The intestinal epithelial barrier: A therapeutic target?

摘要

A fundamental function of the intestinal epithelium is to act as a barrier that regulates interactions between the luminal contents, such as the intestinal microbiota, the underlying immune system, and the remainder of the body, while supporting vectorial transport of nutrients, water, and waste products. Epithelial barrier function requires a contiguous layer of cells as well as the junctions that seal the paracellular space between epithelial cells. Compromised intestinal barrier function has been associated with a number of disease states, both intestinal and systemic. Unfortunately, most current clinical data are correlative, making it difficult to separate cause from effect in interpreting significance of barrier loss. Some data from experimental animal models suggest that compromised epithelial integrity may play a pathogenic role in specific gastrointestinal diseases, but no FDA-approved therapies for targeting the epithelial barrier are presently available. In order for this goal to be achieved, a deeper understanding of both disease pathogenesis and mechanisms of barrier regulation must be reached.