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Imaging of the living human brain is a powerful tool to probe the interactions between brain, gut and microbiome in health and in disorders of brain-gut interactions, in particular IBS. While altered signals from the viscera contribute to clinical symptoms, the brain integrates these interoceptive signals with emotional, cognitive and memory related inputs in a non-linear fashion to produce symptoms. Tremendous progress has occurred in the development of new imaging techniques that look at structural, functional and metabolic properties of brain regions and networks. Standardisation in image acquisition and advances in computational approaches has made it possible to study large data sets of imaging studies, identify network properties and integrate them with non-imaging data. These approaches are beginning to generate brain signatures in IBS that share some features with those obtained in other often overlapping chronic pain disorders such as urological pelvic pain syndromes and vulvodynia, suggesting shared mechanisms. Despite this progress, the identification of preclinical vulnerability factors and outcome predictors has been slow. To overcome current obstacles, the creation of consortia and the generation of standardised multisite repositories for brain imaging and metadata from multisite studies are required.

Ficus benghalensis (Moraceae) is widely found in Asian Countries and has been traditionally prescribed owing to its analgesic, anti-inflammatory, and muscle relaxation properties. Purposely, in this study, phytochemical composition and isolation of fixed oil from F. benghalensis were comprehended for the first time. The fatty acids were isolated from hexane (HO) and chloroform (CO) fractions and were characterized by gas chromatography-mass spectrometry (GC-MS) analysis. The fatty acid ester was identified by comparing the mass spectra with the equipment library. The major fatty acids identified from HO extract were oleic acid methyl ester (42.67), palmitic acid methyl ester (28.79), linoleic acid methyl ester (11.36), docosanoic acid methyl ester (8.83), and stearic acid methyl ester (3.21). Similarly, the major constituents of CO fraction were palmitic acid methyl ester (65.94), oleic acid methyl ester (10.18), stearic acid methyl ester (9.15), elaidic acid methyl ester (5.32), and linoleic acid methyl ester (3.94). Both of the isolated fixed oils were screened for antibacterial, antioxidant, analgesic, and muscle relaxant effects. Regarding the antibacterial effect, the maximum zone of inhibition against Bacillus subtilis was 26.32 and 25.09 mm by HO and CO fractions, respectively. Both HO and CO demonstrated significant antioxidant effects, i.e., 70.23 and 72.09 µg/mL at a higher dose (100 µg/mL). Similarly, both experimented fractions demonstrated significant analgesic effects while the muscle relaxant effect and sedative were non-significant. Results of the present study conclude that fixed oils are the significant antibacterial and analgesic.

Background: A high prevalence of disorders of gut‐brain interaction (DGBI) exist in patients with hypermobile Ehlers‐Danlos Syndrome (hEDS) and hypermobility spectrum disorders (HSD). However, it is unknown if clusters of hEDS/HSD patients exist which overlap with different DGBIs and whether this overlap influences presence of comorbidities and quality of life. We aimed to study these knowledge gaps. Methods: A prospectively collected hEDS/HSD cohort of 1044 individuals were studied. We undertook Uniform Manifold Approximation and Projection‐enabled (UMAP) dimension reduction to create a representation of nonlinear interactions between hEDS/HSD and DGBIs, from which individuals were stratified into clusters. Somatization, Postural Tachycardia Syndrome (PoTS), autonomic symptoms, psychological factors and quality of life were statistically compared between clusters. Key Results: The mean age of patients was 40 ± 13.2 years; 87.8% were female. Patients segregated into three clusters: Cluster 0 (n = 466): hEDS/HSD+ functional foregut disorders (FFD) + irritable bowel syndrome (IBS); Cluster 1 (n = 180): hEDS/HSD+ IBS and Cluster 2 (n = 337): hEDS/HSD alone. In cluster 0, we demonstrated increased somatization (p <0.0001), anxiety (p <0.0001), depression (p <0.0001), PoTS prevalence (p = 0.003), autonomic symptoms (p <0.0001) and reduced quality of life (p <0.0001) compared to cluster 2. Cluster 0 had greater comorbidity burden than cluster 1. Conclusions: Within hEDS/HSD, subgroups exist with a high prevalence of FFD and IBS. These subgroups have a higher prevalence of psychological disorders, dysautonomia and poorer quality of life compared with hEDS/HSD alone. Further research should focus on healthcare utilization, management and prognosis in hEDS/HSD and DGBI overlap. [ABSTRACT FROM AUTHOR]

