Tyszka Martyna, Biliński Jarosław, Basak Grzegorz Władysław
Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland.
J Clin Med. 2021 Jun 6;10(11):2508. doi: 10.3390/jcm10112508.
The intestinal barrier consists of an epithelial lining covered with specialized mucus inhabited by intestinal microbiota. An intact gut barrier ensures a resistance to bacteria and toxins translocation. On the other hand, gut permeability allows the absorption of essential nutrients, fluids and ions. This balance is achieved only by the complex structure and functional characteristics of the intestinal barrier. Allogenic hematopoietic cell transplantation remains the only curative treatment for many hematological diseases, but its application is limited because of possible transplant-related mortality mainly due to graft-versus-host disease and infectious complications. The intestinal barrier has been extensively studied in recent years as the primary site of graft-versus-host disease initiation and propagation. In the present review, we focused on the physiological structure and function of the gut barrier and the evidence of how the disruption of the gut barrier and increased intestinal permeability affects transplant recipients. Finally, therapeutic strategies aiming at intestinal barrier protection with a special focus on microbiome preservation and restoration in the allogenic hematopoietic cell transplantation setting are discussed.
肠道屏障由覆盖着特殊黏液的上皮内衬组成，肠道微生物群栖息于该黏液中。完整的肠道屏障可确保对细菌和毒素移位具有抵抗力。另一方面，肠道通透性允许必需营养素、液体和离子的吸收。这种平衡仅通过肠道屏障的复杂结构和功能特性来实现。异基因造血细胞移植仍然是许多血液系统疾病的唯一治愈性治疗方法，但其应用受到限制，主要是因为可能发生与移植相关的死亡，主要原因是移植物抗宿主病和感染性并发症。近年来，肠道屏障作为移植物抗宿主病起始和传播的主要部位受到了广泛研究。在本综述中，我们重点关注肠道屏障的生理结构和功能，以及肠道屏障破坏和肠道通透性增加如何影响移植受者的证据。最后，讨论了旨在保护肠道屏障的治疗策略，特别关注异基因造血细胞移植环境中微生物群的保存和恢复。
