Department of Clinical and Experimental Medicine, Division of Surgery and Clinical Oncology, Faculty of Health Science, University Hospital, Linköping, Sweden.
Neurogastroenterol Motil. 2010 Jul;22(7):718-33. doi: 10.1111/j.1365-2982.2010.01498.x. Epub 2010 Apr 9.
The ability to control uptake across the mucosa and protect from damage of harmful substances from the lumen is defined as intestinal barrier function. A disturbed barrier dysfunction has been described in many human diseases and animal models, for example, inflammatory bowel disease, irritable bowel syndrome, and intestinal hypersensitivity. In most diseases and models, alterations are seen both of the paracellular pathway, via the tight junctions, and of the transcellular routes, via different types of endocytosis. Recent studies of pathogenic mechanisms have demonstrated the important role of neuroimmune interaction with the epithelial cells in the regulation of barrier function. Neural impulses from extrinsic vagal and/or sympathetic efferent fibers or intrinsic enteric nerves influence mucosal barrier function via direct effects on epithelial cells or via interaction with immune cells. For example, by nerve-mediated activation by corticotropin-releasing hormone or cholinergic pathways, mucosal mast cells release a range of mediators with effects on transcellular, and/or paracellular permeability (for example, tryptase, TNF-alpha, nerve growth factor, and interleukins).
In this review, we discuss current physiological and pathophysiological aspects of the intestinal barrier and, in particular, its regulation by neuroimmune factors.
能够控制黏膜对物质的摄取并防止腔道有害物质的损伤，这被定义为肠道屏障功能。在许多人类疾病和动物模型中，已经描述了这种屏障功能障碍，例如炎症性肠病、肠易激综合征和肠道过敏。在大多数疾病和模型中，无论是通过紧密连接的细胞旁途径，还是通过不同类型的胞吞作用的细胞内途径，都观察到了改变。对发病机制的最近研究表明，神经免疫相互作用与上皮细胞在调节屏障功能方面的重要作用。来自外在迷走神经和/或交感传出纤维或内在肠神经的神经冲动通过直接作用于上皮细胞或通过与免疫细胞相互作用来影响黏膜屏障功能。例如，通过促肾上腺皮质释放激素或胆碱能途径的神经介导激活，黏膜肥大细胞释放一系列具有跨细胞和/或细胞旁通透性作用的介质（例如，胰蛋白酶、TNF-α、神经生长因子和白细胞介素）。
在这篇综述中，我们讨论了肠道屏障的当前生理和病理生理方面，特别是其受神经免疫因素调节的方面。
