{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T22:06:14Z","timestamp":1794002774249,"version":"4.8.0"},"reference-count":44,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,9,21]],"date-time":"2015-09-21T00:00:00Z","timestamp":1442793600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004348","name":"Stockholms L\u00e4ns Landsting","doi-asserted-by":"publisher","award":["20120246"],"award-info":[{"award-number":["20120246"]}],"id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Innate immune responses to conserved microbial products such as lipopolysaccharide (<jats:styled-content style=\"fixed-case\">LPS<\/jats:styled-content>) and flagellin are likely important in microbial\u2013host interactions and intestinal homeostasis. We hypothesized that bacterial translocation and activation of mucosal immunity against common microbial antigens might be involved in the development of irritable bowel syndrome (<jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content>). We therefore compared serum levels of <jats:styled-content style=\"fixed-case\">LPS<\/jats:styled-content>, soluble <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>14 (<jats:styled-content style=\"fixed-case\">sCD<\/jats:styled-content>14), and flagellin antibodies between patients with different subtypes of <jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content> and healthy controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed serum obtained from 88 patients (74 females) aged 19(43)\u201373 years and 106 healthy volunteers (77 females) aged 19(38)\u201362 years. Diarrhea\u2010predominant <jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content> (D\u2010<jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content>) was present in 32 patients (36%), 23 patients (26%) had constipation\u2010predominant <jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content> (C\u2010<jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content>), and 33 patients (38%) had A\u2010<jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content>. We used <jats:styled-content style=\"fixed-case\">ELISA<\/jats:styled-content> for <jats:styled-content style=\"fixed-case\">sCD<\/jats:styled-content>14 and antiflagellin immunoglobulin G and limulus amebocyte assay for <jats:styled-content style=\"fixed-case\">LPS<\/jats:styled-content>. Abdominal symptoms and psychiatric comorbidities were assessed using validated questionnaires.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>We found a significantly higher serum level of <jats:styled-content style=\"fixed-case\">LPS<\/jats:styled-content> in patients with D\u2010<jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content> compared to controls (<jats:italic>p<\/jats:italic> = 0.0155). The level of antibodies to flagellin was higher in patients with <jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content> than in controls (mainly driven by higher levels in D\u2010<jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content>,<jats:italic> p<\/jats:italic> = 0.0018). The levels of <jats:styled-content style=\"fixed-case\">sCD<\/jats:styled-content>14 were lower in D\u2010<jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content> patients compared to controls (<jats:italic>p<\/jats:italic> = 0.0498). We found a weak, but significant correlation between the levels of antiflagellin antibodies and anxiety among <jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content> patients (<jats:italic>\u03c1<\/jats:italic> = 0.38; <jats:italic>p<\/jats:italic> = 0.0045).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>Our results support the concept that immune reactivity to luminal antigens may have a role in the development of D\u2010<jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content>. The serum level of antiflagellin antibodies was found to correlate with patients\u2019 self\u2010reported anxiety score.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.12670","type":"journal-article","created":{"date-parts":[[2015,9,21]],"date-time":"2015-09-21T11:05:40Z","timestamp":1442833540000},"page":"1747-1754","source":"Crossref","is-referenced-by-count":92,"title":["Increased serum levels of lipopolysaccharide and antiflagellin antibodies in patients with diarrhea\u2010predominant irritable bowel syndrome"],"prefix":"10.1111","volume":"27","author":[{"given":"A.","family":"Dlugosz","sequence":"first","affiliation":[{"name":"Karolinska Institutet Department of Medicine and Center for Digestive Diseases Karolinska University Hospital, Huddinge Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Nowak","sequence":"additional","affiliation":[{"name":"Karolinska Institutet Department of Medicine Unit of Infectious Diseases Karolinska 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