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Title: Cytokine levels and symptoms among women with irritable bowel syndrome: Considering the role of hormonal contraceptive use

Author
item KAMP, KENDRA - University Of Washington
item HAN, CLAIRE - University Of Washington
item SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC)
item CAIN, KEVIN - University Of Washington
item BARNEY, PAMELA - University Of Washington
item OPP, MARK - University Of Colorado
item CHANG, LIN - University Of California (UCLA)
item BURR, ROBERT - University Of Washington
item HEITKEMPER, MARGARET - University Of Washington

Submitted to: Biological Research for Nursing
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/16/2020
Publication Date: 7/17/2020
Citation: Kamp, K.J., Han, C., Shulman, R.J., Cain, K.C., Barney, P., Opp, M.R., Chang, L., Burr, R.L., Heitkemper, M.M. 2020. Cytokine levels and symptoms among women with irritable bowel syndrome: Considering the role of hormonal contraceptive use. Biological Research for Nursing. https://doi.org/10.1177/1099800420941252.
DOI: https://doi.org/10.1177/1099800420941252

Interpretive Summary: Irritable bowel syndrome affects approximately 10% of children and adults worldwide. The cause is not well understood but symptoms can be affected by the type of diet eaten and it is more common in females. This study suggests that the hormones in contraceptives can reduce symptoms. Further research is needed to evaluate the hormones and their pathways to determine if nutritional interventions may be possible to cause similar hormonal affects that lessen symptoms.

Technical Abstract: Young to middle-aged women are more likely than men to be diagnosed with irritable bowel syndrome (IBS). Immune dysfunction may be present in IBS, however, few studies have tested whether hormonal contraceptive use is linked to inflammatory markers. The purpose of this study was to compare cytokine levels between women (ages 18-45) with and without IBS and with and without hormonal contraceptive use and to examine the relationships of cytokine levels to IBS gastrointestinal (GI) and non-GI symptoms within those using and not using hormonal contraceptives. Seventy-three women with IBS and 47 healthy control women completed questionnaires (demographics, hormonal contraceptive use) and kept a 28-day symptom diary. Fasting plasma and LPS-stimulated pro-inflammatory (IL-1ß, IL-6, IL-12p40, IL-12p70, IL-8, and TNF-a) and anti-inflammatory (IL-10) cytokines were assayed. No differences were found in plasma or stimulated cytokine levels between IBS and control women. Levels of IL-1ß (p = 0.04) and TNF-a (p = 0.02) were higher among women who did not use hormonal contraceptives compared to women who used hormonal contraceptives. Among women with IBS, significant correlations were found between daily psychological distress and plasma IL-10, IL-12p70, IL-1ß, IL-6, and IL-8 cytokine levels. These results suggest that hormonal contraceptive use might reduce IL-1ß and TNF-a cytokine levels in women with IBS. The impact of hormonal contraceptive use on innate immune activation among women with IBS requires further research.