Division of Hematology and Oncology, State University of New York Upstate Medical University, SUNY Upstate Medical University, 750 E Adams, Syracuse, NY, 13210, USA.
Department of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon.
J Transl Med. 2023 Mar 31;21(1):233. doi: 10.1186/s12967-023-04091-w.
The intestinal barrier is a complex structure that not only regulates the influx of luminal contents into the systemic circulation but is also involved in immune, microbial, and metabolic homeostasis. Evidence implicating disruption in intestinal barrier functions in the development of many systemic diseases, ranging from non-alcoholic steatohepatitis to autism, or systemic complications of intestinal disorders has increased rapidly in recent years, raising the possibility of the intestinal barrier as a potential target for therapeutic intervention to alter the course and mitigate the complications associated with these diseases. In addition to the disease process being associated with a breach in the intestinal barrier functions, patients with hematologic and oncologic diseases are particularly at high risks for the development of increased intestinal permeability, due to the frequent use of broad-spectrum antibiotics and chemoradiation. They also face a distinct challenge of being intermittently severely neutropenic due to treatment of the underlying conditions. In this review, we will discuss how hematologic and oncologic diseases are associated with disruption in the intestinal barrier and highlight the complications associated with an increase in the intestinal permeability. We will explore methods to modulate the complication. To provide a background for our discussion, we will first examine the structure and appraise the methods of evaluation of the intestinal barrier.
肠道屏障是一个复杂的结构，不仅调节肠腔内容物向全身循环的流入，还参与免疫、微生物和代谢稳态。近年来，越来越多的证据表明肠道屏障功能的破坏与许多系统性疾病的发生有关，从非酒精性脂肪性肝炎到自闭症，或肠道疾病的全身并发症，这增加了肠道屏障作为治疗干预潜在靶点的可能性，以改变这些疾病的进程并减轻相关并发症。除了疾病过程与肠道屏障功能的破坏有关外，由于广谱抗生素和化疗放疗的频繁使用，血液系统和肿瘤疾病患者发生肠道通透性增加的风险特别高。由于基础疾病的治疗，他们也间歇性地面临严重中性粒细胞减少的独特挑战。在这篇综述中，我们将讨论血液系统和肿瘤疾病如何与肠道屏障的破坏有关，并强调与肠道通透性增加相关的并发症。我们将探讨调节这些并发症的方法。为了为我们的讨论提供背景，我们将首先检查肠道屏障的结构并评估其评估方法。
