The intestinal barrier: a fundamental role in health and disease

Expert Rev Gastroenterol Hepatol. 2017 Sep;11(9):821-834. doi: 10.1080/17474124.2017.1343143. Epub 2017 Jun 26.


The gastrointestinal mucosa constitutes a critical barrier where millions of microbes and environmental antigens come in close contact with the host immune system. Intestinal barrier defects have been associated with a broad range of diseases and therefore denote a new therapeutic target. Areas covered: This review is based on an extensive literature search in PubMed of how the intestinal barrier contributes to health and as a trigger for disease. It discusses the anatomy of the intestinal barrier and explains the available methods to evaluate its function. Also reviewed is the importance of diet and lifestyle factors on intestinal barrier function, and three prototypes of chronic diseases (inflammatory bowel disease, celiac disease and nonalcoholic fatty liver disease) that have been linked to barrier defects are discussed. Expert commentary: The intestinal barrier has been investigated by various methods, but correlation of results across studies is difficult, representing a major shortcoming in the field. New upcoming techniques and research on the effect of barrier-restoring therapeutics may improve our current understanding of the gut barrier, and provide a step forward towards personalised medicine.

Keywords: Intestinal mucosal barrier; extraintestinal disease; gut health; intestinal epithelial cells; intestinal inflammation; intestinal permeability; mucus layer; tight junctions.

Publication types

  • Review

MeSH terms

  • Celiac Disease / immunology
  • Celiac Disease / physiopathology
  • Humans
  • Inflammatory Bowel Diseases / immunology
  • Inflammatory Bowel Diseases / physiopathology
  • Intestinal Mucosa / immunology*
  • Intestinal Mucosa / physiology
  • Intestinal Mucosa / physiopathology*
  • Non-alcoholic Fatty Liver Disease / immunology
  • Non-alcoholic Fatty Liver Disease / physiopathology
  • Permeability