{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:39:58Z","timestamp":1793385598472,"version":"4.5.0"},"reference-count":42,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,9,21]],"date-time":"2018-09-21T00:00:00Z","timestamp":1537488000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Micro\u2010inflammation is involved in the pathogenesis of irritable bowel syndrome (IBS). The parasympathetic nervous system, via acetylcholine (ACh), and its hydrolytic enzymes, plays a role in regulating inflammation. Increased serum cholinesterase activity, named cholinergic Status (CS), is associated with decreased inflammatory inhibition (ie, pro\u2010inflammation). We assessed the association between IBS diarrhea\u2010predominant (IBS\u2010D) symptoms, CS, and inflammatory biomarkers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Women with IBS\u2010D were prospectively recruited. Serum acetylcholinesterase (AChE), CS, and high\u2010sensitivity C\u2010reactive protein (hs\u2010CRP) levels were analyzed and fecal calprotectin (FC) in a subgroup of patients. The control group included women attending routine health checkups (matched by age and BMI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Ninety\u2010four women with IBS\u2010D were compared to matched controls (1:1). Serum CS, AChE, and the AChE\/butyrylcholinesterase (BChE) ratios were significantly increased in the IBS\u2010D group compared to matched controls (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.018, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001, and <jats:italic>P<\/jats:italic>\u00a0=\u00a00.004, respectively). Using a multiple logistic regression model, IBS\u2010D was almost twice as likely in women with high CS compared to women with low CS (adjusted OR=1.84 (95% CI: 1.01\u20103.33), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.045). Furthermore, IBS\u2010D patients with higher hs\u2010CRP levels demonstrated lower CS and BChE activity and elevated AChE and AChE\/BChE ratios compared to patients with lower hs\u2010CRP levels (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.026, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.036, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.002; and <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0007, respectively). CS was not correlated with the IBS symptoms score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>This is the first study to explore the potential role of serum CS in IBS\u2010D. The findings emphasize the possible role of the autonomic nervous system and its anti\u2010inflammatory properties in IBS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13464","type":"journal-article","created":{"date-parts":[[2018,9,22]],"date-time":"2018-09-22T02:24:26Z","timestamp":1537583066000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Serum cholinesterase activity is elevated in female diarrhea\u2010predominant irritable bowel syndrome patients compared to matched controls"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8115-7274","authenticated-orcid":false,"given":"Keren","family":"Hod","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"},{"name":"Research Division, Epidemiology Service Assuta Medical Centers Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ami D","family":"Sperber","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences Ben\u2010Gurion University of the Negev Beer\u2010Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitsan","family":"Maharshak","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Liver Diseases Tel\u2010Aviv Sourasky Medical Center affiliated to the Sackler Faculty of Medicine Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yishay","family":"Ron","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Liver Diseases Tel\u2010Aviv Sourasky Medical Center affiliated to the Sackler Faculty of Medicine Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izthak","family":"Shapira","sequence":"additional","affiliation":[{"name":"Internal Medicine \u201cC\u201d, \u201cD\u201d and \u201cE\u201d, the Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine Tel Aviv University Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeltser","family":"David","sequence":"additional","affiliation":[{"name":"Internal Medicine \u201cC\u201d, \u201cD\u201d and \u201cE\u201d, the Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine Tel Aviv University Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ori","family":"Rogowski","sequence":"additional","affiliation":[{"name":"Internal Medicine \u201cC\u201d, \u201cD\u201d and \u201cE\u201d, the Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine Tel Aviv University Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shlomo","family":"Berliner","sequence":"additional","affiliation":[{"name":"Internal Medicine \u201cC\u201d, \u201cD\u201d and 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