{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:38:37Z","timestamp":1791419917106,"version":"4.3.3"},"reference-count":150,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Irritable Bowel Syndrome (IBS) is one of the most prevalent gastrointestinal disorders, affecting about 11% of the global population and exerting a substantial burden on quality of life and healthcare systems. Despite the emerging interest in this disease, its pathophysiology remains elusive, reflecting the interplay between the brain\u2013gut axis, neuroendocrine dysregulation, immune activation, barrier dysfunction, microbial imbalance, and environmental triggers. Disruptions in the hypothalamic\u2013pituitary\u2013adrenal axis, impaired serotonin signaling, bile acid malabsorption, and altered intestinal permeability collectively result in the emergence of abnormal motility, visceral hypersensitivity, and chronic inflammation. The gut microbiome further modulates these processes by influencing neurotransmitter metabolism, immune responses, and epithelial integrity, positioning it as both a driver of symptoms and a promising therapeutic target. The aim of this review is to synthesize current mechanistic insights into IBS, highlighting the interconnected roles of the brain\u2013gut axis, immune modulation, and microbial dynamics, and to explore how these pathways may be translated into precision medicine approaches. This review integrates molecular, microbial, and neuroimmune perspectives to propose a systems-level understanding of IBS pathophysiology and its implications for precision medicine. By integrating host\u2013microbe interactions, dietary influences, and genetic predispositions, we highlight the mechanistic complexity underlying IBS and the potential for translating these insights into personalized strategies for symptom control and improved quality of life.<\/jats:p>","DOI":"10.3390\/ijms262110598","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T01:23:59Z","timestamp":1761873839000},"page":"10598","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Unraveling the Pathophysiology of Irritable Bowel Syndrome: Mechanisms and Insights"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4489-1485","authenticated-orcid":false,"given":"Ioanna","family":"Aggeletopoulou","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1914-150X","authenticated-orcid":false,"given":"Konstantinos","family":"Papantoniou","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7790-7845","authenticated-orcid":false,"given":"Ploutarchos","family":"Pastras","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3094-8209","authenticated-orcid":false,"given":"Christos","family":"Triantos","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1038\/s41575-020-0286-8","article-title":"Global burden of irritable bowel syndrome: Trends, predictions and risk factors","volume":"17","author":"Black","year":"2020","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1053\/j.gastro.2016.03.035","article-title":"Rome IV-Functional GI Disorders: Disorders of Gut-Brain Interaction","volume":"150","author":"Drossman","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1038\/s41575-022-00662-2","article-title":"Genetics of irritable bowel syndrome: Shifting gear via biobank-scale studies","volume":"19","author":"Camilleri","year":"2022","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e654","DOI":"10.1016\/j.cgh.2015.09.031","article-title":"Irritable Bowel Syndrome and Microscopic Colitis: A Systematic Review and Meta-analysis","volume":"14","author":"Kamp","year":"2016","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1038\/ajg.2016.466","article-title":"Screening for Celiac Disease in Irritable Bowel Syndrome: An Updated Systematic Review and Meta-analysis","volume":"112","author":"Irvine","year":"2017","journal-title":"Am. J. Gastroenterol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1016\/S0140-6736(20)31548-8","article-title":"Irritable bowel syndrome","volume":"396","author":"Ford","year":"2020","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1053\/j.gastro.2016.02.031","article-title":"Bowel Disorders","volume":"150","author":"Mearin","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.cgh.2019.05.037","article-title":"Epidemiological, Clinical, and Psychological Characteristics of Individuals with Self-reported Irritable Bowel Syndrome Based on the Rome IV vs Rome III Criteria","volume":"18","author":"Black","year":"2020","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"151","DOI":"10.5056\/jnm16214","article-title":"What Is New in Rome IV","volume":"23","author":"Schmulson","year":"2017","journal-title":"J. Neurogastroenterol. Motil."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Borrego-Ruiz, A., and Borrego, J.J. (2025). Early Life Stress and Gut Microbiome Dysbiosis: A Narrative Review. Stresses, 5.","DOI":"10.3390\/stresses5020038"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Ratsika, A., Codagnone, M.C., O\u2019Mahony, S., Stanton, C., and Cryan, J.F. (2021). Priming for Life: Early Life Nutrition and the Microbiota-Gut-Brain Axis. Nutrients, 13.","DOI":"10.3390\/nu13020423"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Marano, G., Traversi, G., Pola, R., Gasbarrini, A., Gaetani, E., and Mazza, M. (2025). Irritable Bowel Syndrome: A Hallmark of Psychological Distress in Women?. Life, 15.","DOI":"10.3390\/life15020277"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Pasta, A., Formisano, E., Calabrese, F., Plaz Torres, M.C., Bodini, G., Marabotto, E., Pisciotta, L., Giannini, E.G., and Furnari, M. (2024). Food Intolerances, Food Allergies and IBS: Lights and Shadows. Nutrients, 16.","DOI":"10.3390\/nu16020265"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Mahurkar-Joshi, S., and Chang, L. (2020). Epigenetic Mechanisms in Irritable Bowel Syndrome. Front. Psychiatry, 11.","DOI":"10.3389\/fpsyt.2020.00805"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Aggeletopoulou, I., and Triantos, C. (2024). Microbiome Shifts and Their Impact on Gut Physiology in Irritable Bowel Syndrome. