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Breakthrough in IBS research: Local immune response to food antigens drives meal-induced abdominal pain

Up to 20% of the population may suffer Irritable bowel syndrome (IBS). One of the main symptoms of IBS is meal-induced abdominal pain which affects the quality of life significantly.

This month, Belgian researchers published a paper in Nature showing for the first time in mice and man that a bacterial gut infection can profoundly change local immune responses in the gut, resulting in certain foods being perceived as harmful, and thereby causing persistent gut pain. So there is a loss of oral tolerance and mast cell degranulation seem to play a pivotal role in this process. The histamine that is released by the mast cells upon degranulation binds to a receptor on sensory neurons, activating them and causing pain.

This work reveals new therapeutic targets like the mast cells in the gut, the molecules (e.g. histamine) released by mast cells, or the receptors on which they act; and blocking the colonic sensory nerves that transmit the noxious information and cause pain.

From a dietary point of view, the question is if oral tolerance can be reacquired once it is lost? Currently, the FODMAPs diet is a popular means to avoid the pain. This diet is low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols. Gradual reintroduction of these FODMAPs may improve the long-term prognosis. This new study may help to identify new (dietary) ways to intervene.

Original article: Aguilera-Lizarraga, J. et al. Nature https://doi.org/10.1038/s41586-020-03118-2 (2021).

NEWS AND VIEWS in Nature: http://https://www.nature.com/articles/d41586-020-03661-y

 

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