Several chemical and molecular factors are reported to be altered and to have a potentially significant role in irritable bowel syndrome (IBS), particularly in IBS with diarrhea (IBS-D). These include bile acids, short chain fatty acids, mucosal barrier proteins, mast cell products such as histamine, proteases and tryptase, enteroendocrine cell products, and mucosal mRNAs, proteins and micro-RNAs. This article reviews the current knowledge and unanswered questions in the pathobiology of the chemical and molecular factors in IBS. Evidence continues to point to significant roles in pathogenesis of these chemical and molecular mechanisms, which may therefore constitute potential targets for future research and therapy. However, it is still necessary to address the interaction between these factors in the gut, and to appraise how they may influence hypervigilance in the central nervous system in patients with IBS.
- Copyright © 2016, American Journal of Physiology-Gastrointestinal and Liver Physiology