The Gut Barrier New Acquisitions and Therapeutic Approaches
The Gut Barrier New Acquisitions and Therapeutic Approaches
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DOI：
10.1097/mcg.0b013e31826ae849
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发表时间：
2012-10-01
影响因子：
2.9
通讯作者：
Gasbarrini, Antonio
中科院分区：
文献类型：
--
作者：
Scaldaferri, Franco;Pizzoferrato, Marco;Gasbarrini, Antonio
肠道屏障对于个体的生存具有两个关键功能：第一，它允许营养吸收，第二，它保护身体免受危险的大分子渗透。它是一个复杂的多层系统，由外部的“解剖”屏障和内部的“功能”免疫屏障组成。这两个屏障的相互作用使得能够保持平衡的渗透性。许多因素可以改变这种平衡：肠道微生物菌群的改变，粘液层的改变和上皮损伤可以增加肠道通透性，允许管腔内容物转移到肠壁的内层。现在有几种技术使我们能够研究肠道渗透性：“体外”模型（Caco-2和HT 29-MTX细胞）和“体内”非侵入性测试（糖测试和放射性同位素扫描测试）用于估计渗透性，并提出健康和疾病中肠道渗透性的分子病理生理机制。许多用于治疗胃肠道疾病的药品也被发现在调节肠道通透性方面发挥积极作用：皮质类固醇、5-氨基水杨酸、抗肿瘤坏死因子、益生菌和粘膜保护剂，如明胶鞣酸盐。本文将特别讨论肠道屏障在维持肠道通透性（微生物群，粘液和上皮细胞）中的作用，用于估计肠道通透性的技术和能够改变它的治疗方法。
The intestinal barrier serves 2 critical functions for the survival of the individual: first, it allows nutrient absorption and second, it defends the body from dangerous macromolecule penetration. It is a complex multilayer system, consisting of an external "anatomic" barrier and an inner "functional" immunological barrier. The interaction of these 2 barriers enables equilibrated permeability to be maintained. Many factors can alter this balance: gut microflora modifications, mucus layer alterations, and epithelial damage can increase intestinal permeability, allowing the translocation of luminal content to the inner layer of intestinal wall. Several techniques are now available that enable us to study gut permeability: "in vitro" models (Caco-2 and HT29-MTX cells) and "in vivo" not invasive tests (sugar tests and radioisotope scanning tests) are used to estimate permeability and to suggest molecular pathophysiological mechanisms of intestinal permeability in health and diseases. Many medicinal products used in the treatment of gastrointestinal diseases have also found to play an active role in modulate intestinal permeability: corticosteroids, 5-aminosalicylic acid, anti tumor necrosis factor, probiotics, and mucosal protectors, like gelatin tannate. This review will particularly address the role of the gut barrier in maintaining intestinal permeability (microbiota, mucus, and epithelial cells), the techniques used for estimating intestinal permeability and the therapeutic approaches able to modify it.