A review of neuroendocrine immune system abnormalities in IBS based on the brain–gut axis and research progress of acupuncture intervention

Functional flavor agents: enhancing health benefits and consumer preferences

Increasing health consciousness among consumers has significantly driven the demand for functional foods; however, market acceptance largely hinges on flavor profiles. Functional flavor agents, which simultaneously enhance taste and provide health benefits, meet the dual consumer demand for flavor and nutrition. This review classifies functional flavor agents into five categories based on their sensory characteristics. Their health benefits are explored with a focus on their potential roles in disease prevention and treatment, including improved energy metabolism, cardiovascular support, anti-tumor effects, modulation of gut microbiota, and enhancement of immune function. Emerging trends in the food industry are highlighted, underscoring the significant influence of these agents on product innovation. However, the integration of functional flavor agents into food products presents challenges, particularly in optimizing interactions to maximize both sensory appeal and health benefits. Innovative approaches are required to navigate the complex interplay between flavor agents and food components, enhancing flavor stability and sensory quality. Ultimately, the strategic application of functional flavor agents in food production holds promise for fostering a health-oriented market that aligns with consumer expectations for taste and nutrition.

The Gut-Brain Axis in Irritable Bowel Syndrome: Implementing the Role of Microbiota and Neuroimmune Interaction in Personalized Prevention-A Narrative Review

Background and Purpose

Irritable bowel syndrome (IBS) is a disorder characterized by microbiota-neuroimmune interaction resulting in disturbance to the gut-brain axis (GBA). The purpose of this review is to garner an overview of the different pathophysiological mechanisms indicated in the development of IBS and the associated sequalae on gut microbiota alongside its role in the GBA. Moreover, we aim to provide an insight into the possibility of utilizing personalized medicine when managing said affected populations.

Methods

A comprehensive review was performed of the relevant literature pertaining to the current state of GBA alteration implicated in IBS, comprising microbiota-neuroimmune interaction alongside disturbance and activation, respectively. Different search databases were utilized, including PubMed/MEDLINE and ScienceDirect.

Results

The review demonstrated the most evident etiologies of IBS being the imbalance of microbiota and the alteration to the GBA. Furthermore, the interrelation between microbiota and neuroimmunity was discussed. Promising avenues for IBS prevention and management are offered through emerging research on the pathophysiological mechanisms indicated in IBS-associated GBA alteration. This entails a role for the involved interactions between microbiota modification and neuroimmunity activation.

Conclusion

Promising prospects for symptom prevention and management are signaled by the possibility of personalized therapy specifically designed to address the GBA dysfunction indicated in IBS. Policymakers and developers should encourage further study and allocate available resources to aid researchers in the implementation and identification of novel preventive therapeutics. Furthermore, physicians should advocate and integrate the use of personalized medical approaches of IBS to help ensure a better quality of life.

Acupuncture and moxibustion as effective treatments for simple obesity in children: a meta-analysis

OBJECTIVE

To systematically review published studies on the application of acupuncture and moxibustion in the treatment of simple obesity in children and evaluate its effectiveness.

METHODS

A comprehensive search was conducted in the Wanfang, CNKI, Chinese Biomedical Literature, VIP, Embase, PubMed, Cochrane Library, and Web of Science for studies on the effects of acupuncture and moxibustion in treating simple obesity in children, published between December 2003 and October 2024. Primary clinical outcomes included blood lipids, fasting blood glucose, fasting insulin, weight-related indicators, clinical effects, leptin, body fat-related indicators, and traditional Chinese medicine (TCM) syndromes. Data were extracted and summarized, and a meta-analysis was performed using Revman 5.3 software and Stata 13.1.

