Intestinal permeability – a new target for disease prevention and therapy

BMC Gastroenterology

Review

Jörg-Dieter Schulzke¹  Giovanni Barbara²  Stephan C Bischoff³  Wim Buurman⁴  Jerry M Wells⁵  Matteo Serino⁶  Herbert Tilg⁷  Alastair Watson⁸  Theo Ockhuizen⁹ 

[1] Department Gastroenterology, Division General Medicine & Nutrition, Charité Berlin, CBF, Germany;Department of Medical and Surgical Sciences and Centre for Applied Biomedical Research, University of Bologna, Bologna, Italy;Department of Nutritional Medicine/Prevention, University of Hohenheim, Fruwirthstrasse 12, 70593, Stuttgart, Germany;Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands;Host-Microbe Interactomics Group, Animal Sciences Department, Wageningen University and Research Centre, Wageningen, The Netherlands;Institut National de la Santé et de la Recherche Médicale (INSERM) & Université Paul Sabatier (UPS), Unité Mixte de Recherche (UMR) 1048, Institut de Maladies Métaboliques et Cardiovasculaires (I2MC), Toulouse, France;Medical University Innsbruck, Department of Internal Medicine I, Innsbruck, Austria;Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK;Nutricom, Rumpt, The Netherlands;

关键词: Intestinal barrier;    Intestinal permeability;    Microbiota;    Tight junctions;    Obesity;    Inflammatory bowel disease;    Irritable bowel syndrome;    Prebiotics;    Probiotics;    Gut health;   

DOI  :  10.1186/s12876-014-0189-7

 received in 2013-12-27, accepted in 2014-10-17,  发布年份 2014

来源: Springer

【 摘 要 】

Data are accumulating that emphasize the important role of the intestinal barrier and intestinal permeability for health and disease. However, these terms are poorly defined, their assessment is a matter of debate, and their clinical significance is not clearly established. In the present review, current knowledge on mucosal barrier and its role in disease prevention and therapy is summarized. First, the relevant terms ‘intestinal barrier’ and ‘intestinal permeability’ are defined. Secondly, the key element of the intestinal barrier affecting permeability are described. This barrier represents a huge mucosal surface, where billions of bacteria face the largest immune system of our body. On the one hand, an intact intestinal barrier protects the human organism against invasion of microorganisms and toxins, on the other hand, this barrier must be open to absorb essential fluids and nutrients. Such opposing goals are achieved by a complex anatomical and functional structure the intestinal barrier consists of, the functional status of which is described by ‘intestinal permeability’. Third, the regulation of intestinal permeability by diet and bacteria is depicted. In particular, potential barrier disruptors such as hypoperfusion of the gut, infections and toxins, but also selected over-dosed nutrients, drugs, and other lifestyle factors have to be considered. In the fourth part, the means to assess intestinal permeability are presented and critically discussed. The means vary enormously and probably assess different functional components of the barrier. The barrier assessments are further hindered by the natural variability of this functional entity depending on species and genes as well as on diet and other environmental factors. In the final part, we discuss selected diseases associated with increased intestinal permeability such as critically illness, inflammatory bowel diseases, celiac disease, food allergy, irritable bowel syndrome, and – more recently recognized – obesity and metabolic diseases. All these diseases are characterized by inflammation that might be triggered by the translocation of luminal components into the host. In summary, intestinal permeability, which is a feature of intestinal barrier function, is increasingly recognized as being of relevance for health and disease, and therefore, this topic warrants more attention.

【 授权许可】

CC BY   
© Bischoff et al.; licensee BioMed Central Ltd. 2014