Cited by 101Gastrointestinal motility and disordersGut microbiota and healthInflammatory Bowel Disease

Serine proteases as luminal mediators of intestinal barrier dysfunction and symptom severity in IBS

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Edogawa, Shoko, Edwinson, Adam L, Peters, Stephanie A, Chikkamenahalli, Lakshmikanth L, Sundt, Wendy, Graves, Sara, Gurunathan, Sakteesh V, Breen-Lyles, Margaret +7 more·2020·Gut

Abstract

Objective: The intestinal lumen contains several proteases. Our aim was to determine the role of faecal proteases in mediating barrier dysfunction and symptoms in IBS. Design: 39 patients with IBS and 25 healthy volunteers completed questionnaires, assessments of in vivo permeability, ex vivo colonic barrier function in Ussing chambers, tight junction (TJ) proteins, ultrastructural morphology and 16 s sequencing of faecal microbiota rRNA. A casein-based assay was used to measure proteolytic activity (PA) in faecal supernatants (FSNs). Colonic barrier function was determined in mice (ex-germ free) humanised with microbial communities associated with different human PA states. Results: Patients with IBS had higher faecal PA than healthy volunteers. 8/20 postinfection IBS (PI-IBS) and 3/19 constipation- predominant IBS had high PA (>95th percentile). High-PA patients had more and looser bowel movements, greater symptom severity and higher in vivo and ex vivo colonic permeability. High-PA FSNs increased paracellular permeability, decreased occludin and increased phosphorylated myosin light chain (pMLC) expression. Serine but not cysteine protease inhibitor significantly blocked high-PA FSN effects on barrier. The effects on barrier were diminished by pharmacological or siRNA inhibition of protease activated receptor-2 (PAR-2). Patients with high-PA IBS had lower occludin expression, wider TJs on biopsies and reduced microbial diversity than patients with low PA. Mice humanised with high-PA IBS microbiota had greater in vivo permeability than those with low-PA microbiota. Conclusion: A subset of patients with IBS, especially in PI-IBS, has substantially high faecal PA, greater symptoms, impaired barrier and reduced microbial diversity. Commensal microbiota affects luminal PA that can influence host barrier function.

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Crossref · 10.1136/gutjnl-2018-317416

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  • Elevated proteolytic activity is observed in stool supernatants from inflammatory bowel disease and irritable bowel syndrome patients compared to healthy subjects.

    “Elevated PA was also observed in stool supernatants from IBD and IBS patients compared to samples from healthy subjects, suggesting that enhanced PA in IBD and IBS may be due to elevations in PA from both host and microbial origin.12,13”
  • Enhanced proteolytic activity in inflammatory bowel disease and irritable bowel syndrome may be due to elevations from both host and microbial origin.

    “suggesting that enhanced PA in IBD and IBS may be due to elevations in PA from both host and microbial origin.12,13”
  • Studies in mice and humans have provided evidence that host- and bacterial-derived proteases may contribute to irritable bowel syndrome pathogenesis and symptom generation.

    “Similar to IBD, studies in mice and humans have provided evidence that host- and bacterial-derived proteases may contribute to pathogenesis and symptom generation.7,13,57,58”

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Authors
Edogawa, S., Edwinson, A. L., Peters, S. A., Chikkamenahalli, L. L., Sundt, W., Graves, S., Gurunathan, S. V., Breen-Lyles, M., Johnson, S., Dyer, R., Graham, R., Chen, J., Kashyap, P., Farrugia, G., & Grover, M.
Affiliations
Mayo Clinic (US)
Corresponding author
Grover, Madhusudan
Venue
Gut
Publisher
BMJ
Published
2019-03-28
Volume
69
Issue
1
Pages
62-73
ISSN
  • 0017-5749 (ISSN-L)
  • 1468-3288
OpenAlex
W2933912422
Cited by
101
References
60
Citations by year
2026: 7 · 2025: 17 · 2024: 14 · 2023: 13 · 2022: 21 · 2021: 20 · 2020: 8 · 2019: 1
FWCI
11.39
Type
journal article
Language
en
Open access
Locations
  • Gut (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
Keywords
irritable bowel syndrome, serine protease, intestinal barrier dysfunction, colonic permeability, tight junction proteins, occludin, myosin light chain phosphorylation, protease-activated receptor 2, irritable bowel syndrome with constipation, gut microbiota, microbial diversity, symptom severity
MeSH terms
Gastrointestinal Microbiome, Adult, Animals, Biopsy, Colon, Feces, Female, Humans, Intestinal Absorption, Intestinal Mucosa, Male, Middle Aged, Permeability, Prospective Studies, Severity of Illness Index, Case-Control Studies, Caco-2 Cells, Irritable Bowel Syndrome, Mice, Serine Proteases, Proteolysis, Tight Junction Proteins, Dysbiosis

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