title: Disrupted barrier function through epithelial cell apoptosis.
abstract: Epithelial barrier function is determined by trans- and paracellular permeabilities, the latter of which is mainly influenced by tight junctions (TJs) and apoptotic leaks within the epithelium. The present article aims to present experimental evidence for a functional role of epithelial apoptoses by means of cell culture models as well as in tissues from patients with inflammatory bowel disease. It is shown that epithelial apoptoses are sites of elevated conductance within the intestinal epithelium and that proinflammatory cytokines like TNF-alpha upregulate both the apoptotic rate and single apoptotic conductivity, making cytokine-induced apoptosis functionally far more relevant than is spontaneous apoptosis. In ulcerative colitis and Crohn's disease (CD), but not in collagenous colitis, apoptotic rates are increased to about 5%, in mild-to-moderately inflamed colon specimens, where as the control apoptotic rate is about 2%. Thus, epithelial apoptoses lead to a loss of ions and water into the intestinal lumen, causing leak flux diarrhea and enabling small antigens of <4,000 Da in the intestinal lumen to enter the intestinal mucosa, thereby perpetuating inflammatory responses. In addition to TNF-alpha, interleukin (IL)-13 is an important inductor of epithelial apoptosis in Th2 immune responses. Therapeutically,TNF-alpha-antibodies (infliximab) can restore barrier function in Crohn's disease by downregulating epithelial apoptoses, while epithelial TJs are unaffected.
authors.affiliation: Medizinische Klinik I, Department of Gastroenterology, Infectious Diseases and Rheumatology, Charité, Campus Benjamin Franklin, 12200 Berlin, Germany. Joerg.Schulzke@Charite.de
authors.forename: Joerg-Dieter
authors.initials: JD
authors.lastname: Schulzke
authors.forename: Christian
authors.initials: C
authors.lastname: Bojarski
authors.forename: Sebastian
authors.initials: S
authors.lastname: Zeissig
authors.forename: Frank
authors.initials: F
authors.lastname: Heller
authors.forename: Alfred H
authors.initials: AH
authors.lastname: Gitter
authors.forename: Michael
authors.initials: M
authors.lastname: Fromm
mesh_terms: D017209:Apoptosis / Q000502:physiology*; D002460:Cell Line; D003093:Colitis, Ulcerative / Q000473:pathology / Q000503:physiopathology*; D003106:Colon / Q000503:physiopathology; D004553:Electric Conductivity; D017097:Electric Impedance; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000503:physiopathology*; D014409:Tumor Necrosis Factor-alpha / Q000502:physiology
chemical_list: D014409:Tumor Necrosis Factor-alpha