Journal
FRONTIERS IN IMMUNOLOGY
Volume 13, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fimmu.2022.1016578
Keywords
psychological stress; inflammatory bowel disease; psychoneuroimmunology; brain-gut axis; anxiety; depression; psychiatric comorbidities; psychotherapy
Categories
Funding
- National Natural Science Foundation of China [82271803]
- Natural Science Foundation of Shandong Province [ZR2019MH123]
- Academic Promotion Programme of Shandong First Medical University [2019QL007, YS22-0001817]
- Open Project of Shandong Provincial Key Laboratory of Animal Biotechnology and Disease Control and Prevention [ABDC-201901]
- Shandong Provincial Integrated Traditional Chinese and Western Medicine Special Disease Prevention Project [YXH2019ZXY003]
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This review explores the possible link between psychological stress and inflammatory bowel disease (IBD) from a psychoneuroimmunology perspective. It emphasizes the bidirectionality of the brain-gut axis, suggesting that IBD pathophysiology increases central nervous system inflammation and contributes to anxiety and depression-like behavioral comorbidities.
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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