Published online Feb 26, 2018. doi: 10.13105/wjma.v6.i1.1
Peer-review started: December 4, 2017
First decision: December 27, 2017
Revised: January 17, 2018
Accepted: February 24, 2018
Article in press: February 25, 2018
Published online: February 26, 2018
Processing time: 93 Days and 13.8 Hours
The irritable bowel syndrome (IBS) is a hot topic and the uncovering its genetic determination is very important.
Knowing the genetic link in the occurrence of IBS could offer the perspective to better know this condition and to improve its management.
In order to shed light on this topic, we carried out a systematic review of the data on main genetic polymorphisms described uptoday.
A PubMed search was carried out in September 2016, looking for studies analyzing the association between gene polymorphisms and IBS. Search keywords were: IBS and gene polymorphism. The inclusion criteria were: original articles that included patients with IBS-C, IBS-D or IBS-M, and that studied genetic polymorphisms in IBS patients. Exclusion criteria were: reviews, lack of abstract, non-English publications.
The result of our study was a review of 12 polymorphisms, residing in 10 genes reported to be associated with the pathogenesis and the pathophysiology of IBS. The main problem that remains to be solved in the current genetic studies analysing IBS is represented by the low number of subjects included in the majority of studies.
High-quality evidence for the relation between genetic polymorphisms and the IBS etiology is lacking, as a result of the insufficient number of high-quality prospective studies. Similar studies on functional gastrointestinal disorders and genetic polymorphisms are also very limited. The strength of articles, included in this review are the determination of each genetic polymorphism, using high efficiency techniques. The polymorphisms of the Serotonin transporter (SERT or SLC6A4) gene were the most frequent genetic polymorphisms studied in this pathology. Investigation of PI-IBS patients showed associations with TNFSF15 genetic polymorphisms which also predispose to Crohn’s disease suggesting a possible common underlying pathogenesis.
From the genetic perspective, the actual IBS subgroups are not sufficient in order to identify distinct phenotypes and further in leading to new guiding principles for treatment. These limitations can be overcome by international cooperation, like the GENIEUR network (Genes in Irritable Bowel Syndrome Research Network Europe), who allows the contribution of specialists from many countries and the collecting of large samples of subjects who are deeply phenoytped to allow genotype phenotype correlation and data mining approached. Such studies allow also the standardization of investigative tools in the approach of IBS patients.