RESULTS

A total of 20 studies met the inclusion criteria, all involving acupuncture and moxibustion therapy. Compared with the control group, acupuncture and moxibustion significantly reduced total cholesterol (TC) (SMD = -0.53; 95% CI: -0.95 to -0.12, P<0.0001, I2 = 87.3%), triglyceride (TG) (SMD = -0.27; 95% CI: -0.54 to -0.01, P = 0.002, I2 = 66.7%), and fasting blood glucose levels (SMD = -0.61; 95% CI: -1.08 to -0.13, I2 = 82.2%, P = 0.001). Compared to metformin group, semaglutide combined with metformin led to significant reductions in body mass indexes (BMI) (SMD = -0.49, 95% CI: -0.80 to -0.18, I2 = 81%). Additionally, acupuncture treatment resulted in a decrease in TCM syndrome scores compared to control therapy (SMD = -1.49; 95% CI = -2.73 to 0.25; I2 = 96.4%, P<0.0001).

CONCLUSION

Acupuncture and moxibustion treatment for simple obesity in children significantly reduced fasting blood glucose, waist circumference, TCM syndromes score, BMI and lipid levels.

Antimicrobial Neuropeptides and Their Receptors: Immunoregulator and Therapeutic Targets for Immune Disorders

The interaction between the neuroendocrine system and the immune system plays a key role in the onset and progression of various diseases. Neuropeptides, recognized as common biochemical mediators of communication between these systems, are receiving increasing attention because of their potential therapeutic applications in immune-related disorders. Additionally, many neuropeptides share significant similarities with antimicrobial peptides (AMPs), and evidence shows that these antimicrobial neuropeptides are directly involved in innate immunity. This review examines 10 antimicrobial neuropeptides, including pituitary adenylate cyclase-activating polypeptide (PACAP), vasoactive intestinal peptide (VIP), α-melanocyte stimulating hormone (α-MSH), ghrelin, adrenomedullin (AM), neuropeptide Y (NPY), urocortin II (UCN II), calcitonin gene-related peptide (CGRP), substance P (SP), and catestatin (CST). Their expression characteristics and the immunomodulatory mechanisms mediated by their specific receptors are summarized, along with potential drugs targeting these receptors. Future studies should focus on further investigating antimicrobial neuropeptides and advancing the development of related drugs in preclinical and/or clinical studies to improve the treatment of immune-related diseases.

Exploring the mechanisms and current status of acupuncture in alleviating tumor metabolism and associated diseases: Insights from the central nervous system and immune microenvironment

Acupuncture, as a traditional Chinese medical treatment, has garnered increasing attention in recent years in fields such as tumor metabolism, the central nervous system, and the immune microenvironment. This paper aims to explore the fundamental principles, mechanisms, and research status of acupuncture therapy for tumor-related diseases. Firstly, we introduce the basic principles of acupuncture therapy, including the theories of meridians and its theoretical basis in tumor treatment. Secondly, we systematically review the mechanisms of acupuncture therapy for tumor-related diseases, discussing how acupuncture alleviates side effects such as pain, depression, fatigue, and gastrointestinal discomfort caused by conventional treatments through modulation of the immune microenvironment, central nervous system, and endocrine system. Subsequently, we discuss the current research status of acupuncture therapy for tumor-related diseases, as well as the application of current research methods and technologies in elucidating acupuncture mechanisms. Additionally, by combining clinical practice with different types of tumor-related diseases as experimental subjects, we demonstrate the application effectiveness and clinical practice experience of acupuncture in tumor treatment. Finally, a comprehensive assessment of acupuncture therapy for tumor-related diseases is provided, summarizing its limitations and prospecting future directions, including interdisciplinary collaboration and personalized treatment. In conclusion, acupuncture, as a feasible adjunctive therapy, is closely related to the central nervous system and the immune microenvironment, holding potential significant value in tumor treatment.

A Randomized Controlled Trial Assessing the Impact of Transcutaneous Electrical Acupoint Stimulation on Gastrointestinal Motility, Nutritional Status, and Immune Function in Patients Following Cerebrovascular Accident Surgery

BACKGROUND

Transcutaneous Electrical Acupoint Stimulation (TEAS) is a technique that involves stimulating specific acupoints on the body with electrical currents. It may regulate nerve excitability and improve nerve function. This study aimed to assess the impact of TEAS on gastrointestinal motility, nutrition, and immune function in patients post cerebrovascular accident surgery in the intensive care unit (ICU).