Objective: To quantify the variation, triggers and impact on quality of life of symptom flares in women with chronic pelvic pain (CPP). Design: Cross‐sectional questionnaire within the Translational Research in Pelvic Pain clinical cohort study. Setting: Women with CPP, with subgroups of women with endometriosis (EAP), interstitial cystitis/bladder pain syndrome (BPS), comorbid endometriosis and interstitial cystitis/bladder pain syndrome (EABP), and those with pelvic pain without endometriosis or interstitial cystitis/bladder pain syndrome (PP). Population or Sample: A total of 100 participants. Methods: Descriptive and comparative analysis from flares questionnaire. Main Outcome Measures: The prevalence, characteristics and triggers of short, medium and long symptom flares in CPP. Results: We received 100 responses of 104 questionnaires sent. Seventy‐six per cent of women with CPP have ever experienced symptom flares of at least one length (short, medium and/or long). Flares are associated with painful and non‐painful symptoms. There is large variation for the frequency, duration, symptoms and triggers for flares. Over 60% of participants reported flares as stopping them from doing things they would usually do, >80% reported thinking about symptoms of flares and >80% reported flares being bothersome. Conclusions: Flares are prevalent and clinically very important in CPP. More research is needed to elucidate the mechanisms and characteristics underlying flares. Clinical practice should include an enquiry into flares with the aim of finding strategies to lessen their burden. [ABSTRACT FROM AUTHOR]

Background: Patients (20%–50%) with inflammatory bowel disease (IBD) experience chronic abdominal pain during remission. The clinical features of IBD patients with abdominal pain during remission remain poorly characterized. This cross‐sectional pilot study aimed to assess patient recruitment, adherence, and feedback to optimize questionnaires for future use and to determine the clinical features that distinguish IBD patients in remission with and without abdominal pain. Methods: Online validated questionnaires about disease activity, symptoms, and psychological factors were sent to participants of the UK National Institute for Health and Care Research (NIHR) IBD BioResource, which is a national research platform consisting of re‐callable IBD patients designed to expedite research into Crohn's and colitis. Inclusion/exclusion criteria of the IBD BioResource main cohort were applied. Descriptive and inferential statistics were applied to participants in remission. p‐values ≤0.01 were considered significant. Key results: A total of 2050 patients were approached; 291 (14.2%) of these agreed to participate. In 35 patients, technical problems, length, and poor understanding of the relevance of some questionnaires affected completion as confirmed by feedback. In total, 244 patients were full responders with 122 (50%) in remission; 33 (27%) of these had chronic abdominal pain. Comparison of those with versus without (n = 89) chronic abdominal pain yielded higher scores in patients with pain for the following: somatization (p < 0.001); gastrointestinal symptoms rating scale score (p = <0.001); highly sensitive person scale (p = 0.007); catastrophizing score (p = 0.010). Trends were observed for azathioprine use (p = 0.021); coping resources inventory health in general (p = 0.046); neuroticism (p = 0.019); and poor sleep (p = 0.03). Conclusions & inferences: Differences in symptoms and psychological characteristics exist between IBD patients in remission with and without abdominal pain. Confirmation of findings in larger studies may facilitate development of personalized chronic pain treatments for IBD patients. [ABSTRACT FROM AUTHOR]

