Published online Nov 14, 2014. doi: 10.3748/wjg.v20.i42.15650
Revised: April 29, 2014
Accepted: May 26, 2014
Published online: November 14, 2014
Intestinal alkaline phosphatase (IAP) plays an essential role in intestinal homeostasis and health through interactions with the resident microbiota, diet and the gut. IAP’s role in the intestine is to dephosphorylate toxic microbial ligands such as lipopolysaccharides, unmethylated cytosine-guanosine dinucleotides and flagellin as well as extracellular nucleotides such as uridine diphosphate. IAP’s ability to detoxify these ligands is essential in protecting the host from sepsis during acute inflammation and chronic inflammatory conditions such as inflammatory bowel disease. Also important in these complications is IAP’s ability to regulate the microbial ecosystem by forming a complex relationship between microbiota, diet and the intestinal mucosal surface. Evidence reveals that diet alters IAP expression and activity and this in turn can influence the gut microbiota and homeostasis. IAP’s ability to maintain a healthy gastrointestinal tract has accelerated research on its potential use as a therapeutic agent against a multitude of diseases. Exogenous IAP has been shown to have beneficial effects when administered during ulcerative colitis, coronary bypass surgery and sepsis. There are currently a handful of human clinical trials underway investigating the effects of exogenous IAP during sepsis, rheumatoid arthritis and heart surgery. In light of these findings IAP has been marked as a novel agent to help treat a variety of other inflammatory and infectious diseases. The purpose of this review is to highlight the essential characteristics of IAP in protection and maintenance of intestinal homeostasis while addressing the intricate interplay between IAP, diet, microbiota and the intestinal epithelium.
Core tip: Intestinal alkaline phosphatase (IAP) is important for intestinal health. IAP’s role in the intestine encompasses both protection from systemic infections and chronic inflammatory diseases such as inflammatory bowel disease. There is a complex interplay occurring between IAP, diet, microbiota and the intestinal epithelium which has accelerated research on IAP as a potential therapeutic against these inflictions. The purpose of this review is to highlight the essential characteristics of IAP in maintaining homeostasis in the intestines while addressing the complex interplay between IAP, diet, microbiota and the intestinal epithelium.