Neuro Immuno Gastroenterology

This book addresses important issues regarding the interaction between the nervous system, the immune system, and the digestive system. Gut flora has a profound influence on the shaping of the immune response, not only in the gastrointestinal system but also in the nervous system. Fascinatingly, manipulation of intestinal immune responses can be used to modulate neurological disease. Conversely, the nervous system and the psyche have significant effects on the functioning of the gut and liver. After introductory chapters on the neurology, the immunology and microbiology of the gut, the effects of the gut immune system and gut flora and its manipulation on neurological disease are discussed, followed by molecular mimicry and immune tolerance in neuroimmune diseases. Additionally, several chapters deal with gastrointestinal manifestations of neurological diseases. Neuro-Immuno-Gastroenterology is aimed at neurologists, gastroenterologists, and immunologists.

Scientists from various disciplines integrate the neuro-biological and immunological aspects of mucosal function in the context of traditional mucosal physiological processes. Coverage includes epithelium-barrier function to antigens, lamina propria-immune and other effector cells, epithelial response to inflammation, epithelial secretory responses to inflammation, interactions of immune cells/mediators with the nervous system, neuro/immune modulation of epithelial function and pathophysiology of inflammation.

Covers the pathophysiology, diagnosis, and management of the full range of clinical disorders involving both the nervous system and the gastrointestinal system.

Bi-directional communication between the central nervous system (CNS) and the enteric nervous system (ENS) occurs both in health and disease. Various CNS- and gut-directed stressors stimulate the brain-gut axis. Processes modulating responsiveness to stressors along the brain-gut axis involve neural pathways, the immunological, and endocrinological mechanisms. Disturbances at every level of neural control of the gastrointestinal tract can affect modulation of gastrointestinal motility, secretion, and immune functions as well as perception and emotional response to visceral events. ENS function, central processing, and autonomic regulation play an important role in the brain-gut dialogue. Stress and emotions may trigger neuroimmune and neuroendocrine reactions via the brain-gut axis. Nutritional strategies may impact on the integrity and the expression of neurophysiological systems, and neuroimmunolgical interventions through diet and toxin reduction may provide potential support to address the growing concerns of environmentally induced brain disease and neurological autoimmune disorders. In this book, you will find an in-depth review of the brain-gut connection.

Diseases of the gastrointestinal tract are common. There is increasing appreciation of the importance of the immune system in the pathogenesis of a number of these diseases. This book covers basic aspects of innate and adaptive immunity in the gastrointestinal tract, oral tolerance, and cellular and molecular mechanisms of acute and chronic inflammation. Specific disease covered include bacterial infections, human immunodeficiency virus (HIV) infection, coeliac disease, and inflammatory bowel disease. Other topics include mucosal immunisation and intestinal transplantation immunology. The readership of this book includes clinicians, scientists, and students interested in the gastrointestinal tract.

Intestinal homeostasis is key to control uptake across the mucosa and protect from harmful substances. Disturbances in the bidirectional communication between the gut and the brain are implicated in irritable bowel syndrome (IBS) and inflammatory bowel diseases (IBD), being Crohn’s disease (CD) and ulcerative colitis (UC) the two most common IBD subtypes. Although these chronic bowel-relapsing inflammatory disorders present different histopathology, they share similar pathological features. Both IBS and IBD are characterized by a disrupted intestinal barrier function, a pro-inflammatory chronic condition, and an altered gut-brain axis. Despite all the scientific effort, the sequence or exact combination of events that drive these diseases are still unknown, and so is the exact role of every single component. Growing evidence suggests altered neuro-immune interactions as a pathogenic factor. The general aim of this thesis was to elucidate the potential involvement of mast cells and eosinophils in IBS and IBD, and the neuro-immune intercellular circuit via vasoactive intestinal polypeptide (VIP) that might exacerbate mucosal inflammation and intestinal barrier disruption. Intestinal tissues from IBS, inactive IBD, healthy controls (HC), and murine colitis were collected. Electrophysiological and permeability studies were performed using the ex vivo Ussing chamber technique. Tissues were processed with immunohistological procedures to study cell numbers, activation, location, and interactions in relation to VIP. We demonstrated for the very first time an increased transcellular passage of live commensal and pathogenic bacteria through the colonic mucosa of IBS, identifying VIP as a key regulatory molecule together with mast cells activation. In vitro experiments revealed the ability of VIP to activate mast cells. Image analysis identified VIP-mast cells in closer proximity in IBD patients and murine colitis compared to controls. Communication between mast cells and VIP was shown upregulated in IBD and mice colitis via VIP receptor (VPAC)1. Similarities and differences between HC, IBS, and IBD were further studied. Results indicated a pronounced increased intestinal permeability in UC, even during remission, followed by IBS, compared to healthy controls. Surprisingly, permeability results did not correlate with mast cells, but with eosinophil number and activation. A further image analysis suggested an inhibitory effect of eosinophils and VIP on mast cells and an altered interaction between them under inflammatory conditions. Lastly, intestinal VIP levels were shown to increase in IBD patients after the treatment with biological agents and were suggested as a possible biomarker for biological treatment outcome. This thesis presents novel insights into the regulation of intestinal permeability, as well as into the pathophysiology of IBD and IBS by demonstrating the importance of neuro-immune interactions between mast cells, VIP, and eosinophils. Altogether, our findings have broadened the knowledge of neuro-immune interactions in IBS and IBD and might have the potential to onsight lead to new therapeutic approaches thereby improving the outcomes for patients suffering from these diseases.

This 1994 volume summarizes basic scientific advances in the area of the gut immune system and the immune abnormalities relevant to gastrointestinal and liver disease.

The field of microbial endocrinology is expressly devoted to understanding the mechanisms by which the microbiota (bacteria within the microbiome) interact with the host (“us”). This interaction is a two-way street and the driving force that governs these interactions are the neuroendocrine products of both the host and the microbiota. Chapters include neuroendocrine hormone-induced changes in gene expression and microbial endocrinology and probiotics. This is the first in a series of books dedicated to understanding how bi-directional communication between host and bacteria represents the cutting edge of translational medical research, and hopefully identifies new ways to understand the mechanisms that determine health and disease.​