Topic Highlight
Copyright ©2014 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Feb 7, 2014; 20(5): 1165-1179
Published online Feb 7, 2014. doi: 10.3748/wjg.v20.i5.1165
Intestinal barrier in inflammatory bowel disease
Lena Antoni, Sabine Nuding, Jan Wehkamp, Eduard F Stange
Lena Antoni, Sabine Nuding, Jan Wehkamp, Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology Stuttgart, University of Tübingen, D-70376 Stuttgart, Germany
Jan Wehkamp, Eduard F Stange, Department of Internal Medicine I, Robert-Bosch-Hospital, D-70376 Stuttgart, Germany
Author contributions: Antoni L, Nuding S and Stange EF wrote the paper; Wehkamp J critically reviewed the manuscript.
Supported by Robert Bosch Foundation, Stuttgart, Germany
Correspondence to: Eduard F Stange, MD, Department of Internal Medicine I, Robert-Bosch-Hospital, Auerbachstr 110, D-70376 Stuttgart, Germany.
Telephone: +49-711-81013406 Fax: +49-711-81013793
Received: September 27, 2013
Revised: November 8, 2013
Accepted: December 12, 2013
Published online: February 7, 2014

A complex mucosal barrier protects as the first line of defense the surface of the healthy intestinal tract from adhesion and invasion by luminal microorganisms. In this review, we provide an overview about the major components of this protective system as for example an intact epithelium, the synthesis of various antimicrobial peptides (AMPs) and the formation of the mucus layer. We highlight the crucial importance of their correct functioning for the maintenance of a proper intestinal function and the prevention of dysbiosis and disease. Barrier disturbances including a defective production of AMPs, alterations in thickness or composition of the intestinal mucus layer, alterations of pattern-recognition receptors, defects in the process of autophagy as well as unresolved endoplasmic reticulum stress result in an inadequate host protection and are thought to play a crucial role in the pathogenesis of the inflammatory bowel diseases Crohn’s disease and ulcerative colitis.

Keywords: Intestinal barrier, Antimicrobial peptide, Mucus layer, Inflammatory bowel disease, Crohn’s disease, Ulcerative colitis, Goblet cell, Paneth cell

Core tip: An efficient intestinal mucosal barrier is critical for protection against invading microorganisms, therefore impairments in this system have serious adverse effects on health. In patients suffering from the inflammatory bowel diseases Crohn’s disease and ulcerative colitis, the intestinal barrier function is compromised at different levels including, amongst others, a defective production of antimicrobial peptides, alterations of the mucus layer and defects in the process of autophagy. In this article, we outline important components of the healthy intestinal mucosal barrier and review their disturbances in inflammatory bowel disease.