Visceral pain: role of the microbiome-gut-brain axis

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Rea, Kieran
O'Mahony, Siobhain M.
Dinan, Timothy G.
Cryan, John F.
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Portland Press
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A growing body of preclinical and clinical evidence supports a relationship between the complexity and diversity of the microorganisms that inhabit our gut (human gastrointestinal microbiome) and health status. These microbes can influence centrally regulated emotional behaviour through mechanisms including microbially derived bioactive molecules, mucosal immune and enteroendocrine cell activation, as well as vagal nerve stimulation. Changes to the microbial environment, as a consequence of illness, stress or injury can lead to a broad spectrum of local physiological and behavioural effects including a decrease in gut barrier integrity, altered gut motility, inflammatory mediator release, as well as nociceptive and distension receptor sensitization. Impacts at a central level include alterations in the hypothalamic-pituitary-adrenal axis, neuroinflammatory events and concomitant changes to neurotransmitter systems. Thus, both central and peripheral pathways associated with pain manifestation and perception are altered as a consequence of the microbiome-gut-brain axis imbalance. The dogmatic approach of antibiotic treatment in the latter century, for the treatment of many diseases and conditions, has undergone a radical change. We are 90% microbe, and pragmatism suggests that we manipulate this ecosystem for the treatment of various ailments, stress dysfunction and affective disorders, including the alleviation of visceral pain.
Human gastrointestinal microbiome , Health status , Centrally regulated emotional behaviour , Vagal nerve stimulation , Pain manifestation
Rea, K.,O'Mahony, S., Dinan, T. G. and Cryan, J. F. (2017) 'Visceral pain: role of the microbiome-gut-brain axis', The Biochemist, 39(2), pp. 6-9.
© 2017, the Authors. Published by Portland Press. All rights reserved. This document is the Accepted Manuscript version of a Published Work that appeared in final form in The Biochemist, © Biochemical Society, after review and technical editing by the publisher. To access the final edited and published work see