[PDF][PDF] A potential role for stress-induced microbial alterations in IgA-associated irritable bowel syndrome with diarrhea

S Rengarajan, KA Knoop, A Rengarajan, JN Chai… - Cell Reports …, 2020 - cell.com
S Rengarajan, KA Knoop, A Rengarajan, JN Chai, JG Grajales-Reyes, VK Samineni
Cell Reports Medicine, 2020cell.com
Stress is a known trigger for flares of inflammatory bowel disease (IBD) and irritable bowel
syndrome (IBS); however, this process is not well understood. Here, we find that restraint
stress in mice leads to signs of diarrhea, fecal dysbiosis, and a barrier defect via the opening
of goblet-cell associated passages. Notably, stress increases host immunity to gut bacteria
as assessed by immunoglobulin A (IgA)-bound gut bacteria. Stress-induced microbial
changes are necessary and sufficient to elicit these effects. Moreover, similar to mice, many …
Summary
Stress is a known trigger for flares of inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS); however, this process is not well understood. Here, we find that restraint stress in mice leads to signs of diarrhea, fecal dysbiosis, and a barrier defect via the opening of goblet-cell associated passages. Notably, stress increases host immunity to gut bacteria as assessed by immunoglobulin A (IgA)-bound gut bacteria. Stress-induced microbial changes are necessary and sufficient to elicit these effects. Moreover, similar to mice, many diarrhea-predominant IBS (IBS-D) patients from two cohorts display increased antibacterial immunity as assessed by IgA-bound fecal bacteria. This antibacterial IgA response in IBS-D correlates with somatic symptom severity and was distinct from healthy controls or IBD patients. These findings suggest that stress may play an important role in patients with IgA-associated IBS-D by disrupting the intestinal microbial community that alters gastrointestinal function and host immunity to commensal bacteria.
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