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The Role of Intestinal Permeability in Gastrointestinal Disorders and Current Methods of Evaluation

An increased intestinal permeability has been described in various gastrointestinal and non-gastrointestinal disorders. Nevertheless, the concept and definition of intestinal permeability is relatively broad and includes not only an altered paracellular route, regulated by tight junction proteins, b...

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Autores principales: Vanuytsel, Tim, Tack, Jan, Farre, Ricard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8427160/
https://www.ncbi.nlm.nih.gov/pubmed/34513903
http://dx.doi.org/10.3389/fnut.2021.717925
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author Vanuytsel, Tim
Tack, Jan
Farre, Ricard
author_facet Vanuytsel, Tim
Tack, Jan
Farre, Ricard
author_sort Vanuytsel, Tim
collection PubMed
description An increased intestinal permeability has been described in various gastrointestinal and non-gastrointestinal disorders. Nevertheless, the concept and definition of intestinal permeability is relatively broad and includes not only an altered paracellular route, regulated by tight junction proteins, but also the transcellular route involving membrane transporters and channels, and endocytic mechanisms. Paracellular intestinal permeability can be assessed in vivo by using different molecules (e.g., sugars, polyethylene glycols, (51)Cr-EDTA) and ex vivo in Ussing chambers combining electrophysiology and probes of different molecular sizes. The latter is still the gold standard technique for assessing the epithelial barrier function, whereas in vivo techniques, including putative blood biomarkers such as intestinal fatty acid-binding protein and zonulin, are broadly used despite limitations. In the second part of the review, the current evidence of the role of impaired barrier function in the pathophysiology of selected gastrointestinal and liver diseases is discussed. Celiac disease is one of the conditions with the best evidence for impaired barrier function playing a crucial role with zonulin as its proposed regulator. Increased permeability is clearly present in inflammatory bowel disease, but the question of whether this is a primary event or a consequence of inflammation remains unsolved. The gut-liver axis with a crucial role in impaired intestinal barrier function is increasingly recognized in chronic alcoholic and metabolic liver disease. Finally, the current evidence does not support an important role for increased permeability in bile acid diarrhea.
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spelling pubmed-84271602021-09-10 The Role of Intestinal Permeability in Gastrointestinal Disorders and Current Methods of Evaluation Vanuytsel, Tim Tack, Jan Farre, Ricard Front Nutr Nutrition An increased intestinal permeability has been described in various gastrointestinal and non-gastrointestinal disorders. Nevertheless, the concept and definition of intestinal permeability is relatively broad and includes not only an altered paracellular route, regulated by tight junction proteins, but also the transcellular route involving membrane transporters and channels, and endocytic mechanisms. Paracellular intestinal permeability can be assessed in vivo by using different molecules (e.g., sugars, polyethylene glycols, (51)Cr-EDTA) and ex vivo in Ussing chambers combining electrophysiology and probes of different molecular sizes. The latter is still the gold standard technique for assessing the epithelial barrier function, whereas in vivo techniques, including putative blood biomarkers such as intestinal fatty acid-binding protein and zonulin, are broadly used despite limitations. In the second part of the review, the current evidence of the role of impaired barrier function in the pathophysiology of selected gastrointestinal and liver diseases is discussed. Celiac disease is one of the conditions with the best evidence for impaired barrier function playing a crucial role with zonulin as its proposed regulator. Increased permeability is clearly present in inflammatory bowel disease, but the question of whether this is a primary event or a consequence of inflammation remains unsolved. The gut-liver axis with a crucial role in impaired intestinal barrier function is increasingly recognized in chronic alcoholic and metabolic liver disease. Finally, the current evidence does not support an important role for increased permeability in bile acid diarrhea. Frontiers Media S.A. 2021-08-26 /pmc/articles/PMC8427160/ /pubmed/34513903 http://dx.doi.org/10.3389/fnut.2021.717925 Text en Copyright © 2021 Vanuytsel, Tack and Farre. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Nutrition
Vanuytsel, Tim
Tack, Jan
Farre, Ricard
The Role of Intestinal Permeability in Gastrointestinal Disorders and Current Methods of Evaluation
title The Role of Intestinal Permeability in Gastrointestinal Disorders and Current Methods of Evaluation
title_full The Role of Intestinal Permeability in Gastrointestinal Disorders and Current Methods of Evaluation
title_fullStr The Role of Intestinal Permeability in Gastrointestinal Disorders and Current Methods of Evaluation
title_full_unstemmed The Role of Intestinal Permeability in Gastrointestinal Disorders and Current Methods of Evaluation
title_short The Role of Intestinal Permeability in Gastrointestinal Disorders and Current Methods of Evaluation
title_sort role of intestinal permeability in gastrointestinal disorders and current methods of evaluation
topic Nutrition
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8427160/
https://www.ncbi.nlm.nih.gov/pubmed/34513903
http://dx.doi.org/10.3389/fnut.2021.717925
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