Importance of disrupted intestinal barrier in inflammatory bowel diseases - PubMed

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• PMID: 20725949
• DOI: 10.1002/ibd.21403

Review

Importance of disrupted intestinal barrier in inflammatory bowel diseases

Sa'ad Y Salim et al. Inflamm Bowel Dis. 2011 Jan.

Abstract

The current paradigm of inflammatory bowel diseases (IBD), both Crohn's disease (CD) and ulcerative colitis (UC), involves the interaction between environmental factors in the intestinal lumen and inappropriate host immune responses in genetically predisposed individuals. The intestinal mucosal barrier has evolved to maintain a delicate balance between absorbing essential nutrients while preventing the entry and responding to harmful contents. In IBD, disruptions of essential elements of the intestinal barrier lead to permeability defects. These barrier defects exacerbate the underlying immune system, subsequently resulting in tissue damage. The epithelial phenotype in active IBD is very similar in CD and UC. It is characterized by increased secretion of chloride and water, leading to diarrhea, increased permeability via both the transcellular and paracellular routes, and increased apoptosis of epithelial cells. The main cytokine that seems to drive these changes is tumor necrosis factor alpha in CD, whereas interleukin (IL)-13 may be more important in UC. Therapeutic restoration of the mucosal barrier would provide protection and prevent antigenic overload due to intestinal "leakiness." Here we give an overview of the key players of the intestinal mucosal barrier and review the current literature from studies in humans and human systems on mechanisms underlying mucosal barrier dysfunction in IBD.

Comment in

• Clinical significance of serum diamine oxidase activity in inflammatory bowel disease: Importance of evaluation of small intestinal permeability.

  Honzawa Y, Nakase H, Matsuura M, Chiba T. Honzawa Y, et al. Inflamm Bowel Dis. 2011 Feb;17(2):E23-5. doi: 10.1002/ibd.21588. Epub 2010 Dec 16. Inflamm Bowel Dis. 2011. PMID: 21225906 No abstract available.

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