Cited by 187Inflammatory Bowel DiseaseTryptophan and brain disordersGut microbiota and health

Psychological stress in inflammatory bowel disease: Psychoneuroimmunological insights into bidirectional gut–brain communications

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Ge, Li, Liu, Shuman, Li, Sha, Yang, Jing, Hu, Guangran, Xu, Changqing, Song, Wengang·2022·Frontiers in Immunology

Abstract

Inflammatory bowel disease (IBD), mainly including ulcerative colitis (UC) and Crohn’s disease (CD), is an autoimmune gastrointestinal disease characterized by chronic inflammation and frequent recurrence. Accumulating evidence has confirmed that chronic psychological stress is considered to trigger IBD deterioration and relapse. Moreover, studies have demonstrated that patients with IBD have a higher risk of developing symptoms of anxiety and depression than healthy individuals. However, the underlying mechanism of the link between psychological stress and IBD remains poorly understood. This review used a psychoneuroimmunology perspective to assess possible neuro-visceral integration, immune modulation, and crucial intestinal microbiome changes in IBD. Furthermore, the bidirectionality of the brain–gut axis was emphasized in the context, indicating that IBD pathophysiology increases the inflammatory response in the central nervous system and further contributes to anxiety- and depression-like behavioral comorbidities. This information will help accurately characterize the link between psychological stress and IBD disease activity. Additionally, the clinical application of functional brain imaging, microbiota-targeted treatment, psychotherapy and antidepressants should be considered during the treatment and diagnosis of IBD with behavioral comorbidities. This review elucidates the significance of more high-quality research combined with large clinical sample sizes and multiple diagnostic methods and psychotherapy, which may help to achieve personalized therapeutic strategies for IBD patients based on stress relief.

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Crossref · 10.3389/fimmu.2022.1016578

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  • Stress is considered a trigger in patients with functional gastrointestinal disorders such as IBS and functional dyspepsia, and in IBDs such as ulcerative colitis and Crohn's disease.

    “Stress is considered a trigger in patients with functional gastrointestinal disorders, such as IBS and functional dyspepsia, as well as IBDs like ulcerative colitis and Crohn’s disease (493).”
  • The gut-brain axis is a complex bidirectional communication system driven by neural, hormonal, metabolic, immunological, and microbial signals.

    “The gut–brain axis is a complex bidirectional communication system driven by neural, hormonal, metabolic, immunological, and microbial signals [77,78].”

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Authors
Ge, L., Liu, S., Li, S., Yang, J., Hu, G., Xu, C., & Song, W.
Affiliations
  • Shandong Provincial QianFoShan Hospital (CN)
  • Shandong First Medical University (CN)
Corresponding author
Song, Wengang
Venue
Frontiers in Immunology
Published
2022-10-06
Volume
13
Pages
1016578-1016578
ISSN
1664-3224 (ISSN-L)
OpenAlex
W4303184202
Cited by
187
References
225
Citations by year
2026: 58 · 2025: 74 · 2024: 42 · 2023: 12 · 2022: 1
FWCI
4.98
Type
journal article
Language
en
Open access
Locations
  • Frontiers in Immunology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • National Natural Science Foundation of China
  • Natural Science Foundation of Shandong Province
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
  • Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Keywords
inflammatory bowel disease, psychological stress, psychoneuroimmunology, gut-brain axis, ulcerative colitis, Crohn's disease, anxiety, depression, immunomodulation, gut microbiota, neuroinflammation, psychotherapy, antidepressants, recurrence
MeSH terms
Antidepressive Agents, Brain, Chronic Disease, Humans, Psychoneuroimmunology, Stress, Psychological, Inflammatory Bowel Diseases

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