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Review

Neurotransmitter Dysfunction in Irritable Bowel Syndrome: Emerging Approaches for Management

1
Centro de Salud Univérsitas, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain
2
Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
3
Servicio de Urgencias, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain
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Departamento de Farmacología, Fisiología y Medicina Legal y Forense, Facultad de Veterinaria, Universidad de Zaragoza, 50009 Zaragoza, Spain
5
Instituto Agroalimentario de Aragón—IA2—(Universidad de Zaragoza—CITA), 50013 Zaragoza, Spain
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Departamento de Bioquímica y Biología Molecular y Celular, Facultad de Ciencias, Universidad de Zaragoza, 50009 Zaragoza, Spain
*
Author to whom correspondence should be addressed.
Academic Editor: H. Christian Weber
J. Clin. Med. 2021, 10(15), 3429; https://doi.org/10.3390/jcm10153429
Received: 30 June 2021 / Revised: 13 July 2021 / Accepted: 28 July 2021 / Published: 31 July 2021
(This article belongs to the Special Issue Clinical Advances in Chronic Intestinal Diseases Treatment)
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder whose aetiology is still unknown. Most hypotheses point out the gut-brain axis as a key factor for IBS. The axis is composed of different anatomic and functional structures intercommunicated through neurotransmitters. However, the implications of key neurotransmitters such as norepinephrine, serotonin, glutamate, GABA or acetylcholine in IBS are poorly studied. The aim of this review is to evaluate the current evidence about neurotransmitter dysfunction in IBS and explore the potential therapeutic approaches. IBS patients with altered colorectal motility show augmented norepinephrine and acetylcholine levels in plasma and an increased sensitivity of central serotonin receptors. A decrease of colonic mucosal serotonin transporter and a downregulation of α2 adrenoceptors are also correlated with visceral hypersensitivity and an increase of 5-hydroxyindole acetic acid levels, enhanced expression of high affinity choline transporter and lower levels of GABA. Given these neurotransmitter dysfunctions, novel pharmacological approaches such as 5-HT3 receptor antagonists and 5-HT4 receptor agonists are being explored for IBS management, for their antiemetic and prokinetic effects. GABA-analogous medications are being considered to reduce visceral pain. Moreover, agonists and antagonists of muscarinic receptors are under clinical trials. Targeting neurotransmitter dysfunction could provide promising new approaches for IBS management. View Full-Text
Keywords: IBS; microbiota; visceral hypersensitivity; colorectal motility IBS; microbiota; visceral hypersensitivity; colorectal motility
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MDPI and ACS Style

Gros, M.; Gros, B.; Mesonero, J.E.; Latorre, E. Neurotransmitter Dysfunction in Irritable Bowel Syndrome: Emerging Approaches for Management. J. Clin. Med. 2021, 10, 3429. https://doi.org/10.3390/jcm10153429

AMA Style

Gros M, Gros B, Mesonero JE, Latorre E. Neurotransmitter Dysfunction in Irritable Bowel Syndrome: Emerging Approaches for Management. Journal of Clinical Medicine. 2021; 10(15):3429. https://doi.org/10.3390/jcm10153429

Chicago/Turabian Style

Gros, Mónica, Belén Gros, José E. Mesonero, and Eva Latorre. 2021. "Neurotransmitter Dysfunction in Irritable Bowel Syndrome: Emerging Approaches for Management" Journal of Clinical Medicine 10, no. 15: 3429. https://doi.org/10.3390/jcm10153429

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