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Brain-gut interactions in inflammatory bowel disease.
Bonaz B. L., Bernstein C. N.
Gastroenterology 144, 1 (2013) 36-49 - http://www.hal.inserm.fr/inserm-00745108
(23063970)
Brain-gut interactions in inflammatory bowel disease.
Bruno Bonaz () 1, 2, Charles Bernstein3
1 :  GIN - U836 - Grenoble Institut des Neurosciences
http://neurosciences.ujf-grenoble.fr/
INSERM : U836 – Université Joseph Fourier - Grenoble I – CHU Grenoble – CEA : DSV/IRTSV
UJF - Site Santé La Tronche - BP 170 - 38042 Grenoble Cedex 9
France
2 :  Clinique Universitaire d'Hépato-Gastroentérologie
CHU Grenoble
France
3 :  Section of Gastroenterology
University of Manitoba – Department of Internal Medicine
Winnipeg, Manitoba Canada R3T 2N2
Canada
INSERM U836, équipe 8, Stress et interactions neurodigestives
Psycho-neuro-endocrine-immune modulation through the brain-gut axis likely has a key role in the pathogenesis of inflammatory bowel disease (IBD). The brain-gut axis involves interactions among the neural components, including (1) the autonomic nervous system, (2) the central nervous system, (3) the stress system (hypothalamic-pituitary-adrenal axis), (4) the (gastrointestinal) corticotropin-releasing factor system, and (5) the intestinal response (including the intestinal barrier, the luminal microbiota, and the intestinal immune response). Animal models suggest that the cholinergic anti-inflammatory pathway through an anti-tumor necrosis factor effect of the efferent vagus nerve could be a therapeutic target in IBD through a pharmacologic, nutritional, or neurostimulation approach. In addition, the psychophysiological vulnerability of patients with IBD, secondary to the potential presence of any mood disorders, distress, increased perceived stress, or maladaptive coping strategies, underscores the psychological needs of patients with IBD. Clinicians need to address these issues with patients because there is emerging evidence that stress or other negative psychological attributes may have an effect on the disease course. Future research may include exploration of markers of brain-gut interactions, including serum/salivary cortisol (as a marker of the hypothalamic-pituitary-adrenal axis), heart rate variability (as a marker of the sympathovagal balance), or brain imaging studies. The widespread use and potential impact of complementary and alternative medicine and the positive response to placebo (in clinical trials) is further evidence that exploring other psycho-interventions may be important therapeutic adjuncts to the conventional therapeutic approach in IBD.
Sciences du Vivant/Neurosciences
Sciences du Vivant/Immunologie
Sciences du Vivant/Médecine humaine et pathologie/Hépatologie et Gastroentérologie
Anglais
1528-0012

Articles dans des revues avec comité de lecture
10.1053/j.gastro.2012.10.003
Gastroenterology (Gastroenterology)
Publisher WB Saunders
ISSN 0016-5085 
internationale
01/2013
12/10/2012
144
1
36-49

Autonomic nervous system – Brain-gut axis – Corticotropin-releasing factor – Inflammatory bowel diseases – Stress
Animals – Anxiety – Autonomic Nervous System – Brain – Corticotropin-Releasing Hormone – Depression – Gastrointestinal Tract – Humans – Hypothalamo-Hypophyseal System – Inflammatory Bowel Diseases – Pituitary-Adrenal System – Stress – Physiological – Psychological
Dr Bernstein is supported in part by the Bingham Chair in Gastroenterology. He has served as consultant to Abbott Canada, Janssen Canada, Shire Canada, Vertex Pharamceuticals, Bristol Myers Squibb and has received a research grant from Abbott Canada and an educational grant from Aptalis Pharmaceuticals.
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