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Recent advances in pharmacological research on the management of irritable bowel syndrome

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Abstract

Irritable bowel syndrome (IBS), a common gastrointestinal (GI) disorder, is associated with various factors, including lifestyle, infection, stress, intestinal flora, and related diseases. The pharmacotherapeutic stimulation of receptors and downstream signaling pathways is effective in reducing IBS symptoms; however, it is still associated with adverse effects. Various receptors related to GI motility and visceral hypersensitivity should be considered to enhance the benefit/risk ratio of IBS treatments. This review discusses recent pharmacological advances in IBS management. Several receptors related to GI motility and abdominal pain are investigated in various angles. 5-Hydroxytryptamine (5-HT) is an important neurotransmitter that activates the colonic mucosal 5-HT4 receptor without causing severe cardiovascular adverse effects. The clinical potential of ramosetron for diarrhea-predominant IBS has been suggested because of a lower risk of ischemic colitis than conventional 5-HT3 receptor antagonists. Toll-like receptors (TLRs), especially TLR2 and TLR4, show a significant effect on the post-infection symptoms and lipopolysaccharide-mediated regulation of GI motility. Histamine is a well-known nitrogenous compound that regulates inflammatory responses and visceral hypersensitivity. Histamine 1 receptor-mediated sensitization of the transient receptor potential vanilloid 1 is associated with IBS. Pharmacological approaches based on these signaling pathways could be useful in the development of novel IBS treatments.

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Acknowledgement

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), which is funded by the Ministry of Education, Science and Technology (Grant No. 2016R1D1A1A09918019), and by the Chung-Ang University research grant in 2017.

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  1. Department of Pharmacology, College of Pharmacy, Chung-Ang University, 84 Heukseok-RO, Dongjak-Gu, Seoul, 06974, Republic of Korea

    Yoonjin Nam & Uy Dong Sohn

  2. Department of Medical Plant Science, Jung Won University, 85 Munmu-ro, Goesan-eup, Goesan-gun, Chungbuk, 28024, Republic of Korea

    Young Sil Min

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  1. Yoonjin Nam
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Nam, Y., Min, Y.S. & Sohn, U.D. Recent advances in pharmacological research on the management of irritable bowel syndrome. Arch. Pharm. Res. 41, 955–966 (2018). https://doi.org/10.1007/s12272-018-1068-5

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