A spotlight on intestinal permeability and inflammatory bowel diseases

ABSTRACT

Introduction

The intestinal barrier is a multi-faced structure lining the surface of the intestinal mucosa of the GI tract. To exert its main functions as a physical and immunological defense barrier, several components of the intestinal barrier act in a concerted and cooperative manner.

Areas covered

Herein, we first introduce to the basic organization of the intestinal barrier and then summarize different methods to assess barrier function in and ex vivo. Finally, we provide an in-depth overview of the relevance of intestinal barrier dysfunction in inflammatory bowel diseases.

Expert opinion

In parallel to a more fundamental understanding of the intestinal barrier as a key component for intestinal integrity is the notion that intestinal barrier defects are associated with a variety of diseases such as inflammatory bowel diseases. Recent research has fueled and perpetuated the concept that barrier defects are critical components of disease development, disease behavior, and potentially also an area of therapeutic intervention in IBD patients. Although being far away from standard, new technologies can be used to easily assess barrier healing in IBD and to derive clinical consequences from these findings such as more accurate forecasting of future disease behavior or the identification of novel therapeutic targets.

KEYWORDS:

• Intestinal barrier
• intestinal permeability
• inflammatory bowel diseases
• confocal laser endomicroscopy
• Crohn’s disease
• ulcerative colitis
• leaky gut

Article highlights

• The intestinal barrier is a multi-faced structure lining the surface of the intestinal mucosa of the GI tract that acts as a physical and immunological defense barrier

• Increasing evidence suggests that defects in the intestinal barrier are associated with a variety of diseases such as inflammatory bowel diseases (IBD)

• As such recent research has fueled and perpetuated the concept that barrier defects are critical components of disease development, disease behavior and potentially also an area of therapeutic intervention in IBD patients

• In this article, we introduce to the basic organization of the intestinal barrier and summarize different methods to assess barrier function in and ex vivo

• Finally, we provide an in-depth overview on the relevance of intestinal barrier dysfunction in inflammatory bowel diseases

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

T Rath wrote the manuscript. R Atreya and MF Neurath critically revised the manuscript.

Additional information

Funding

This paper was not funded.