Longitudinal analysis indicates symptom severity influences immune profile in irritable bowel syndrome

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 donated a venous blood sample...

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