METHODS

A randomized controlled trial included 300 post-cerebrovascular surgery patients at Lishui Central Hospital (January 2021-June 2023). Patients were randomly assigned to TEAS or control groups in a 1:1 ratio. The TEAS group received TEAS at bilateral Zusanli (ST36), Shangjuxu (ST37), Tianshu (ST25), Neiguan (PC6), and Hegu (LI4) according to the International Acupuncture Point Code, plus standard care. The control group received routine enteral nutrition and sham TEAS. Nutritional, immune, and gastrointestinal motility indicators were compared.

RESULTS

A randomized controlled trial involving 300 post-surgery patients compared TEAS to sham TEAS, demonstrating significant enhancements (p < 0.05) in immune function and gastrointestinal motility. Compared to the control group, the TEAS group showed significant improvements in the patient's serum nutritional levels (prealbumin, albumin, hemoglobin, and total protein), immune status (IgG, IgA, IgM, and CD4+/CD8+), gastrointestinal motility (daily gastric residual volume, time to achieve target feeding volume, time for nutritional fluid to meet standards, time to first bowel movement, time to first passage of activated charcoal stool, time to reach the defecation volume), and overall condition (the scores of clinical scales and ICU stay duration) (p < 0.05). The TEAS group also experienced a significantly lower incidence of adverse events (p < 0.05).

CONCLUSIONS

Early TEAS intervention positively impacted recovery, shortened ICU stay, and improved outcomes in patients post cerebrovascular accident surgery.

Physiopathological Roles of White Adiposity and Gut Functions in Neuroinflammation

White adipose tissue (WAT) and the gut are involved in the development of neuroinflammation when an organism detects any kind of injury, thereby triggering metainflammation. In fact, the autonomous nervous system innervates both tissues, although the complex role played by the integrated sympathetic, parasympathetic, and enteric nervous system functions have not been fully elucidated. Our aims were to investigate the participation of inflamed WAT and the gut in neuroinflammation. Firstly, we conducted an analysis into how inflamed peripheral WAT plays a key role in the triggering of metainflammation. Indeed, this included the impact of the development of local insulin resistance and its metabolic consequences, a serious hypothalamic dysfunction that promotes neurodegeneration. Then, we analyzed the gut-brain axis dysfunction involved in neuroinflammation by examining cell interactions, soluble factors, the sensing of microbes, and the role of dysbiosis-related mechanisms (intestinal microbiota and mucosal barriers) affecting brain functions. Finally, we targeted the physiological crosstalk between cells of the brain-WAT-gut axis that restores normal tissue homeostasis after injury. We concluded the following: because any injury can result not only in overall insulin resistance and dysbiosis, which in turn can impact upon the brain, but that a high-risk of the development of neuroinflammation-induced neurodegenerative disorder can also be triggered. Thus, it is imperative to avoid early metainflammation by applying appropriate preventive (e.g., lifestyle and diet) or pharmacological treatments to cope with allostasis and thus promote health homeostasis.

Correlation between the neuroendocrine axis, microbial species, inflammatory response, and gastrointestinal symptoms in irritable bowel syndrome

BACKGROUND

This study examines the complex relationships among the neuroendocrine axis, gut microbiome, inflammatory responses, and gastrointestinal symptoms in patients with irritable bowel syndrome (IBS). The findings provide new insights into the pathophysiology of IBS and suggest potential therapeutic targets for improving patient outcomes.

AIM

To investigate the interactions between the neuroendocrine axis, gut microbiome, inflammation, and gastrointestinal symptoms in patients with IBS.

