Intestinal permeability – a new target for disease prevention and therapy
Open accessAbstract
Data are accumulating that emphasize the important role of the intestinal barrier and intestinal permeability for health and disease. However, these terms are poorly defined, their assessment is a matter of debate, and their clinical significance is not clearly established. In the present review, current knowledge on mucosal barrier and its role in disease prevention and therapy is summarized. First, the relevant terms 'intestinal barrier' and 'intestinal permeability' are defined. Secondly, the key element of the intestinal barrier affecting permeability are described. This barrier represents a huge mucosal surface, where billions of bacteria face the largest immune system of our body. On the one hand, an intact intestinal barrier protects the human organism against invasion of microorganisms and toxins, on the other hand, this barrier must be open to absorb essential fluids and nutrients. Such opposing goals are achieved by a complex anatomical and functional structure the intestinal barrier consists of, the functional status of which is described by 'intestinal permeability'. Third, the regulation of intestinal permeability by diet and bacteria is depicted. In particular, potential barrier disruptors such as hypoperfusion of the gut, infections and toxins, but also selected over-dosed nutrients, drugs, and other lifestyle factors have to be considered. In the fourth part, the means to assess intestinal permeability are presented and critically discussed. The means vary enormously and probably assess different functional components of the barrier. The barrier assessments are further hindered by the natural variability of this functional entity depending on species and genes as well as on diet and other environmental factors. In the final part, we discuss selected diseases associated with increased intestinal permeability such as critically illness, inflammatory bowel diseases, celiac disease, food allergy, irritable bowel syndrome, and--more recently recognized--obesity and metabolic diseases. All these diseases are characterized by inflammation that might be triggered by the translocation of luminal components into the host. In summary, intestinal permeability, which is a feature of intestinal barrier function, is increasingly recognized as being of relevance for health and disease, and therefore, this topic warrants more attention.
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The intestinal epithelium and overlaying mucus layer protect the host by providing a physical and immunological barrier against pathogens while regulating fluid and nutrient absorption.
“The intestinal epithelium and the overlaying mucus layer serve a key role in protecting the host by providing a physical and immunological barrier against potentially harmful pathogens while also regulating fluid and nutrient absorption77.”
From The gut Microbiome in adult and pediatric functional gastrointestinal disorders (2019) · cites this paper as [77]
In the absence of infection, endotoxin crosses the mucosal membranes of gut, gums, nose or lungs, the main source being intestinal permeability.
“However, in the absence of infection, endotoxin still crosses the mucosal membranes of gut, gums, nose or lungs, the main source being intestinal permeability [36, 37].”
From The endotoxin hypothesis of neurodegeneration (2019) · cites this paper as [36]
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- Authors
- Bischoff, S. C., Barbara, G., Buurman, W., Ockhuizen, T., Schulzke, J.-D., Serino, M., Tilg, H., Watson, A., & Wells, J. M.
- Affiliations
- University of Hohenheim (DE)
- University of Bologna (IT)
- Maastricht University Medical Centre (NL)
- Stiftung Charité (DE)
- Innsbruck Medical University (AT)
- University of East Anglia (GB)
- Wageningen University & Research (NL)
- Corresponding author
- Bischoff, Stephan C
- ORCID
- Venue
- BMC Gastroenterology
- Published
- 2014-11-18
- Volume
- 14
- Issue
- 1
- Pages
- 189-189
- ISSN
- 1471-230X (ISSN-L)
- PMC
- PMC4253991
- OpenAlex
- W2133808995
- Cited by
- 1,755
- References
- 272
- Citations by year
- 2026: 139 · 2025: 166 · 2024: 185 · 2023: 177 · 2022: 197 · 2021: 204 · 2020: 174 · 2019: 156 · 2018: 124 · 2017: 121 · 2016: 83 · 2015: 27
- FWCI
- 12.61
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Gastroenterology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, cc-by)
- UEA Digital Repository (University of East Anglia) (acceptedVersion)
- Socio-Environmental Systems Modeling (acceptedVersion, cc-by)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, cc-by)
- Funders
- Biotechnology and Biological Sciences Research Council (BBS/E/F/00044446)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Keywords
- intestinal permeability, intestinal barrier, gut microbiota, diet, barrier disruption, infection, toxins, critically ill patients, inflammatory bowel disease, celiac disease, food allergy, irritable bowel syndrome, obesity, metabolic disorders, inflammation
- MeSH terms
- Animals, Diet, Fatty Liver, Histamine, Humans, Intestinal Mucosa, Intestines, Obesity, Peptide Hydrolases, Permeability, Serotonin, Inflammatory Bowel Diseases, Biomarkers, Critical Illness, Ion Transport, Probiotics, Receptor, Cannabinoid, CB1, Prebiotics
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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