In addition to genetic factors and antigen exposure, intestinal barrier dysfunction plays a key role in the pathogenesis of numerous allergic and autoimmune diseases. The hypothesis of this article is that synthetic surfactant food additives (also called emulsifiers) - which are applied in relatively high concentrations in even the most frequently consumed foods -cause increased intestinal permeability, hence they can play a significant role in the increasing incidence of numerous allergic and autoimmune diseases. In many cases the surfactants added to foods are exactly the same as the ones used in pharmaceutics as absorption enhancers. Numerous synthetic surfactant food additives have been shown to increase the intestinal permeability through paracellular and/or transcellular mechanisms and some of them were also shown to inhibit P-glycoprotein. Additionally, based on the general characteristics of surfactants it can be predicted that they decrease the hydrophobicity of the mucus layer, which has also been shown to associate with increased intestinal permeability.
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