Center for Diabetes, Obesity and Metabolism, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Ann Nutr Metab. 2017;71 Suppl 1:11-16. doi: 10.1159/000479918. Epub 2017 Sep 28.
The intestinal epithelial layer is the chief barricade between the luminal contents and the host. A healthy homeostatic intestinal barrier is pivotal for maintaining gastrointestinal health, which impacts the overall health as it safeguards the gut-blood axis and checks gut microbes including potential pathogens from entering into the circulation.
Under healthy milieus, the intestinal barrier is generally very dynamic and effective, with luminal side being heavily infested with a wide variety of gut microbes while the basolateral side remains virtually sterile. However, certain conditions such as abnormal exposure to toxins, drugs, pathogens etc. or a state of hyper-inflammation due to disease conditions may weaken or destabilize the integrity of gut epithelia. A perturbed gut integrity and permeability ("leaky gut") may lead to microbial (bacterial) translocation, and the eventual leakage of bacteria or their metabolites into the circulation can make the host susceptible to various types of diseases via inducing chronic or acute inflammatory response. Key Message: Given a close association with gut integrity, bacterial translocation and inflammatory responses have recently emerged as a clinically important research field and have unveiled novel aspects of gut microbial ecology and various gastrointestinal, metabolic, and lifestyle diseases. This review aims to describe the significance of a healthy gut barrier integrity and permeability, as well as the factors and consequences associated with a compromised gut barrier, while discussing briefly the dietary approaches including probiotics and prebiotics that could ameliorate gut health by restoring gut environment and barrier integrity, thereby preventing bacterial translocation.
肠上皮层是腔内容物与宿主之间的主要屏障。健康的肠道内稳态屏障对于维持胃肠道健康至关重要,因为它保护着肠道-血液轴,并阻止肠道微生物(包括潜在的病原体)进入循环。
在健康的环境中,肠道屏障通常非常活跃且有效,腔侧定植着大量的肠道微生物,而基底外侧侧则几乎无菌。然而,某些情况,如异常暴露于毒素、药物、病原体等,或因疾病状态导致的过度炎症,可能会削弱或破坏肠道上皮细胞的完整性。受损的肠道完整性和通透性(“渗漏肠道”)可能导致微生物(细菌)易位,细菌或其代谢物最终渗漏到循环中会使宿主易患各种类型的疾病,通过诱导慢性或急性炎症反应。
鉴于与肠道完整性密切相关,细菌易位和炎症反应最近已成为一个重要的临床研究领域,揭示了肠道微生物生态学和各种胃肠道、代谢和生活方式疾病的新方面。本综述旨在描述健康肠道屏障完整性和通透性的重要性,以及与肠道屏障受损相关的因素和后果,同时简要讨论了饮食方法,包括益生菌和益生元,通过恢复肠道环境和屏障完整性来改善肠道健康,从而防止细菌易位。