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms252212395"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"10813","DOI":"10.1007\/s12035-025-04846-0","article-title":"Microbiome Gut-Brain-Axis: Impact on Brain Development and Mental Health","volume":"62","author":"Ramadan","year":"2025","journal-title":"Mol. Neurobiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.21037\/atm-21-2779","article-title":"Uncovering the pathophysiology of irritable bowel syndrome by exploring the gut-brain axis: A narrative review","volume":"9","author":"Tang","year":"2021","journal-title":"Ann. Transl. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"16014","DOI":"10.1038\/nrdp.2016.14","article-title":"Irritable bowel syndrome","volume":"2","author":"Enck","year":"2016","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1053\/j.gastro.2016.02.032","article-title":"Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV","volume":"150","author":"Drossman","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_20","first-page":"203","article-title":"The gut-brain axis: Interactions between enteric microbiota, central and enteric nervous systems","volume":"28","author":"Carabotti","year":"2015","journal-title":"Ann. Gastroenterol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Karakan, T., Ozkul, C., K\u00fcpeli Akkol, E., Bilici, S., Sobarzo-S\u00e1nchez, E., and Capasso, R. (2021). Gut-Brain-Microbiota Axis: Antibiotics and Functional Gastrointestinal Disorders. Nutrients, 13.","DOI":"10.3390\/nu13020389"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Ionescu, V.A., Gheorghe, G., Georgescu, T.F., Bacalbasa, N., Gheorghe, F., and Diaconu, C.C. (2024). The Latest Data Concerning the Etiology and Pathogenesis of Irritable Bowel Syndrome. J. Clin. Med., 13.","DOI":"10.3390\/jcm13175124"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1016\/j.chom.2018.05.004","article-title":"Gut Microbiota-Produced Tryptamine Activates an Epithelial G-Protein-Coupled Receptor to Increase Colonic Secretion","volume":"23","author":"Bhattarai","year":"2018","journal-title":"Cell Host Microbe"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Patterson, E., Ryan, P.M., Wiley, N., Carafa, I., Sherwin, E., Moloney, G., Franciosi, E., Mandal, R., Wishart, D.S., and Tuohy, K. (2019). Gamma-aminobutyric acid-producing lactobacilli positively affect metabolism and depressive-like behaviour in a mouse model of metabolic syndrome. Sci. Rep., 9.","DOI":"10.1038\/s41598-019-51781-x"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Dicks, L.M.T. (2022). Gut Bacteria and Neurotransmitters. Microorganisms, 10.","DOI":"10.3390\/microorganisms10091838"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1002\/j.2040-4603.2016.tb00694.x","article-title":"Regulation of the Hypothalamic-Pituitary-Adrenocortical Stress Response","volume":"6","author":"Herman","year":"2016","journal-title":"Compr. Physiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"383","DOI":"10.31887\/DCNS.2006.8.4\/ssmith","article-title":"The role of the hypothalamic-pituitary-adrenal axis in neuroendocrine responses to stress","volume":"8","author":"Smith","year":"2006","journal-title":"Dialogues Clin. Neurosci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"568","DOI":"10.4103\/0976-3147.169802","article-title":"Irritable bowel syndrome: Is it \u201cirritable brain\u201d or \u201cirritable bowel\u201d?","volume":"6","author":"Padhy","year":"2015","journal-title":"J. Neurosci. Rural Pract."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/S2468-1253(20)30363-0","article-title":"Common mental disorders in irritable bowel syndrome: Pathophysiology, management, and considerations for future randomised controlled trials","volume":"6","author":"Staudacher","year":"2021","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Pastras, P., and Aggeletopoulou, I. (2024). Impact of Enteric Nervous Cells on Irritable Bowel Syndrome: Potential Treatment Options. Microorganisms, 12.","DOI":"10.3390\/microorganisms12102036"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1111\/apt.13459","article-title":"Alterations in serotonin metabolism in the irritable bowel syndrome","volume":"43","author":"Thijssen","year":"2016","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/2049-9256-2-4","article-title":"The relationship between irritable bowel syndrome and psychiatric disorders: From molecular changes to clinical manifestations","volume":"2","author":"Buga","year":"2014","journal-title":"J. Mol. Psychiatry"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1136\/gutjnl-2012-304042","article-title":"Characterisation of faecal protease activity in irritable bowel syndrome with diarrhoea: Origin and effect of gut transit","volume":"63","author":"Tooth","year":"2014","journal-title":"Gut"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1136\/gut.2007.140210","article-title":"Increased faecal serine protease activity in diarrhoeic IBS patients: A colonic lumenal factor impairing colonic permeability and