Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Nov:70:101846.
doi: 10.1016/j.smim.2023.101846. Epub 2023 Oct 4.

The epithelial barrier: The gateway to allergic, autoimmune, and metabolic diseases and chronic neuropsychiatric conditions

Duygu Yazici  1 , Ismail Ogulur  1 , Yagiz Pat  1 , Huseyn Babayev  1 , Elena Barletta  2 , Sena Ardicli  1 , Manal Bel Imam  1 , Mengting Huang  1 , Jana Koch  2 , Manru Li  1 , Debbie Maurer  1 , Urszula Radzikowska  3 , Pattraporn Satitsuksanoa  1 , Stephan R Schneider  1 , Na Sun  4 , Stephan Traidl  5 , Alexandra Wallimann  1 , Sebastian Wawrocki  1 , Damir Zhakparov  1 , Danielle Fehr  6 , Reihane Ziadlou  6 , Yasutaka Mitamura  1 , Marie-Charlotte Brüggen  6 , Willem van de Veen  3 , Milena Sokolowska  3 , Katja Baerenfaller  2 , Kari Nadeau  7 , Mubeccel Akdis  1 , Cezmi A Akdis  8
Affiliations
Free article
Review

The epithelial barrier: The gateway to allergic, autoimmune, and metabolic diseases and chronic neuropsychiatric conditions

Duygu Yazici et al. Semin Immunol. 2023 Nov.
Free article

Abstract

Since the 1960 s, our health has been compromised by exposure to over 350,000 newly introduced toxic substances, contributing to the current pandemic in allergic, autoimmune and metabolic diseases. The "Epithelial Barrier Theory" postulates that these diseases are exacerbated by persistent periepithelial inflammation (epithelitis) triggered by exposure to a wide range of epithelial barrier-damaging substances as well as genetic susceptibility. The epithelial barrier serves as the body's primary physical, chemical, and immunological barrier against external stimuli. A leaky epithelial barrier facilitates the translocation of the microbiome from the surface of the afflicted tissues to interepithelial and even deeper subepithelial locations. In turn, opportunistic bacterial colonization, microbiota dysbiosis, local inflammation and impaired tissue regeneration and remodelling follow. Migration of inflammatory cells to susceptible tissues contributes to damage and inflammation, initiating and aggravating many chronic inflammatory diseases. The objective of this review is to highlight and evaluate recent studies on epithelial physiology and its role in the pathogenesis of chronic diseases in light of the epithelial barrier theory.

Keywords: Allergy; Autoimmune diseases; Barrier dysfunction; Epithelial barrier theory; Epithelitis; Lungs; Metabolic diseases; Microbiota; Rhinitis; Sinusitis; Skin; Type 2 immunity.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest CA has received research grants from the Swiss National Science Foundation, Christine Kühne-Center for Allergy Research and Education, European Commission Horizon’s 2020 Framework Programme “CURE”, Novartis Research Institutes, GlaxoSmithKline and AstraZeneca; served in the advisory board and received research grants from GlaxoSmithKline, Sanofi/Regeneron, SciBase, Seed-Health and Novartis; appointed as Editor-in-Chief of Allergy. YM and WV report grants from Novartis. MS reports grants from the Swiss National Science Foundation, GSK and Novartis. KN reports grants from National Institute of Allergy and Infectious Diseases (United States), National Heart, Lung, and Blood Institute (United States), National Institute of Environmental Health Sciences (United States), and Food Allergy Research & Education (United States); stock options from IgGenix, Seed Health, ClostraBio, and ImmuneID (United States). All other authors have no conflicts of interest to disclose.

LinkOut - more resources