Tight junction structure, function, and assessment in the critically ill: a systematic review.
Tight junction structure, function, and assessment in the critically ill: a systematic review.
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DOI：
10.1186/s40635-018-0203-4
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发表时间：
2018-09-26
影响因子：
3.5
通讯作者：
Pierce RW
中科院分区：
文献类型：
--
作者：
Vermette D;Hu P;Canarie MF;Funaro M;Glover J;Pierce RW
上皮和内皮屏障的完整性对于体内平衡至关重要，由称为紧密连接 (TJ) 的细胞边界结构来维持。在危重疾病中，TJ可能会被破坏，导致屏障功能障碍，表现为毛细血管渗漏、肺水肿、肠道细菌易位和多器官衰竭。我们的目标是提供 TJ 结构和功能的临床重点概述，并系统回顾和分析所有评估内皮和上皮 TJ 破坏标记物与危重人类临床结果相关的研究。我们系统地检索了 MEDLINE、EMBASE 和 PubMed。通过有针对性的搜索发现了其他文章。我们纳入了研究内皮或上皮 TJ 结构或功能的生物标志物与危重疾病之间关系的研究。由于样本量和异质性，对结果进行了定性分析。共有5297篇摘要符合检索条件，其中150篇文章符合全文审查要求。其中，30 项研究符合纳入标准。 30 份报告中有 15 份研究了内皮紧密连接的蛋白质，15 份研究了上皮 TJ 标记物，仅在胃肠道上皮中。没有研究调查 TJ 衍生蛋白在原发性心脏或肺部病理学中的作用。 TJ 完整性对于体内平衡至关重要。我们发现多项研究表明 TJ 会因严重疾病而受到干扰。这些研究强调了屏障破坏在许多危重疾病状态中的重要性，并将 TJ 相关标记物与临床相关结果相关联。对多种组织特异性紧密蛋白的作用的进一步研究，特别是在呼吸或心力衰竭的情况下，可能会带来诊断和治疗的进展。该系统评价已在 PROSPERO 数据库中注册：CRD42017074546。本文的在线版本 (10.1186/s40635-018-0203-4) 包含补充材料，可供授权用户使用。
Epithelial and endothelial barrier integrity, essential for homeostasis, is maintained by cellular boarder structures known as tight junctions (TJs). In critical illness, TJs may become disrupted, resulting in barrier dysfunction manifesting as capillary leak, pulmonary edema, gut bacterial translocation, and multiple organ failure. We aim to provide a clinically focused overview of TJ structure and function and systematically review and analyze all studies assessing markers of endothelial and epithelial TJ breakdown correlated with clinical outcomes in critically ill humans. We systematically searched MEDLINE, EMBASE, and PubMed. Additional articles were identified by targeted searches. We included studies that looked at the relationship between biomarkers of endothelial or epithelial TJ structure or function and critical illness. Results were qualitatively analyzed due to sample size and heterogeneity. A total of 5297 abstracts met search criteria, of which 150 articles met requirements for full text review. Of these, 30 studies met inclusion criteria. Fifteen of the 30 reports investigated proteins of endothelial tight junctions and 15 investigated epithelial TJ markers, exclusively in the gastrointestinal epithelium. No studies investigated TJ-derived proteins in primary cardiac or pulmonary pathology. TJ integrity is essential for homeostasis. We identified multiple studies that indicate TJs are disrupted by critical illness. These studies highlight the significance of barrier disruption across many critical disease states and correlate TJ-associated markers to clinically relevant outcomes. Further study on the role of multiple tissue-specific claudins, particularly in the setting of respiratory or cardiac failure, may lead to diagnostic and therapeutic advances. This systematic review is registered in the PROSPERO database: CRD42017074546. The online version of this article (10.1186/s40635-018-0203-4) contains supplementary material, which is available to authorized users.