New therapeutic perspectives in irritable bowel syndrome: Targeting low-grade inflammation, immuno-neuroendocrine axis, motility, secretion and beyond

Figure 1 Complex interplay between low-grade inflammation, immuno-neuroendocrine axis, and microbiota. Brain (influenced by multiple innate and acquired factors) and gut interact bidirectionally to shape the clinical phenotype of irritable bowel syndrome (IBS). This bi-directional pathway acts not only on gastrointestinal motility, visceral sensitivity and secretion; however, the influence of both the immune system and microbiota modulates several functions that could create the definitive clinical phenotype of IBS.