = 0.048) and kynurenine (p = 0.019) and low level of IL-10 (p = 0.047) in the CSF. IBS-SSS was associated with high tumor necrosis factor and low IL-10 in the CSF; pc = 0.341 and p = 0.009 and pc = −0.299 and p = 0.023, respectively. Propionic minus butyric acid in faeces was negatively associated with IL-10 in the CSF (pc = −0.416, p = 0.005). Conclusions FGID were associated with a proinflammatory immune activation in the central nervous system and a disturbed tryptophan metabolism that could have been mediated by the faecal microbiota.

Highlights

Subjects with depression and unexplained neurological symptoms have a high prevalence of gastrointestinal comorbidity probably related to the brain-gut communication
functional gastrointestinal disorders (FGID) were associated with a proinflammatory immune activation in the central nervous system and a disturbed tryptophan metabolism that could have been mediated by the faecal microbiota
Analysis of irritable bowel syndrome (IBS)-SSS was missing in one patient in the neurological group, analyses of the cerebrospinal fluid (CSF) were missing in four subjects in the depression group, and analyses of faeces were missing in two subjects in the neurological group and 14 in the depression group

Summary

Introduction

Subjects with depression and unexplained neurological symptoms have a high prevalence of gastrointestinal comorbidity probably related to the brain-gut communication. IBS was associated with high levels of tryptophan (p = 0 048) and kynurenine (p = 0 019) and low level of IL-10 (p = 0 047) in the CSF. Functional gastrointestinal disorders (FGID) are common, probably due to the cross talk between the brain and the gut through the brain-gut axis [3]. Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder (FGID) with a prevalence rate of approximately 8% in the Western world [4]. IBS is characterised by abdominal pain and disturbed bowel functions and a high prevalence of comorbidities such as muscle-skeletal pain, fatigue, anxiety, and depression [5, 6].

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