Leaky Gut As a Danger Signal for Autoimmune Diseases

Abstract

The intestinal epithelial lining, together with factors secreted from it, forms a barrier that separates the host from the environment. In pathologic conditions, the permeability of the epithelial lining may be compromised allowing the passage of toxins, antigens, and bacteria in the lumen to enter the blood stream creating a "leaky gut." In individuals with a genetic predisposition, a leaky gut may allow environmental factors to enter the body and trigger the initiation and development of autoimmune disease. Growing evidence shows that the gut microbiota is important in supporting the epithelial barrier and therefore plays a key role in the regulation of environmental factors that enter the body. Several recent reports have shown that probiotics can reverse the leaky gut by enhancing the production of tight junction proteins; however, additional and longer term studies are still required. Conversely, pathogenic bacteria that can facilitate a leaky gut and induce autoimmune symptoms can be ameliorated with the use of antibiotic treatment. Therefore, it is hypothesized that modulating the gut microbiota can serve as a potential method for regulating intestinal permeability and may help to alter the course of autoimmune diseases in susceptible individuals.

Keywords: autoimmunity; gut microbiota; leaky gut; microbial translocation; probiotics.

Figure 1

Illustration of host intestinal barriers, including physical barrier (epithelium, tight junctions, mucus, commensal bacteria), biomedical barrier [antimicrobial proteins (AMPs)], and immunological barrier (lymphocytes and IgA). Also shown is the microbial translocation to remote tissues (for example, kidney and pancreas) in the presence of a leaky gut.