sensitivity","volume":"57","author":"Gecse","year":"2008","journal-title":"Gut"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3976","DOI":"10.3748\/wjg.v20.i14.3976","article-title":"Post-infectious irritable bowel syndrome: Mechanistic insights into chronic disturbances following enteric infection","volume":"20","author":"Beatty","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1038\/nrgastro.2017.37","article-title":"Post-infectious IBS, tropical sprue and small intestinal bacterial overgrowth: The missing link","volume":"14","author":"Ghoshal","year":"2017","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1053\/j.gastro.2014.03.013","article-title":"Salmonella gastroenteritis during childhood is a risk factor for irritable bowel syndrome in adulthood","volume":"147","author":"Cremon","year":"2014","journal-title":"Gastroenterology"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Singh, M., Singh, V., Schurman, J.V., Colombo, J.M., and Friesen, C.A. (2020). The relationship between mucosal inflammatory cells, specific symptoms, and psychological functioning in youth with irritable bowel syndrome. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-68961-9"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Burns, G.L., Talley, N.J., and Keely, S. (2022). Immune responses in the irritable bowel syndromes: Time to consider the small intestine. BMC Med., 20.","DOI":"10.1186\/s12916-022-02301-8"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1972","DOI":"10.1053\/gast.2002.37059","article-title":"Full-thickness biopsy of the jejunum reveals inflammation and enteric neuropathy in irritable bowel syndrome","volume":"123","author":"Lindberg","year":"2002","journal-title":"Gastroenterology"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1080\/00365520903171276","article-title":"Pathogenic mechanisms of postinfectious functional gastrointestinal disorders: Results 3 years after gastroenteritis","volume":"44","author":"Mearin","year":"2009","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e14339","DOI":"10.1111\/nmo.14339","article-title":"Mast cell mediation of visceral sensation and permeability in irritable bowel syndrome","volume":"34","author":"Hasler","year":"2022","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Salvo-Romero, E., Mart\u00ednez, C., Lobo, B., Rodi\u00f1o-Janeiro, B.K., Pigrau, M., S\u00e1nchez-Chardi, A.D., Gonz\u00e1lez-Castro, A.M., Fortea, M., Pardo-Camacho, C., and Nieto, A. (2020). Overexpression of corticotropin-releasing factor in intestinal mucosal eosinophils is associated with clinical severity in Diarrhea-Predominant Irritable Bowel Syndrome. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-77176-x"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1111\/nmo.12358","article-title":"Cytokine imbalance in irritable bowel syndrome: A systematic review and meta-analysis","volume":"26","author":"Bashashati","year":"2014","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"115","DOI":"10.5217\/ir.2019.00125","article-title":"Proinflammatory cytokines in irritable bowel syndrome: A comparison with inflammatory bowel disease","volume":"18","author":"Mitselou","year":"2020","journal-title":"Intest. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12328-021-01555-8","article-title":"Targeted therapy of irritable bowel syndrome with anti-inflammatory cytokines","volume":"15","author":"Kumar","year":"2022","journal-title":"Clin. J. Gastroenterol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1136\/gutjnl-2013-306236","article-title":"Increased humoral immunity in the jejunum of diarrhoea-predominant irritable bowel syndrome associated with clinical manifestations","volume":"64","author":"Vicario","year":"2015","journal-title":"Gut"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e00146","DOI":"10.14309\/ctg.0000000000000146","article-title":"Increased Ileal Immunoglobulin A Production and Immunoglobulin A-Coated Bacteria in Diarrhea-Predominant Irritable Bowel Syndrome","volume":"11","author":"Liu","year":"2020","journal-title":"Clin. Transl. Gastroenterol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1136\/gutjnl-2011-301856","article-title":"Sensory neuro-immune interactions differ between irritable bowel syndrome subtypes","volume":"62","author":"Hughes","year":"2013","journal-title":"Gut"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.bbi.2014.07.001","article-title":"Immune derived opioidergic inhibition of viscerosensory afferents is decreased in Irritable Bowel Syndrome patients","volume":"42","author":"Hughes","year":"2014","journal-title":"Brain Behav. Immun."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1756284821993586","DOI":"10.1177\/1756284821993586","article-title":"Intestinal barrier dysfunction in irritable bowel syndrome: A systematic review","volume":"14","author":"Hanning","year":"2021","journal-title":"Ther. Adv. Gastroenterol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Rettura, F., Lambiase, C., Tedeschi, R., Grosso, A., Cancelli, L., Ricchiuti, A., Bottari, A., Giacomelli, L., de Bortoli, N., and Bellini, M. (2025). Mucoprotectants and gut barrier: Mechanisms of action and clinical applications in IBS. Is there a possible role?. Front. Pharmacol., 16.","DOI":"10.3389\/fphar.2025.1538791"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1053\/j.gastro.2019.03.046","article-title":"Many Patients with Irritable Bowel Syndrome Have Atypical Food Allergies Not Associated with Immunoglobulin E","volume":"157","author":"Pflaum","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Rodi\u00f1o-Janeiro, B.K., Mart\u00ednez, C., Fortea, M., Lobo, B., Pigrau, M., Nieto, A., Gonz\u00e1lez-Castro, A.M., Salvo-Romero, E., Guagnozzi, D., and