METHODS

Patients diagnosed with IBS between January 2022 and January 2023 were selected for the study. Healthy individuals undergoing routine check-ups during the same period served as the control group. Data were collected on neuroendocrine hormone levels, gut microbiome profiles, inflammatory biomarkers, and gastrointestinal symptomatology to analyze their interrelations and their potential roles in IBS pathogenesis.

RESULTS

IBS patients exhibited significant dysregulation of the neuroendocrine axis, with altered levels of cortisol, serotonin, and neuropeptides compared to healthy controls. The gut microbiome of IBS patients showed reduced diversity and specific alterations in bacterial genera, including Bifidobacterium, Lactobacillus, and Faecalibacterium, which were associated with neuroendocrine disturbances. Additionally, elevated levels of inflammatory markers, such as C-reactive protein, interleukin-6, and tumor necrosis factor-α, were observed and correlated with the severity of gastrointestinal symptoms like abdominal pain, bloating, and altered bowel habits.

CONCLUSION

The findings suggest that targeting the neuroendocrine axis, gut microbiome, and inflammatory pathways may offer novel therapeutic strategies to alleviate symptoms and improve the quality of life in IBS patients.

Different acupuncture and moxibustion therapies in the treatment of IBS-D with anxiety and depression: A network meta-analysis

BACKGROUND

Currently, a variety of Western medical interventions are available for the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D) with comorbid anxiety and depression. However, the attendant negative effects also emerge, putting pressure on healthcare resources and socio-economic structures. In recent years, the benefits of acupuncture (ACU) and moxibustion in the treatment of IBS-D with anxiety and depression have gradually emerged. However, there are many types of ACU-moxibustion-related treatments, and the aim of this study is to examine the effectiveness of different ACU-moxibustion therapies in the treatment of anxiety and depression in IBS-D patients.

METHODS

Searched and identified randomized controlled trials (RCTS) of ACU for the treatment of anxiety and depression in patients with irritable bowel syndrome (IBS). The search spanned from the establishment of the database until September 1, 2023. Revman 5.4 and Stata 15.0 software were used for network meta-analysis (NMA), and the included interventions were ranked by the area under the cumulative ranking curve.

RESULTS

A total of 26 articles involving 8 interventions were included. In terms of improving HAMA score, MOX was superior to EA, combined therapies, CH, WM and placebo; In terms of improving HAMD score, MOX was superior to ACU, EA, combined therapies, WM and placebo; In terms of improving the SAS score, The combined therapies were superior to EA, CH and WM; In terms of improving SDS scores, The combined therapies were superior to EA, CH and WM; In terms of improving IBS-SSS score, The combined therapies were superior to WM; In terms of reducing recurrence rates, CH was superior to combined therapies; In terms of improving total effective rates, MOX was superior to EA, CH, WM and placebo; MOX, combined therapies, ACU and EA ranked higher in SUCRA of different outcome indicators.

CONCLUSION

MOX, combined therapies, ACU and EA have certain curative effect on anxiety and depression in patients with IBS-D, and their safety is high. ACU and MOX combined with other therapies also have significant advantages in the treatment effect.

Advances in acupuncture regulation on the autonomic nervous system from 2013 to 2022: A bibliometric analysis via citespace

OBJECTIVE

To understand research advances and frontiers of acupuncture regulation on the autonomic nervous system (ANS) over the past decade through a bibliometric analysis.

METHODS

Publications related to acupuncture regulation on the ANS were retrieved from the Web of Science Core Collection (WoSCC) database. CiteSpace software was used to analyze the datasets and generate knowledge maps.

RESULTS

A total of 445 relevant publications published between 2013 and 2022 were included in this bibliometric analysis. The number of annual publications fluctuated from 2013 to 2016 but increased gradually from 2016 to 2022. China produced the highest number of publications, while the USA established the most extensive cooperation relationships. China Academy of Chinese Medical Science was the most productive institution. Chen Jiande D.Z. was the most prolific author and Rong Peijing holds the most extensive cooperation network. Han Jisheng was the most co-cited author. Relevant research involved mechanism exploration and clinical efficacy research, and "anti-inflammatory effect" was the most active research topic, especially cholinergic anti-inflammatory mechanisms. The most cited references mainly focused on inflammation. Gastrointestinal and cardiovascular disorders were the most active medical conditions studied in this field.

