# immune system



## trbell (Nov 1, 2000)

1: Curr Gastroenterol Rep. 2003 Aug;5(4):331-6. Related Articles, Links Current insights into the pathophysiology of irritable bowel syndrome.Schwetz I, Bradesi S, Mayer EA.Center of Neurovisceral Sciences and Women's Health, CURE: Digestive Diseases Research Center, David Geffen School of Medicine at UCLA, VAGLAHS, Bldg. 115, Room 223, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA. emayer###ucla.eduRecent reports have emphasized the possible role of mucosal immune activation and inflammation in neuropathic changes in the pathophysiology of irritable bowel syndrome (IBS). However, novel findings using functional brain imaging techniques have underlined the importance of altered perception of visceral stimuli to symptom generation in IBS. These new developments have rekindled an old debate on peripheral versus central mechanisms in the pathophysiology of IBS. In this review we discuss the latest findings in light of these two concepts. In addition, we provide evidence for the hypothesis that, in the absence of alterations in endogenous pain modulation systems and changes in visceral perception, chronic inflammatory mucosal changes in the gut are not a plausible mechanism to explain the presence of chronic abdominal pain, a cardinal IBS symptom.Bada


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## Mike NoLomotil (Jun 6, 2000)

Need to introduce these people to some other people doing in vivo study of oral tolerance, medhanisms, and loss of oral tolerance so they can chat!"..in the absence of alterations in endogenous pain modulation systems and changes in visceral perception, chronic inflammatory mucosal changes in the gut are not a plausible mechanism to explain the presence of chronic abdominal pain, a cardinal IBS symptom."Indeed the key is "alterations in endogenous pain modulation systems"....and the single symptom of "abdominal pain".Depending upon the reaction and the degree of chronic and perpetual provocation in response to normally innocuous antigen, specific proaglsic mediators which can affect not only local (gut) receptors (afferent) but central receptors and efferents seem to be at times released...blood brain barrier function can be altered and mediators cross over into the BBB gaining access to the entire CNS.Besides there are more sysmptoms than pain, and the aberrant inflammatory ressonse quantified, especially if it is chronic and perpetaul secondary to loss of tolerance to innocuous antigen, certainly goes a long way towrds explaing the patients diarrjeic episodes.Indeed jejunal isolation and challnge with food antigen in IBS patients who have no food allergy repeatably provoke the symptoms.I would rather see them share their individual findings then combine theior investigations ON THE SAME PATIENTS than debate what they MAy or MAY NOT suggest.But that would be too easy I guess...Anyone must understand Oral Tolerance a tad first to understand why losing it causes the symptoms the diarrheic IBS sufferers who lost oral tolerance to food antigens did and why these lymphocyte markers (T cell types) specific to the process keep showing up in these new studies which seems to puzzle the guys doing the work. They are not thinking about this process. They are trying to make the findings fit into their own theories about the biopsychosocial development of IBS via stress induced derangement of serotonin receptor function or some other such creative thinking. At least it is creative when they are looking at a patient with lost oral tolerance and they do not know that is what they are looking at. So how do we tell ï¿½opinion leadersï¿½? We donï¿½t. But we CAN teach the caregiver who does know that the opinion leaders are bringing many theories to them but no clinical solutions. http://www.sunderland.ac.uk/~hs0acu/lec02.ppt also helpfulCurrent Understanding of Gastrointestinal Immunoregulation and Its Relation to Food Allergy PER BRANDTZAEG Laboratory for Immunohistochemistry and Immunopathology (LIIPAT), Institute of Pathology, University of Oslo, Rikshospitalet, N-0027 Oslo, Norway Address for correspondence: P. Brandtzaeg, LIIPAT, Institute of Pathology, Rikshospitalet, N-0027 Oslo, Norway. Voice: +47 23 07 27 43; fax: +47 23 07 15 11. per.brandtzaeg###labmed.uio.no Ann. N.Y. Acad. Sci. 964: 13-45 (2002). abstract http://www.annalsnyas.org/cgi/content/abstract/964/1/13 Free PDF download of whole tutorial http://www.annalsnyas.org/cgi/reprint/964/1/13.pdf


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