Leaky gut and autoimmune diseases

A Fasano - Clinical reviews in allergy & immunology, 2012 - Springer
Clinical reviews in allergy & immunology, 2012Springer
Autoimmune diseases are characterized by tissue damage and loss of function due to an
immune response that is directed against specific organs. This review is focused on the role
of impaired intestinal barrier function on autoimmune pathogenesis. Together with the gut-
associated lymphoid tissue and the neuroendocrine network, the intestinal epithelial barrier,
with its intercellular tight junctions, controls the equilibrium between tolerance and immunity
to non-self antigens. Zonulin is the only physiologic modulator of intercellular tight junctions …
Abstract
Autoimmune diseases are characterized by tissue damage and loss of function due to an immune response that is directed against specific organs. This review is focused on the role of impaired intestinal barrier function on autoimmune pathogenesis. Together with the gut-associated lymphoid tissue and the neuroendocrine network, the intestinal epithelial barrier, with its intercellular tight junctions, controls the equilibrium between tolerance and immunity to non-self antigens. Zonulin is the only physiologic modulator of intercellular tight junctions described so far that is involved in trafficking of macromolecules and, therefore, in tolerance/immune response balance. When the zonulin pathway is deregulated in genetically susceptible individuals, autoimmune disorders can occur. This new paradigm subverts traditional theories underlying the development of these diseases and suggests that these processes can be arrested if the interplay between genes and environmental triggers is prevented by re-establishing the zonulin-dependent intestinal barrier function. Both animal models and recent clinical evidence support this new paradigm and provide the rationale for innovative approaches to prevent and treat autoimmune diseases.
Springer