CONCLUSIONS

Research related to acupuncture regulation on the ANS mainly focused on anti-inflammation, and regulating gastrointestinal and cardiovascular function over the past decade. However, the mechanisms of the autonomic effects of acupuncture need further investigation. High-quality clinical studies are required to determine the optimal parameters of acupuncture for clinical application.

Treatment of Depression with Acupuncture Based on Pathophysiological Mechanism

Depression is a prevalent mental disorder and has a profound impact on an individual's psychological and physical well-being. It is characterized by a persistently depressed mood, loss of interest, energy loss, and cognitive dysfunction. In recent years, more and more people have changed to mental diseases, such as depression, anxiety, mania and so on. In the incidence of depression, covering all ages, but still mainly young and middle-aged women. Traditional treatments for depression mainly rely on medication and psychotherapy, but these methods are not effective for all patients and are often accompanied by certain side effects. Therefore, finding safe and effective alternative or adjuvant treatments has become a priority. Here we highlight the research progress of acupuncture in the treatment of depression and to explore the mechanism of acupuncture in the treatment of depression. Acupuncture treatment of depression is an ancient and effective method, the mechanism involves multiple biological pathways, for example, by regulating neurotransmitter levels, regulating the neuroendocrine axis, improving neuroplasticity, anti-inflammatory and other effects, improving emotional state and play an antidepressant role. To provide evidence to support the widespread use of acupuncture in clinical practice. We hope to provide new treatment ideas and methods for patients with depression, and even reduce the incidence of depression.

Efficacy of moxibustion in diarrhea-predominant irritable bowel syndrome model rats: a systematic review and meta-analysis

Objective: To systematically evaluate the efficacy of moxibustion in diarrhea-predominant irritable bowel syndrome (IBS-D) model rats. Methods: A comprehensive search was conducted in the China National Knowledge Infrastructure, WanFang Data, VIP, PubMed, Embase, and Web of Science databases from their inception to June 30, 2023. Relevant animal experiments investigating moxibustion for treating IBS-D in model rats were included. Two independent researchers screened the literature, extracted data, and evaluated the risk of bias in the selected studies. The meta-analysis was performed using RevMan 5.3 software. Results: In total, 21 animal studies comprising 680 model rats were included. The meta-analysis results demonstrated that moxibustion enhanced the threshold capacity of the abdominal withdrawal reflex (AWR) [standardized mean difference (SMD) = 1.84; 95% confidence interval (CI): 1.09, 2.60; p < 0.00001], ameliorated the rate of loose stool (SMD = -4.03; 95% CI: -5.76, -2.30; p < 0.00001), and decreased the colon 5-hydroxytryptamine (SMD = -3.67; 95% CI: -5.33, -2.01; p < 0.00001), serum interleukin-1β (SMD = -3.24, 95% CI: -4.06, -2.41; p < 0.00001), serum tumor necrosis factor-α (SMD = -2.35, 95% CI: -4.12, -0.58; p < 0.00001), and serum substance P (SMD = -5.14, 95% CI: -8.45, -1.83; p = 0.002) concentrations. Moxibustion did not affect the blood calcitonin gene-related peptide level compared to the blank model group (p = 0.15). Conclusion: Moxibustion modulated the brain-gut interaction, reduced visceral hypersensitivity, inhibited intestinal inflammation, and regulated the immune balance, improving the rate of loose stool and increasing the AWR threshold capacity in IBS-D model rats, achieving good analgesic and antidiarrheal effects. However, these conclusions require further validation due to limitations in the quantity and quality of the included studies.