Pardo-Camacho, C. (2018). Decreased TESK1-mediated cofilin 1 phosphorylation in the jejunum of IBS-D patients may explain increased female predisposition to epithelial dysfunction. Sci. Rep., 8.","DOI":"10.1038\/s41598-018-20540-9"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1136\/gut.2007.138982","article-title":"Increased capsaicin receptor TRPV1-expressing sensory fibres in irritable bowel syndrome and their correlation with abdominal pain","volume":"57","author":"Akbar","year":"2008","journal-title":"Gut"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"173","DOI":"10.2147\/CEG.S455101","article-title":"Intestinal Permeability, Irritable Bowel Syndrome with Constipation, and the Role of Sodium-Hydrogen Exchanger Isoform 3 (NHE3)","volume":"17","author":"Lacy","year":"2024","journal-title":"Clin. Exp. Gastroenterol."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Mallardi, D., Maqoud, F., Guido, D., Aloisio, M., Linsalata, M., and Russo, F. (2025). Mapping Research Trends on Intestinal Permeability in Irritable Bowel Syndrome with a Focus on Nutrition: A Bibliometric Analysis. Nutrients, 17.","DOI":"10.3390\/nu17061064"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1177\/2050640619826419","article-title":"Serum zonulin is elevated in IBS and correlates with stool frequency in IBS-D","volume":"7","author":"Singh","year":"2019","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2165","DOI":"10.1038\/ajg.2011.257","article-title":"The expression and the cellular distribution of the tight junction proteins are altered in irritable bowel syndrome patients with differences according to the disease subtype","volume":"106","author":"Youmba","year":"2011","journal-title":"Am. J. Gastroenterol."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Gargano, D., Appanna, R., Santonicola, A., De Bartolomeis, F., Stellato, C., Cianferoni, A., Casolaro, V., and Iovino, P. (2021). Food Allergy and Intolerance: A Narrative Review on Nutritional Concerns. Nutrients, 13.","DOI":"10.3390\/nu13051638"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Xu, J., Wang, B., and Ao, H. (2025). Corticosterone effects induced by stress and immunity and inflammation: Mechanisms of communication. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1448750"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Shaikh, S.D., Sun, N., and Canakis, A. (2023). Irritable Bowel Syndrome and the Gut Microbiome: A Comprehensive Review. J. Clin. Med., 12.","DOI":"10.3390\/jcm12072558"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1038\/nrgastro.2017.51","article-title":"Non-conventional features of peripheral serotonin signalling\u2014The gut and beyond","volume":"14","author":"Spohn","year":"2017","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.cell.2017.05.034","article-title":"Enterochromaffin Cells Are Gut Chemosensors that Couple to Sensory Neural Pathways","volume":"170","author":"Bellono","year":"2017","journal-title":"Cell"},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Hwang, Y.K., and Oh, J.S. (2025). Interaction of the Vagus Nerve and Serotonin in the Gut\u2013Brain Axis. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26031160"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1172\/JCI78361","article-title":"Neuroepithelial circuit formed by innervation of sensory enteroendocrine cells","volume":"125","author":"Shahid","year":"2015","journal-title":"J. Clin. Investig."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Guzel, T., and Mirowska-Guzel, D. (2022). The Role of Serotonin Neurotransmission in Gastrointestinal Tract and Pharmacotherapy. Molecules, 27.","DOI":"10.3390\/molecules27051680"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1007\/164_2016_103","article-title":"Serotonergic Mechanisms Regulating the GI Tract: Experimental Evidence and Therapeutic Relevance","volume":"239","author":"Terry","year":"2017","journal-title":"Handb. Exp. Pharmacol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1038\/sj.bjp.0705762","article-title":"Role of serotonin in the pathophysiology of the irritable bowel syndrome","volume":"141","author":"Crowell","year":"2004","journal-title":"Br. J. Pharmacol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"69","DOI":"10.15171\/mejdd.2019.130","article-title":"Post-infectious Irritable Bowel Syndrome: A Narrative Review","volume":"11","author":"Sadeghi","year":"2019","journal-title":"Middle East. J. Dig. Dis."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1651","DOI":"10.1053\/j.gastro.2003.09.028","article-title":"Relative importance of enterochromaffin cell hyperplasia, anxiety, and depression in postinfectious IBS","volume":"125","author":"Dunlop","year":"2003","journal-title":"Gastroenterology"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1053\/j.gastro.2005.09.031","article-title":"Altered 5-hydroxytryptamine signaling in patients with constipation- and diarrhea-predominant irritable bowel syndrome","volume":"130","author":"Atkinson","year":"2006","journal-title":"Gastroenterology"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1053\/j.gastro.2011.01.052","article-title":"Impaired uptake of serotonin by platelets from patients with irritable bowel syndrome correlates with duodenal immune activation","volume":"140","author":"Foley","year":"2011","journal-title":"Gastroenterology"},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Zhang, Z.F., Duan, Z.J., Wang, L.X., Yang, D., Zhao, G., and Zhang, L. (2014). The serotonin transporter gene polymorphism (5-HTTLPR) and irritable bowel syndrome: A meta-analysis of 25 studies. BMC Gastroenterol., 14.","DOI":"10.1186\/1471-230X-14-23"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1007\/s00109-022-02244-w","article-title":"The serotonin receptor 3E variant is a risk factor for female IBS-D","volume":"100","author":"Fritz","year":"2022","journal-title":"J. Mol. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"4290430","DOI":"10.1155\/2017\/4290430","article-title":"Serotonin-Related Gene Variants in Patients with Irritable Bowel Syndrome and Depressive or Anxiety Disorders","volume":"2017","author":"Grzesiak","year":"2017","journal-title":"Gastroenterol. Res. Pract."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"G439","DOI":"10.1152\/ajpgi.00368.2015","article-title":"Interferon-\u03b3 is increased in the gut of patients with irritable bowel syndrome and modulates serotonin metabolism","volume":"310","author":"Barbaro","year":"2016","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1038\/ajg.2011.86","article-title":"Intestinal serotonin release, sensory neuron activation, and abdominal pain in irritable bowel syndrome","volume":"106","author":"Cremon","year":"2011","journal-title":"Am. J. Gastroenterol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1111\/nmo.12600","article-title":"Visceral hypersensitivity in irritable bowel syndrome: Evidence for involvement of serotonin metabolism\u2014A preliminary study","volume":"27","author":"Keszthelyi","year":"2015","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Gros, M., and Gros, B. (2021). Neurotransmitter Dysfunction in Irritable Bowel Syndrome: Emerging Approaches for Management. J. Clin. Med., 10.","DOI":"10.3390\/jcm10153429"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1136\/flgastro-2020-101436","article-title":"Bile acid diarrhoea: Pathophysiology, diagnosis and management","volume":"12","author":"Farrugia","year":"2021","journal-title":"Frontline Gastroenterol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1002\/j.2040-4603.2020.tb00108.x","article-title":"Intestinal Absorption of Bile Acids in Health and Disease","volume":"10","author":"Ticho","year":"2019","journal-title":"Compr. Physiol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"G996","DOI":"10.1152\/ajpgi.90343.2008","article-title":"beta-Klotho and FGF-15\/19 inhibit the apical sodium-dependent bile acid transporter in enterocytes and cholangiocytes","volume":"295","author":"Sinha","year":"2008","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Wang, L.X., Frey, M.R., and Kohli, R. (2022). The Role of FGF19 and MALRD1 in Enterohepatic Bile Acid Signaling. Front. Endocrinol., 12.","DOI":"10.3389\/fendo.2021.799648"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1002\/hep.23708","article-title":"Glycosylation of fibroblast growth factor receptor 4 is a key regulator of fibroblast growth factor 19-mediated down-regulation of cytochrome P450 7A1","volume":"52","author":"Triantis","year":"2010","journal-title":"Hepatology"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.1016\/j.cgh.2015.03.002","article-title":"High Prevalence of Idiopathic Bile Acid Diarrhea Among Patients With Diarrhea-Predominant Irritable Bowel Syndrome Based on Rome III Criteria","volume":"13","author":"Aziz","year":"2015","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.1053\/j.gastro.2011.02.063","article-title":"A Klotho\u03b2 variant mediates protein stability and associates with colon transit in irritable bowel syndrome with diarrhea","volume":"140","author":"Wong","year":"2011","journal-title":"Gastroenterology"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1016\/j.cgh.2013.04.020","article-title":"Bowel functions, fecal unconjugated primary and secondary bile acids, and colonic transit in patients with irritable bowel syndrome","volume":"11","author":"Shin","year":"2013","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1038\/ajg.2014.215","article-title":"Effect of increased bile acid synthesis or fecal excretion in irritable bowel syndrome-diarrhea","volume":"109","author":"Camilleri","year":"2014","journal-title":"Am. J. Gastroenterol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1053\/j.gastro.2010.07.052","article-title":"Chenodeoxycholate in females with irritable bowel syndrome-constipation: A pharmacodynamic and pharmacogenetic analysis","volume":"139","author":"Rao","year":"2010","journal-title":"Gastroenterology"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1111\/nmo.12829","article-title":"Interplay between bile acid metabolism and microbiota in irritable bowel syndrome","volume":"28","author":"Dior","year":"2016","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"549","DOI":"10.5056\/jnm22129","article-title":"Bile Acid and Gut Microbiota in Irritable Bowel Syndrome","volume":"28","author":"Min","year":"2022","journal-title":"J. Neurogastroenterol. Motil."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.gtc.2010.12.011","article-title":"The role of genetics in IBS","volume":"40","author":"Saito","year":"2011","journal-title":"Gastroenterol. Clin. N. Am."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s40348-016-0038-6","article-title":"Genetics of irritable bowel syndrome","volume":"3","year":"2016","journal-title":"Mol. Cell. Pediatr."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1038\/s41588-021-00950-8","article-title":"Genome-wide analysis of 53,400 people with irritable bowel syndrome highlights shared genetic pathways with mood and anxiety disorders","volume":"53","author":"Eijsbouts","year":"2021","journal-title":"Nat. Genet."