Abstract
Background: Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders, exhibiting complex and controversial pathological features. Both oxidative stress and inflammation-related reactive oxygen species production may be involved in IBS pathological development. Thus, we focused on several aspects regarding the causes of oxidative stress occurrence in IBS. Additionally, in the molecular context of oxidative changes, we tried to discuss these possible neurological implications in IBS. Methods: The literature search included the main available databases (e.g., ScienceDirect, Pubmed/Medline, Embase, and Google Scholar). Articles in the English language were taken into consideration. Our screening was conducted based on several words such as “irritable bowel syndrome”, “gut brain axis”, “oxidative stress”, “neuroendocrine”, and combinations. Results: While no consistent evidence suggests clear pathway mechanisms, it seems that the inflammatory response may also be relevant in IBS. The mild implication of oxidative stress in IBS has been described through clinical studies and some animal models, revealing changes in the main markers such as antioxidant status and peroxidation markers. Moreover, it seems that the neurological structures involved in the brain-gut axis may be affected in IBS rather than the local gut tissue and functionality. Due to a gut-brain axis bidirectional communication error, a correlation between neurological impairment, emotional over-responsiveness, mild inflammatory patterns, and oxidative stress can be suggested. Conclusions: Therefore, there is a possible correlation between neurological impairment, emotional over-responsiveness, mild inflammatory patterns, and oxidative stress that are not followed by tissue destruction in IBS patients. Moreover, it is not yet clear whether oxidative stress, inflammation, or neurological impairments are key determinants or in which way these three interact in IBS pathology. However, the conditions in which oxidative imbalances occur may be an interesting research lead in order to find possible explanations for IBS development.
Highlights
Reactive oxygen species (ROS) and reactive nitrogen species (RNS) are the most common and abundant small active molecules in normal metabolism
[50] described a possible pathway of neuroinflammation involved in enteric nerve system impairment that would lead to hyper-excitability followed by impaired intestinal motility
Still, based on the gender differences previously described in the current literature, Oran et al reported no significant difference in terms of age and gender between the groups
Summary
Reactive oxygen species (ROS) and reactive nitrogen species (RNS) are the most common and abundant small active molecules in normal metabolism. While clear beneficial effects of ROS have been shown, a constant balance between ROS production and reduction is imperative Both enzymatic and non-enzymatic mechanisms are responsible for removing free radicals and inhibiting oxidative processes, by being oxidized themselves [4]. The excessive generation of ROS generates an important homeostatic imbalance that eventually leads to many unwanted effects such as oxidative tissue damage and inflammation [4] While many stressors such as radiation, toxic substance intake, nonsteroidal anti-inflammatory agents, infections, and inflammation may lead to high ROS production, natural antioxidant defenses can limit the harmful effects of them [6]. Inflammatory bowel disease and its subtypes, gastrointestinal ulcers and their subtypes, gastroesophageal reflux disease, gastritis, enteritis, colitis, pancreatitis, liver cirrhosis, and cancer originate from oxidative imbalance [15] Withal, it seems that the GIT diseases are the most common systemic impairments occurring in the general population [16]. Some of the gastrointestinal diseases seem to lack detectable organic causes, being classified as functional disorders [19]
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