Therapeutic effects of curcumin on constipation-predominant irritable bowel syndrome is associated with modulating gut microbiota and neurotransmitters

Introduction

Constipation-predominant irritable bowel syndrome (IBS-C) is a functional bowel disease that affects 10-20% of the population worldwide. Curcumin (CUR) is widely used in traditional Chinese medicine to treat IBS, but its mechanism of action needs further investigation.

Methods

In this study, we used mosapride (MOS) as a positive control to evaluate the changes in gut microbiota in IBS-C rat models after treatment with CUR or MOS by analyzing 16S rDNA variation. In addition, we used enzyme immunoassay kits and immunohistochemical analysis to investigate whether CUR or MOS influenced serotonin (5-HT), substance P (SP), and vasoactive intestinal peptide (VIP) levels in the serum and colon of IBS-C rats.

Results

The study showed that rats supplemented with CUR showed significantly increased fecal weight, fecal water content, small intestine transit rate and significantly decreased serum levels of 5-HT, VIP and SP compared to the IBS group (p < 0.05). In addition, treatment with CUR changed the relative abundance of Blautia, Sutterella, Acetanaerobacterium and Ruminococcus2 in the gut microbiota.

Discussion

This study showed that the efficacy of CUR on IBS-C was possibly by modulating the microbiota and lowering the serum levels of HT, SP, and VIP.

From Mother to Infant, from Placenta to Gut: Understanding Varied Microbiome Profiles in Neonates

The field of human microbiome and gut microbial diversity research has witnessed a profound transformation, driven by advances in omics technologies. These advancements have unveiled essential connections between microbiome alterations and severe conditions, prompting the development of new frameworks through epidemiological studies. Traditionally, it was believed that each individual harbored unique microbial communities acquired early in life, evolving over the course of their lifetime, with little acknowledgment of any prenatal microbial development, but recent research challenges this belief. The neonatal microbiome's onset, influenced by factors like delivery mode and maternal health, remains a subject of intense debate, hinting at potential intrauterine microbial processes. In-depth research reveals associations between microbiome profiles and specific health outcomes, ranging from obesity to neurodevelopmental disorders. Understanding these diverse microbiome profiles is essential for unraveling the intricate relationships between the microbiome and health outcomes.

Peripheral Blood Inflammatory Cytokine Factors Expressions are Associated with Response to Acupuncture Therapy in Postpartum Depression Patients

Background

Increasing evidences demonstrate that immune dysregulation can result in depression, and it is reported that persistent inflammatory response is related to the unresponsiveness of antidepressant treatment.

Purpose

This study aimed to explore the reason why some responded but some not responded to acupuncture in treating postpartum depression (PPD), and whether it related to the levels of inflammatory cytokines.

Patients and Methods

Women diagnosed with PPD were recruited in to accept 8-week acupuncture. All subjects were assessed the 17-item Hamilton Depression Rating Scale (HDRS17) at baseline, week 1, week 2, week 4 and week 8 during the treatment. A panel of 9 cytokines was measured at baseline and 8 weeks.

Results

Of the 121 participants, 96 completed the 8-week assessment and 46 completed the blood sample collection. HDRS17 scores of 96 subjects showed significant statistical reduction since the first week (P = 0.002) and reached to 5.31 (P < 0.000) at the end of therapy. And we divided the 46 subjects into responders and non-responders according to the response rate of HDRS17 scores. Responders and non-responders did not differ significantly between-group in changes in the 9 cytokines. In responders, IL-6, IL-10 and IFN-γ levels were statistically lower (P = 0.006; P = 0.033; P = 0.024), while TGF-β1 was statistically higher after 8 weeks treatment (P < 0.000). In non-responders, the levels of IL-5, TNF-α and TGF-β1 were statistically higher (P = 0.018; P < 0.000; P < 0.000), while IFN-γ was statistically lower (P = 0.005).

Conclusion

Acupuncture could alleviate depressive symptoms of patients with PPD and might through adjusting peripheral inflammatory response by up-regulating anti-inflammatory cytokines and down-regulating pro-inflammatory cytokines.