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Longitudinal analysis indicates symptom severity influences immune profile in irritable bowel syndrome
  1. Chris Mavrangelos1,
  2. Melissa A Campaniello1,
  3. Jane M Andrews2,
  4. Peter A Bampton3,
  5. Patrick A Hughes1
  1. 1Gastrointestinal Neuro-immune Interactions Laboratory, Centre for Nutrition and Gastrointestinal Diseases, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide & South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
  2. 2Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
  3. 3Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia
  1. Correspondence to Dr Patrick A Hughes, Gastrointestinal Neuro-immune Interactions Laboratory, Centre for Nutrition and Gastrointestinal Diseases, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide & South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia; patrick.hughes{at}adelaide.edu.au

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The recent study by Wouters et al1 reported that psychological status inversely correlates with immune profile in the development of postinfectious IBS. While there is increasing evidence of chronic low-grade immune activation in IBS, this field is mired in controversy.2 In our opinion, this contention is related to two major methodological issues: the tendency to group all patients with IBS together rather than stratifying according to bowel habit,3 and the overwhelming predominance of cross-sectional studies. We addressed these issues by performing a longitudinal study of patients with IBS comparing immune function within patients when symptom free and when they experience symptom flare.

Eleven subjects with long-standing IBS (initially characterised by ROME II criteria: 5 IBS-D, 4 IBS-A, 2 IBS-C; 10 female; 59±3 years (mean±SEM)) were enrolled sequentially from tertiary centres in Adelaide, Australia. Subjects completed a valid self-report Bowel Disease Questionnaire3 and …

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