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1053\/j.gastro.2018.03.064","article-title":"Female-Specific Association Between Variants on Chromosome 9 and Self-Reported Diagnosis of Irritable Bowel Syndrome","volume":"155","author":"Bonfiglio","year":"2018","journal-title":"Gastroenterology"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1136\/gutjnl-2016-312456","article-title":"Functional variants in the sucrase-isomaltase gene associate with increased risk of irritable bowel syndrome","volume":"67","author":"Diekmann","year":"2018","journal-title":"Gut"},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Husein, D.M., Rizk, S., Hoter, A., Wanes, D., D\u2019Amato, M., and Naim, H.Y. (2022). Severe pathogenic variants of intestinal sucrase-isomaltase interact avidly with the wild type enzyme and negatively impact its function and trafficking. Biochim. Biophys. Acta Mol. Basis Dis., 1868.","DOI":"10.1016\/j.bbadis.2022.166523"},{"key":"ref_99","doi-asserted-by":"crossref","unstructured":"Zamfir-Taranu, A., L\u00f6scher, B.S., Franke, A., Bonfiglio, F., Ohlsson, B., and D\u2019Amato, M. (2025). Sucrase-isomaltase hypomorphic variant Val15Phe affects the response to a sucrose challenge test in patients with IBS. Gut, in press.","DOI":"10.1136\/gutjnl-2025-336393"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"G494","DOI":"10.1152\/ajpgi.00016.2017","article-title":"Irritable bowel syndrome patients have SCN5A channelopathies that lead to decreased Na(V)1.5 current and mechanosensitivity","volume":"314","author":"Strege","year":"2018","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1111\/nmo.12569","article-title":"The role of the SCN5A-encoded channelopathy in irritable bowel syndrome and other gastrointestinal disorders","volume":"27","author":"Verstraelen","year":"2015","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_102","doi-asserted-by":"crossref","unstructured":"Grozi\u0107, A., Coker, K., Dussik, C.M., Sabir, M.S., Sabir, Z., Bradley, A., Zhang, L., Park, J., Yale, S., and Kaneko, I. (2022). Identification of putative transcriptomic biomarkers in irritable bowel syndrome (IBS): Differential gene expression and regulation of TPH1 and SERT by vitamin D. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0275683"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"1962","DOI":"10.1053\/j.gastro.2022.02.016","article-title":"Mucosal Serotonin Reuptake Transporter Expression in Irritable Bowel Syndrome Is Modulated by Gut Microbiota Via Mast Cell-Prostaglandin E2","volume":"162","author":"Gao","year":"2022","journal-title":"Gastroenterology"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"eabl4290","DOI":"10.1126\/science.abl4290","article-title":"Single-nucleus cross-tissue molecular reference maps toward understanding disease gene function","volume":"376","author":"Eraslan","year":"2022","journal-title":"Science"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1038\/s41380-023-01972-w","article-title":"The neurobiology of irritable bowel syndrome","volume":"28","author":"Mayer","year":"2023","journal-title":"Mol. Psychiatry"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"e14257","DOI":"10.1111\/nmo.14257","article-title":"Neuronal-enriched extracellular vesicles in individuals with IBS: A pilot study of COMT and BDNF","volume":"34","author":"Weaver","year":"2022","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1038\/s41467-021-21280-7","article-title":"GWAS of peptic ulcer disease implicates Helicobacter pylori infection, other gastrointestinal disorders and depression","volume":"12","author":"Wu","year":"2021","journal-title":"Nat. Commun."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1038\/s41588-020-00763-1","article-title":"Large-scale association analyses identify host factors influencing human gut microbiome composition","volume":"53","author":"Kurilshikov","year":"2021","journal-title":"Nat. Genet."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1038\/s41588-020-00747-1","article-title":"Genome-wide association study in 8,956 German individuals identifies influence of ABO histo-blood groups on gut microbiome","volume":"53","author":"Hermes","year":"2021","journal-title":"Nat. Genet."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1007\/s00535-023-01997-6","article-title":"New insights into irritable bowel syndrome pathophysiological mechanisms: Contribution of epigenetics","volume":"58","author":"Dothel","year":"2023","journal-title":"J. Gastroenterol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1053\/j.gastro.2014.09.032","article-title":"Epigenetic regulation of genes that modulate chronic stress-induced visceral pain in the peripheral nervous system","volume":"148","author":"Hong","year":"2015","journal-title":"Gastroenterology"},{"key":"ref_112","doi-asserted-by":"crossref","unstructured":"Kano, M., Muratsubaki, T., Van Oudenhove, L., Morishita, J., Yoshizawa, M., Kohno, K., Yagihashi, M., Tanaka, Y., Mugikura, S., and Dupont, P. (2017). Altered brain and gut responses to corticotropin-releasing hormone (CRH) in patients with irritable bowel syndrome. Sci. Rep., 7.","DOI":"10.1038\/s41598-017-09635-x"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.mce.2017.07.036","article-title":"Estrogen signaling deregulation related with local immune response modulation in irritable bowel syndrome","volume":"471","author":"Jacenik","year":"2018","journal-title":"Mol. Cell Endocrinol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1136\/gutjnl-2014-307748","article-title":"Epigenetic upregulation of metabotropic glutamate receptor 2 in the spinal cord