防疏堵漏，共筑肠城

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摘译及点评｜上海国际医学中心夏璐

来源｜医学界消化频道（CCCF—IBD学习驿站出品）

Improvementofa‘Leaky’IntestinalBarrier

EduardF.Stange

Abstract

InCrohn’sdisease,themucuslayerappearstobedefectiveintermsoflowdefensinlevelsandlackofantibacterialactivity.ThesedeficienciesactuallyexplaintheMontrealphenotypesandthestablelocalizationofdiseaseintheterminalileumwithlowα-defensinsfromPanethcellsand/orlowβ-defensinsincolonicdisease,respectively.Conversely,inulcerativecolitis(UC)thedefensinproductionisnormaloreveninduced,butthemucuslayeristhinnerandpatchy,moreintheliquidformandalsochemicallyalteredsothatantibacterialpeptidesarenotretainedandlostintotheluminalbacterialbulk.Therefore,bothbarrierproblemsallowslowbacterialattachmentandinvasion,ultimatelytriggeringthemassiveresponseofadaptiveimmunityandtissuedestruction.Therefore,leakinessshouldrefertotheantibacterialbarrierandnottothegeneralbarrieragainstsmallmolecules,suchasmannitolorlactulose,whicharenotantigenic.ThemostpromisingapproachinUCseemstobetheuseofprobioticsorthenatural







































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