Sex hormones in the modulation of irritable bowel syndrome

作     者：Agata Mulak Yvette Taché Muriel Larauche 

作者机构：Department of Gastroenterology and HepatologyWroclaw Medical University 50-556 Wroclaw Poland CURE:Digestive Diseases Research Center and Oppenheimer Family Center for Neurobiology of Stress Digestive Diseases Division Department of MedicineUniversity of California Los Angeles VA Greater Los Angeles Healthcare System Los Angeles CA 90073 United States 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2014年第20卷第10期

页      面：2433-2448页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Supported by The Veterans Administration Research Career Scientist Award(to TachéY) National Institute of Health grants No.P50 DK-64539(to TachéY) No.K01-DK088937(to Larauche M) 

主　　题：Brain-gut axis Irritable bowel syndrome Microbiota Pain modulation Sex hormones 

摘      要：Compelling evidence indicates sex and gender differences in epidemiology, symptomatology, pathophysiology, and treatment outcome in irritable bowel syndrome (IBS). Based on the female predominance as well as the correlation between IBS symptoms and hormonal status, several models have been proposed to examine the role of sex hormones in gastrointestinal (GI) function including differences in GI symptoms expression in distinct phases of the menstrual cycle, in pre- and post-menopausal women, during pregnancy, hormonal treatment or after oophorectomy. Sex hormones may influence peripheral and central regulatory mechanisms of the brain-gut axis involved in the pathophysiology of IBS contributing to the alterations in visceral sensitivity, motility, intestinal barrier function, and immune activation of intestinal mucosa. Sex differences in stress response of the hypothalamic-pituitary-adrenal axis and autonomic nervous system, neuroimmune interactions triggered by stress, as well as estrogen interactions with serotonin and corticotropin-releasing factor signaling systems are being increasingly recognized. A concept of “microgenderome related to the potential role of sex hormone modulation of the gut microbiota is also emerging. Significant differences between IBS female and male patients regarding symptomatology and comorbidity with other chronic pain syndromes and psychiatric disorders, together with differences in efficacy of serotonergic medications in IBS patients confirm the necessity for more sex-tailored therapeutic approach in this disorder.