attenuates oestrogen-induced visceral hypersensitivity","volume":"64","author":"Cao","year":"2015","journal-title":"Gut"},{"key":"ref_115","doi-asserted-by":"crossref","unstructured":"Chriett, S., D\u0105bek, A., Wojtala, M., Vidal, H., Balcerczyk, A., and Pirola, L. (2019). Prominent action of butyrate over \u03b2-hydroxybutyrate as histone deacetylase inhibitor, transcriptional modulator and anti-inflammatory molecule. Sci. Rep., 9.","DOI":"10.1038\/s41598-018-36941-9"},{"key":"ref_116","doi-asserted-by":"crossref","unstructured":"Pozuelo, M., Panda, S., Santiago, A., Mendez, S., Accarino, A., Santos, J., Guarner, F., Azpiroz, F., and Manichanh, C. (2015). Reduction of butyrate- and methane-producing microorganisms in patients with Irritable Bowel Syndrome. Sci. Rep., 5.","DOI":"10.1038\/srep12693"},{"key":"ref_117","doi-asserted-by":"crossref","unstructured":"Nohesara, S., Mostafavi Abdolmaleky, H., Pirani, A., Pettinato, G., and Thiagalingam, S. (2025). The Obesity\u2013Epigenetics\u2013Microbiome Axis: Strategies for Therapeutic Intervention. Nutrients, 17.","DOI":"10.3390\/nu17091564"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.chom.2015.12.005","article-title":"The Host Shapes the Gut Microbiota via Fecal MicroRNA","volume":"19","author":"Liu","year":"2016","journal-title":"Cell Host Microbe"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"15426","DOI":"10.1074\/jbc.M117.788596","article-title":"Commensal microbiota-induced microRNA modulates intestinal epithelial permeability through the small GTPase ARF4","volume":"292","author":"Nakata","year":"2017","journal-title":"J. Biol. Chem."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"2070","DOI":"10.1096\/fj.14-257931","article-title":"HDAC1 and HDAC2 collectively regulate intestinal stem cell homeostasis","volume":"29","author":"Zimberlin","year":"2015","journal-title":"FASEB J."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1038\/s41586-020-1975-8","article-title":"Neuronal programming by microbiota regulates intestinal physiology","volume":"578","author":"Obata","year":"2020","journal-title":"Nature"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1016\/j.dld.2024.01.209","article-title":"The role of miRNA in IBS pathogenesis, diagnosis and therapy: The latest thought","volume":"56","author":"Zhang","year":"2024","journal-title":"Dig. Liver Dis."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1136\/gutjnl-2013-306464","article-title":"Decreased miR-199 augments visceral pain in patients with IBS through translational upregulation of TRPV1","volume":"65","author":"Zhou","year":"2016","journal-title":"Gut"},{"key":"ref_124","doi-asserted-by":"crossref","unstructured":"Jadhav, V.V., Han, J., Fasina, Y., and Harrison, S.H. (2022). Connecting gut microbiomes and short chain fatty acids with the serotonergic system and behavior in Gallus gallus and other avian species. Front. Physiol., 13.","DOI":"10.3389\/fphys.2022.1035538"},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.1001\/jama.300.15.1793","article-title":"Will the history and physical examination help establish that irritable bowel syndrome is causing this patient\u2019s lower gastrointestinal tract symptoms?","volume":"300","author":"Ford","year":"2008","journal-title":"JAMA"},{"key":"ref_126","doi-asserted-by":"crossref","unstructured":"Xu, J., and Lu, Y. (2025). The microbiota-gut-brain axis and central nervous system diseases: From mechanisms of pathogenesis to therapeutic strategies. Front. Microbiol., 16.","DOI":"10.3389\/fmicb.2025.1583562"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"191","DOI":"10.2174\/1570159X20666220927092016","article-title":"Potential Therapeutic Effects of Short-Chain Fatty Acids on Chronic Pain","volume":"22","author":"Tang","year":"2024","journal-title":"Curr. Neuropharmacol."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"400","DOI":"10.3390\/immuno4040026","article-title":"Gut Microbiome as a Target of Intervention in Inflammatory Bowel Disease Pathogenesis and Therapy","volume":"4","author":"Hetta","year":"2024","journal-title":"Immuno"},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"e13983","DOI":"10.1111\/nmo.13983","article-title":"Changes in fecal short-chain fatty acids following fecal microbiota transplantation in patients with irritable bowel syndrome","volume":"33","author":"Valeur","year":"2021","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"e00012","DOI":"10.14309\/ctg.0000000000000012","article-title":"Alterations of Gut Microbiota in Patients with Irritable Bowel Syndrome Based on 16S rRNA-Targeted Sequencing: A Systematic Review","volume":"10","author":"Duan","year":"2019","journal-title":"Clin. Transl. Gastroenterol."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.jcmgh.2020.08.002","article-title":"Human-Derived Bifidobacterium dentium Modulates the Mammalian Serotonergic System and Gut-Brain Axis","volume":"11","author":"Engevik","year":"2021","journal-title":"Cell Mol. Gastroenterol. Hepatol."