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黏液保护剂与肠道屏障:在肠易激综合征中的作用机制及临床应用。是否存在潜在作用?

Mucoprotectants and gut barrier: mechanisms of action and clinical applications in IBS. Is there a possible role?

作者信息

Rettura Francesco, Lambiase Christian, Tedeschi Riccardo, Grosso Antonio, Cancelli Lorenzo, Ricchiuti Angelo, Bottari Andrea, Giacomelli Luca, de Bortoli Nicola, Bellini Massimo

机构信息

Gastrointestinal Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.

Regional Center for Functional and Motility Digestive Disorders, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.

出版信息

Front Pharmacol. 2025 May 12;16:1538791. doi: 10.3389/fphar.2025.1538791. eCollection 2025.


DOI:10.3389/fphar.2025.1538791
PMID:40421206
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12104585/
Abstract

Impaired gut barrier function plays a pivotal role in the pathophysiology of irritable bowel syndrome (IBS), particularly in IBS with diarrhea. Mucoprotectants, such as xyloglucan, gelatin tannate and pea protein tannins, offer a novel therapeutic approach by restoring intestinal permeability and reducing inflammation. This review assesses preclinical and clinical evidence supporting mucoprotectants in IBS with diarrhea management. Preclinical studies indicate their efficacy in reducing intestinal permeability and inflammation, while clinical trials demonstrate improvements in stool consistency, abdominal pain and bloating. Despite these promising results, comparative studies are needed to establish the superiority of specific mucoprotectants and their optimal use in clinical practice.

摘要

肠道屏障功能受损在肠易激综合征(IBS)的病理生理学中起关键作用,尤其是在腹泻型IBS中。木葡聚糖、鞣酸明胶和豌豆蛋白单宁等粘膜保护剂通过恢复肠道通透性和减轻炎症提供了一种新的治疗方法。这篇综述评估了支持粘膜保护剂用于腹泻型IBS治疗的临床前和临床证据。临床前研究表明它们在降低肠道通透性和炎症方面的疗效,而临床试验则证明在改善大便性状、腹痛和腹胀方面有效果。尽管有这些令人鼓舞的结果,但仍需要进行比较研究以确定特定粘膜保护剂的优越性及其在临床实践中的最佳用法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc42/12104585/6b09553c5d12/fphar-16-1538791-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc42/12104585/6b09553c5d12/fphar-16-1538791-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc42/12104585/6b09553c5d12/fphar-16-1538791-g001.jpg

相似文献

[1]
Mucoprotectants and gut barrier: mechanisms of action and clinical applications in IBS. Is there a possible role?

Front Pharmacol. 2025-5-12

[2]
The role of mucoprotectants in the management of gastrointestinal disorders.

Expert Rev Gastroenterol Hepatol. 2017-9-26

[3]
Long-term safety and efficacy study of a medical device containing xyloglucan, pea protein reticulated with tannins and xylo-oligosaccharides, in patients with diarrhoea-predominant irritable bowel syndrome.

Therap Adv Gastroenterol. 2021-5-30

[4]
Translational evaluation of Gelsectan effects on gut barrier dysfunction and visceral pain in animal models and irritable bowel syndrome with diarrhoea.

United European Gastroenterol J. 2024-10

[5]
Efficacy and safety of Gelsectan for diarrhoea-predominant irritable bowel syndrome: A randomised, crossover clinical trial.

United European Gastroenterol J. 2019-7-3

[6]
A randomized double-blind, placebo-controlled trial to evaluate the safety and efficacy of live CECT 7347 (ES1) and heat-treated CECT 7347 (HT-ES1) in participants with diarrhea-predominant irritable bowel syndrome.

Gut Microbes. 2024

[7]
The Role of Purported Mucoprotectants in Dealing with Irritable Bowel Syndrome, Functional Diarrhea, and Other Chronic Diarrheal Disorders in Adults.

Adv Ther. 2021-5

[8]
Baizhu shaoyao decoction restores the intestinal barrier and brain-gut axis balance to alleviate diarrhea-predominant irritable bowel syndrome via FoxO1/FoxO3a.

Phytomedicine. 2024-1

[9]
A Combination of Xyloglucan, Pea Protein and Chia Seed Ameliorates Intestinal Barrier Integrity and Mucosa Functionality in a Rat Model of Constipation-Predominant Irritable Bowel Syndrome.

J Clin Med. 2022-11-29

[10]
Gelatin tannate and tyndallized probiotics: a novel approach for treatment of diarrhea.

Eur Rev Med Pharmacol Sci. 2017-2

本文引用的文献

[1]
Intestinal Barrier Impairment, Preservation, and Repair: An Update.

Nutrients. 2024-10-15

[2]
Adapted Low-FODMAP Diet in IBS Patients with and without Fibromyalgia: Long-Term Adherence and Outcomes.

Nutrients. 2024-10-9

[3]
Translational evaluation of Gelsectan® effects on gut barrier dysfunction and visceral pain in animal models and irritable bowel syndrome with diarrhea.

United European Gastroenterol J. 2024-10

[4]
Translational evaluation of Gelsectan effects on gut barrier dysfunction and visceral pain in animal models and irritable bowel syndrome with diarrhoea.

United European Gastroenterol J. 2024-10

[5]
Molecular Mechanisms Underlying Loss of Vascular and Epithelial Integrity in Irritable Bowel Syndrome.

Gastroenterology. 2024-11

[6]
Effect of xyloglucan associations with gelatin or gelose on Escherichia coli-derived lipopolysaccharide-induced enteritis in rats.

Drugs Context. 2023-10-26

[7]
Misinterpreting Diarrhea-Predominant Irritable Bowel Syndrome and Functional Diarrhea: Pathophysiological Highlights.

J Clin Med. 2023-9-5

[8]
Role of Low-FODMAP diet in functional dyspepsia: "Why", "When", and "to Whom".

Best Pract Res Clin Gastroenterol. 2023

[9]
Italian guidelines for the management of irritable bowel syndrome: Joint Consensus from the Italian Societies of: Gastroenterology and Endoscopy (SIGE), Neurogastroenterology and Motility (SINGEM), Hospital Gastroenterologists and Endoscopists (AIGO), Digestive Endoscopy (SIED), General Medicine (SIMG), Gastroenterology, Hepatology and Pediatric Nutrition (SIGENP) and Pediatrics (SIP).

Dig Liver Dis. 2023-2

[10]
A Combination of Xyloglucan, Pea Protein and Chia Seed Ameliorates Intestinal Barrier Integrity and Mucosa Functionality in a Rat Model of Constipation-Predominant Irritable Bowel Syndrome.

J Clin Med. 2022-11-29

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