Review article: intestinal barrier dysfunction and central nervous system disorders—a controversial association
Open accessAbstract
BACKGROUND: Central nervous system (CNS) development and physiopathology are greatly affected by environmental stimuli. The intestinal barrier restricts the entrance of toxins, pathogens, and antigens while modulating the expression of various neuroactive compounds. The existence of a rich gut-to-brain communication raises the possibility that intestinal barrier alterations may take part in the pathophysiology of CNS disorders. AIM: To review evidence associating intestinal barrier dysfunction with the development of CNS disorders. METHODS: Literature search was conducted on PubMed using the following terms: intestinal barrier, intestinal permeability, central nervous system, mental disorders, schizophrenia, autism, stress, anxiety, depression, and neurodegeneration. RESULTS: Clinical and animal model studies of the association between intestinal barrier and schizophrenia, autism spectrum disorders, neurodegenerative diseases or depression were reviewed. The majority of reports concentrated on schizophrenia and autism spectrum disorders. About half of these described increased intestinal permeability/mucosal damage in patients compared with healthy controls, with up to 43% of children with autism spectrum disorders and up to 35% of schizophrenia patients displaying abnormally high urinary excretion of the sugars used as permeability markers. However, another substantial group of studies did not find such differences. In autism spectrum disorders, some reports show that the use of diets such as the gluten-free casein-free diet may contribute to the normalisation of lactulose/mannitol ratio, but to date there is no adequately controlled study showing improvement in behavioural symptoms following these dietary interventions. CONCLUSIONS: Evidence of altered intestinal permeability in individuals suffering from CNS disorders is limited and cannot be regarded as proven. Moreover the efficacy of targeting gut barrier in the management of neurological and behavioural aspects of CNS disorders has not yet been established, and needs further investigation.
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Alterations in gut permeability have been described in individuals with ASD.
“Indeed, alterations in gut permeability have been described in individuals with ASD (Julio-Pieper et al., 2014; Mayer et al., 2014).”
From Mechanisms underlying microbial-mediated changes in social behavior in mouse models of autism spectrum disorder (2019) · cites this paper as Julio-Pieper et al., 2014
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The gut-brain axis: is intestinal inflammation a silent driver of Parkinson’s disease pathogenesis?
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- Authors
- Julio-Pieper, M., Bravo, J. A., Aliaga, E., & Gotteland, M.
- Affiliations
- Instituto de Química; Facultad de Ciencias; Pontificia Universidad Católica de Valparaíso; Valparaíso Chile
- Pontificia Universidad Católica de Valparaíso (CL)
- University of Chile (CL)
- Venue
- Alimentary Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2014-09-28
- Volume
- 40
- Issue
- 10
- Pages
- 1187-1201
- ISSN
- 0269-2813 (ISSN-L)
- OpenAlex
- W2094708275
- Cited by
- 84
- References
- 114
- Citations by year
- 2025: 4 · 2024: 4 · 2023: 6 · 2022: 11 · 2021: 9 · 2020: 8 · 2019: 6 · 2018: 6 · 2017: 11 · 2016: 11 · 2015: 8
- FWCI
- 1.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Alimentary Pharmacology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Funders
- CONICYT (79112017)
- Pontificia Universidad Catolica de Valparaiso (037.302/2013)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Life Sciences › Neuroscience › Neurology › Barrier Structure and Function Studies
- Keywords
- intestinal barrier dysfunction, intestinal permeability, gut-brain axis, central nervous system disorders, schizophrenia, autism spectrum disorder, neurodegeneration, depression, anxiety, lactulose/mannitol ratio, gluten-free casein-free diet
- MeSH terms
- Animals, Brain, Central Nervous System Diseases, Humans, Intestinal Diseases, Intestinal Mucosa, Intestines, Permeability
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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