Sex-Bias in Irritable Bowel Syndrome: Linking Steroids to the Gut-Brain Axis

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that is more common in females. Despite its high global incidence, the disease mechanism is still unclear and therapeutic options remain limited. The sexual dimorphism in IBS incidence suggests that sex steroids play a role in...

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Bibliographic Details
Published in:Frontiers in endocrinology (Lausanne) 2021-05, Vol.12, p.684096-684096
Main Authors: So, Sik Yu, Savidge, Tor C
Format: Article
Language:English
Subjects:
androgens
Animals
Brain-Gut Axis
Endocrinology
Epigenesis, Genetic
estrogens
Female
Gastrointestinal Microbiome
gut microbiota
gut-brain axis
Humans
irritable bowel syndrome
Irritable Bowel Syndrome - metabolism
Irritable Bowel Syndrome - microbiology
Irritable Bowel Syndrome - therapy
Male
Sex Characteristics
sex steroids
Steroids - metabolism
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Summary:Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that is more common in females. Despite its high global incidence, the disease mechanism is still unclear and therapeutic options remain limited. The sexual dimorphism in IBS incidence suggests that sex steroids play a role in disease onset and symptoms severity. This review considers sex steroids and their involvement in IBS symptoms and the underlying disease mechanisms. Estrogens and androgens play important regulatory roles in IBS symptomology, including visceral sensitivity, gut motility and psychological conditions, possibly through modulating the gut-brain axis. Steroids are regulators of hypothalamic-pituitary-adrenal activity and autonomic nervous system function. They also modulate gut microbiota and enteric nervous systems, impacting serotonin and mast cell signaling. Sex steroids also facilitate bidirectional cross-talk between the microbiota and host following bacterial transformation and recycling of steroids by the intestine. The sex-specific interplay between sex steroids and the host provides neuroendocrinology insight into the pathophysiology, epigenetics and treatment of IBS patients.
ISSN:1664-2392
1664-2392
DOI:10.3389/fendo.2021.684096