title: Abnormal Barrier Function in Gastrointestinal Disorders.
abstract: There is increasing concern in identifying the mechanisms underlying the intimate control of the intestinal barrier, as deregulation of its function is strongly associated with digestive (organic and functional) and a number of non-digestive (schizophrenia, diabetes, sepsis, among others) disorders. The intestinal barrier is a complex and effective defensive functional system that operates to limit luminal antigen access to the internal milieu while maintaining nutrient and electrolyte absorption. Intestinal permeability to substances is mainly determined by the physicochemical properties of the barrier, with the epithelium, mucosal immunity, and neural activity playing a major role. In functional gastrointestinal disorders (FGIDs), the absence of structural or biochemical abnormalities that explain chronic symptoms is probably close to its end, as recent research is providing evidence of structural gut alterations, at least in certain subsets, mainly in functional dyspepsia (FD) and irritable bowel syndrome (IBS). These alterations are associated with increased permeability, which seems to reflect mucosal inflammation and neural activation. The participation of each anatomical and functional component of barrier function in homeostasis and intestinal dysfunction is described, with a special focus on FGIDs.
authors.affiliation: Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium.|Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain.
authors.forename: Ricard
authors.initials: R
authors.lastname: Farré
authors.affiliation: Laboratory of Translational Mucosal Immunology, Digestive Diseases Research Unit, Vall d'Hebron Institut de Recerca, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain. maria.vicario@vhir.org.|Department of Gastroenterology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain. maria.vicario@vhir.org.|Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain. maria.vicario@vhir.org.
authors.forename: María
authors.initials: M
authors.lastname: Vicario
mesh_terms: D000818:Animals; D005767:Gastrointestinal Diseases / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D018928:Immunity, Mucosal; D007408:Intestinal Absorption; D007413:Intestinal Mucosa / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology*; D010539:Permeability; D020127:Recovery of Function; D019108:Tight Junctions / Q000378:metabolism; D016896:Treatment Outcome
keywords: Barrier function; Enteric nervous system; Epithelial integrity; Intestinal permeability; Paracellular transport; Tight junctions; Transport routes