Perineuronal nets (PNN) are highly specialized structures of the extracellular matrix around specific groups of neurons in the central nervous system (CNS). They play functions related to optimizing physiological processes and protection neurons against harmful stimuli. Traditionally, their existence was only described in the CNS. However, there was no description of the presence and composition of PNN in the enteric nervous system (ENS) until now. Thus, our aim was to demonstrate the presence and characterize the components of the PNN in the enteric nervous system. Samples of intestinal tissue from mice and humans were analyzed by RT‐PCR and immunofluorescence assays. We used a marker (Wisteria floribunda agglutinin) considered as standard for detecting the presence of PNN in the CNS and antibodies for labeling members of the four main PNN‐related protein families in the CNS. Our results demonstrated the presence of components of PNN in the ENS of both species; however its molecular composition is species‐specific. [ABSTRACT FROM AUTHOR]

The perineuronal net (PNN) is a well‐described highly specialized extracellular matrix structure found in the central nervous system. Thus far, no reports of its presence or connection to pathological processes have been described in the peripheral nervous system. Our study demonstrates the presence of a PNN in the spinal afferent innervation of the distal colon of mice and characterizes structural and morphological alterations induced in an ulcerative colitis (UC) model. C57Bl/6 mice were given 3% dextran sulfate sodium (DSS) to induce acute or chronic UC. L6/S1 dorsal root ganglia (DRG) were collected. PNNs were labeled using fluorescein‐conjugated Wisteria Floribunda (WFA) l lectin, and calcitonin gene‐related peptide (CGRP) immunofluorescence was used to detect DRG neurons. Most DRG cell bodies and their extensions toward peripheral nerves were found surrounded by the PNN‐like structure (WFA+), labeling neurons' cytoplasm and the pericellular surfaces. The amount of WFA+ neuronal cell bodies was increased in both acute and chronic UC, and the PNN‐like structure around cell bodies was thicker in UC groups. In conclusion, a PNN‐like structure around DRG neuronal cell bodies was described and found modulated by UC, as changes in quantity, morphology, and expression profile of the PNN were detected, suggesting a potential role in sensory neuron peripheral sensitization, possibly modulating the pain profile of ulcerative colitis. [ABSTRACT FROM AUTHOR]

Background: Dysfunction in the autonomic nervous system is common throughout many functional gastrointestinal diseases (FGIDs) that have been historically difficult to treat. In recent years, transcutaneous vagal nerve stimulation (tVNS) has shown promise for improving FGID symptoms. However, the brain effects of tVNS remain unclear, which we investigated by neuroimaging meta‐analysis. Methods: A total of 157 studies were identified, 4 of which were appropriate for inclusion, encompassing 60 healthy human participants. Using activation likelihood analysis estimation, we statistically quantified functional brain activity changes across three domains: (1) tVNS vs. null stimulation, (2) tVNS vs. sham stimulation, and (3) sham stimulation vs. null stimulation. Key Results: tVNS significantly increased activity in the insula, anterior cingulate, inferior and superior frontal gyri, caudate and putamen, and reduced activity in the hippocampi, occipital fusiform gyri, temporal pole, and middle temporal gyri, when compared to null stimulation (all corrected p < 0.005). tVNS increased activity in the anterior cingulate gyrus, left thalamus, caudate, and paracingulate gyrus and reduced activity in right thalamus, posterior cingulate cortex, and temporal fusiform cortex, when compared to sham stimulation (all corrected p < 0.005). Sham stimulation significantly increased activity in the insula and reduced activity in the posterior cingulate and paracingulate gyrus (all corrected p < 0.001), when contrasted to null stimulation. Conclusions: Brain effects of tVNS localize to regions associated with both physiological autonomic regulation and regions whose activity is modulated across numerous FGIDs, which may provide a neural basis for efficacy of this treatment. Functional activity differences between sham and null stimulation illustrate the importance of robust control procedures for future trials. [ABSTRACT FROM AUTHOR]