Convergence of neuro-endocrine-immune pathways in the pathophysiology of irritable bowel syndrome

Figure 1 Convergence of neural endocrine and immune signalling pathways in bowel dysfunction. The figure illustrates the complex nature of functional bowel syndromes such as IBS. It illustrates interaction between three major bodily systems, neural pathways between the brain and gut, hormonal release, primarily from stress-induced activation of the HPA axis and secretion of immune factors such as cytokines. ACTH: Adrenocorticotropic hormone; CRF: Corticotropin-releasing factor; HPA: Hypothalamic-pituitary-adrenal; IBS: Irritable bowel syndrome.