The gut-brain axis (GBA) is broadly accepted to describe the bidirectional circuit that links the gastrointestinal tract with the central nervous system (CNS). Interest in the GBA has grown dramatically over past two decades along with advances in our understanding of the importance of the axis in the pathophysiology of numerous common clinical disorders including mood disorders, neurodegenerative disease, diabetes mellitus, non-alcohol fatty liver disease (NAFLD) and enhanced abdominal pain (visceral hyperalgesia). Paralleling the growing interest in the GBA, there have been seminal developments in our understanding of how environmental factors such as psychological stress and other extrinsic factors alter gene expression, primarily via epigenomic regulatory mechanisms. This process has been driven by advances in next-generation multi-omics methods and bioinformatics. Recent reviews address various components of GBA, but the role of epigenomic regulatory pathways in chronic stress-associated visceral hyperalgesia in relevant regions of the GBA including the amygdala, spinal cord, primary afferent (nociceptive) neurons, and the intestinal barrier has not been addressed. Rapidly developing evidence suggests that intestinal epithelial barrier dysfunction and microbial dysbiosis play a potentially significant role in chronic stress-associated visceral hyperalgesia in nociceptive neurons innervating the lower intestine via downregulation in intestinal epithelial cell tight junction protein expression and increase in paracellular permeability. These observations support an important role for the regulatory epigenome in the development of future diagnostics and therapeutic interventions in clinical disorders affecting the GBA.

肠脑轴 (GBA) 被广泛认为是描述连接胃肠道与中枢神经系统 (CNS) 的双向回路。在过去的二十年中，随着我们对轴在许多常见临床疾病（包括情绪障碍、神经退行性疾病、糖尿病、非酒精性脂肪肝病 (NAFLD)）病理生理学中的重要性的认识不断加深，人们对 GBA 的兴趣急剧增长和增强的腹痛（内脏痛觉过敏）。随着人们对大湾区的兴趣日益浓厚，我们对心理压力和其他外在因素等环境因素如何主要通过表观基因组调控机制改变基因表达的理解也取得了重大进展。这一过程是由下一代多组学方法和生物信息学的进步推动的。最近的评论涉及 GBA 的各个组成部分，但表观基因组调控途径在 GBA 相关区域（包括杏仁核、脊髓、初级传入（伤害性）神经元和肠道屏障）中慢性应激相关内脏痛觉过敏中的作用尚未得到解决。快速发展的证据表明，肠上皮屏障功能障碍和微生物失调通过肠上皮细胞紧密连接蛋白表达的下调和细胞旁通透性的增加，在支配下肠的伤害性神经元的慢性应激相关内脏痛觉过敏中发挥着潜在的重要作用。