},{"key":"ref_132","doi-asserted-by":"crossref","unstructured":"Luck, B., Horvath, T.D., Engevik, K.A., Ruan, W., Haidacher, S.J., Hoch, K.M., Oezguen, N., Spinler, J.K., Haag, A.M., and Versalovic, J. (2021). Neurotransmitter profiles are altered in the gut and brain of mice mono-associated with Bifidobacterium dentium. Biomolecules, 11.","DOI":"10.3390\/biom11081091"},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"e13227","DOI":"10.1111\/nmo.13227","article-title":"Butyrate promotes visceral hypersensitivity in an IBS-like model via enteric glial cell-derived nerve growth factor","volume":"30","author":"Long","year":"2018","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_134","doi-asserted-by":"crossref","unstructured":"Jiang, M., Incarnato, D., Modderman, R., Lazaro, A.A., Jonkers, I.H., Bianchi, F., and van den Bogaart, G. (2025). Low butyrate concentrations exert anti-inflammatory and high concentrations exert pro-inflammatory effects on macrophages. J. Nutr. Biochem., 144.","DOI":"10.1016\/j.jnutbio.2025.109962"},{"key":"ref_135","doi-asserted-by":"crossref","unstructured":"Ju, X., Jiang, Z., Ma, J., and Yang, D. (2024). Changes in Fecal Short-Chain Fatty Acids in IBS Patients and Effects of Different Interventions: A Systematic Review and Meta-Analysis. Nutrients, 16.","DOI":"10.3390\/nu16111727"},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1136\/gutjnl-2018-317416","article-title":"Serine proteases as luminal mediators of intestinal barrier dysfunction and symptom severity in IBS","volume":"69","author":"Edogawa","year":"2020","journal-title":"Gut"},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1093\/gastro\/goy052","article-title":"Fight them or feed them: How the intestinal mucus layer manages the gut microbiota","volume":"7","author":"Schroeder","year":"2019","journal-title":"Gastroenterol. Rep."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1159\/000542758","article-title":"Effects of a Protease Inhibitor Camostat Mesilate on Gut Microbial Function in Patients with Irritable Bowel Syndrome: A Pilot Randomized Placebo-Controlled Study","volume":"106","author":"Kanazawa","year":"2025","journal-title":"Digestion"},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1053\/j.gastro.2019.11.301","article-title":"Differences in fecal microbiomes and metabolomes of people with vs without irritable bowel syndrome and bile acid malabsorption","volume":"158","author":"Jeffery","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_140","doi-asserted-by":"crossref","unstructured":"Schaus, S.R., Vasconcelos Pereira, G., Luis, A.S., Madlambayan, E., Terrapon, N., Ostrowski, M.P., Jin, C., Henrissat, B., Hansson, G.C., and Martens, E.C. (2024). Ruminococcus torques is a keystone degrader of intestinal mucin glycoprotein, releasing oligosaccharides used by Bacteroides thetaiotaomicron. mBio, 15.","DOI":"10.1128\/mbio.00039-24"},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.medj.2021.03.018","article-title":"Microbial regulation of enteroendocrine cells","volume":"2","author":"Arora","year":"2021","journal-title":"Med"},{"key":"ref_142","doi-asserted-by":"crossref","unstructured":"Masse, K.E., and Lu, V.B. (2023). Short-chain fatty acids, secondary bile acids and indoles: Gut microbial metabolites with effects on enteroendocrine cell function and their potential as therapies for metabolic disease. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1169624"},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1007\/s13311-017-0585-0","article-title":"Anxiety, Depression, and the Microbiome: A Role for Gut Peptides","volume":"15","author":"Lach","year":"2018","journal-title":"Neurotherapeutics"},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"932","DOI":"10.5009\/gnl15588","article-title":"Irritable Bowel Syndrome, Particularly the Constipation-Predominant Form, Involves an Increase in Methanobrevibacter smithii, Which Is Associated with Higher Methane Production","volume":"10","author":"Ghoshal","year":"2016","journal-title":"Gut Liver"},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1089\/ars.2013.5312","article-title":"Hydrogen sulfide signaling in the gastrointestinal tract","volume":"20","author":"Linden","year":"2014","journal-title":"Antioxid. Redox Signal"},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1172\/JCI92390","article-title":"FODMAP diet modulates visceral nociception by lipopolysaccharide-mediated intestinal inflammation and barrier dysfunction","volume":"128","author":"Zhou","year":"2018","journal-title":"J. Clin. Investig."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"8550","DOI":"10.1002\/jcp.27828","article-title":"The possible role of bacteria, viruses, and parasites in initiation and exacerbation of irritable bowel syndrome","volume":"234","author":"Shariati","year":"2019","journal-title":"J. Cell Physiol."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"e0011621","DOI":"10.1128\/IAI.00116-21","article-title":"The Host Cellular Immune Response to Infection by Campylobacter Spp. and Its Role in Disease","volume":"89","author":"Callahan","year":"2021","journal-title":"Infect. Immun."},{"key":"ref_149","doi-asserted-by":"crossref","unstructured":"Imbrea, A.-M., Balta, I., Dumitrescu, G., McCleery, D., Pet, I., Iancu, T., Stef, L., Corcionivoschi, N., and Liliana, P.-C. (2024). Exploring the Contribution of Campylobacter jejuni to Post-Infectious Irritable Bowel Syndrome: A Literature Review. Appl. Sci., 14.","DOI":"10.3390\/app14083373"},{"key":"ref_150","doi-asserted-by":"crossref","unstructured":"Patel, S., and McCormick, B.A. (2014). Mucosal Inflammatory Response to Salmonella typhimurium Infection. Front. Immunol., 5.","DOI":"10.3389\/fimmu.2014.00311"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/21\/10598\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T13:17:37Z","timestamp":1762175857000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/21\/10598"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,30]]},"references-count":150,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["ijms262110598"],"URL":"https:\/\/doi.org\/10.3390\/ijms262110598","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,30]]}}}