Cited by 591Gastrointestinal motility and disordersPain Mechanisms and TreatmentsInflammatory Bowel Disease

Role for protease activity in visceral pain in irritable bowel syndrome

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Cenac, Nicolas, Andrews, Christopher N., Holzhausen, Marinella, Chapman, Kevin, Cottrell, Graeme, Andrade-Gordon, Patricia, Steinhoff, Martin, Barbara, Giovanni +6 more·2007·Journal of Clinical Investigation

Abstract

Mediators involved in the generation of symptoms in patients with irritable bowel syndrome (IBS) are poorly understood. Here we show that colonic biopsy samples from IBS patients release increased levels of proteolytic activity (arginine cleavage) compared to asymptomatic controls. This was dependent on the activation of NF-kappaB. In addition, increased proteolytic activity was measured in vivo, in colonic washes from IBS compared with control patients. Trypsin and tryptase expression and release were increased in colonic biopsies from IBS patients compared with control subjects. Biopsies from IBS patients (but not controls) released mediators that sensitized murine sensory neurons in culture. Sensitization was prevented by a serine protease inhibitor and was absent in neurons lacking functional protease-activated receptor-2 (PAR2). Supernatants from colonic biopsies of IBS patients, but not controls, also caused somatic and visceral hyperalgesia and allodynia in mice, when administered into the colon. These pronociceptive effects were inhibited by serine protease inhibitors and a PAR2 antagonist and were absent in PAR2-deficient mice. Our study establishes that proteases are released in IBS and that they can directly stimulate sensory neurons and generate hypersensitivity symptoms through the activation of PAR2.

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Crossref · 10.1172/jci29255

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  • Some studies failed to demonstrate increased activated mast cells in IBS patients.

    “However, some studies failed to demonstrate increased activated mast cells in IBS patients (35, 36, 57, 58, 168) and there are no consistent differences in the tissue concentrations of activated mast cells in patients with different IBS subtypes (36, 189).”
  • Other studies have reported elevated levels of histamine and tryptase release in patients with IBS compared with controls.

    “Other studies have reported elevated levels of histamine and tryptase release in patients with IBS compared with controls (11, 13, 35, 73).”
  • Trypsin-like activity and tryptase release are increased in colonic biopsies from irritable bowel syndrome patients.

    “For example, Trypsin-like activity and tryptase release are increased in colonic biopsies from IBS patients.7,58”
  • 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”
  • Biopsy supernatants from IBS patients excite spinal afferent neurons via PAR-2 activation.

    “Biopsy supernatants from IBS patients have also been shown to excite spinal afferent neurons via PAR-2 activation.7,58,155”

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Authors
Cenac, N., Andrews, C. N., Holzhausen, M., Chapman, K., Cottrell, G., Andrade-Gordon, P., Steinhoff, M., Barbara, G., Beck, P., Bunnett, N. W., Sharkey, K. A., Ferraz, J. G. P., Shaffer, E., & Vergnolle, N.
Affiliations
  • University of Calgary (CA)
  • University of California, San Francisco (US)
  • University of Münster (DE)
  • University of Bologna (IT)
Corresponding author
Vergnolle, Nathalie
Venue
Journal of Clinical Investigation
Published
2007-03-01
Volume
117
Issue
3
Pages
636-647
ISSN
0021-9738 (ISSN-L)
OpenAlex
W2140528350
Cited by
591
References
66
Citations by year
2026: 12 · 2025: 19 · 2024: 22 · 2023: 19 · 2022: 21 · 2021: 24 · 2020: 26 · 2019: 27 · 2018: 25 · 2017: 32 · 2016: 37 · 2015: 28 · 2014: 36 · 2013: 38 · 2012: 41
FWCI
39.19
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Investigation (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • CentAUR (University of Reading) (submittedVersion)
  • Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
Funders
  • Crohn's and Colitis Foundation
  • Crohn's and Colitis Foundation of Canada
  • Canadian Association of Gastroenterology
  • Fondation pour la Recherche Médicale
  • Alberta Heritage Foundation for Medical Research
  • National Institutes of Health (DK43207, DK57480)
  • Canadian Institutes of Health Research (DK43207)
  • National Institute of Diabetes and Digestive and Kidney Diseases (DK 43207, R01DK043207, DK-57480, R56DK043207)
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
Keywords
irritable bowel syndrome, visceral pain, proteolytic activity, NF-κB, trypsin, tryptase, protease-activated receptor 2, sensory neuron sensitization, visceral hypersensitivity, allodynia, serine protease inhibitors, colonic biopsy
MeSH terms
Adult, alpha 1-Antitrypsin, Colon, Female, Humans, Hyperalgesia, Male, Middle Aged, Neurons, Afferent, Endopeptidases, Trypsin, Abdominal Pain, Serine Proteinase Inhibitors, NF-kappa B, Irritable Bowel Syndrome, Receptor, PAR-2, Tryptases

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