Nonsteroidal Anti-Inflammatory Drug-Induced Leaky Gut Modeled Using Polarized Monolayers of Primary Human Intestinal Epithelial Cells

ACS Infect Dis. 2018 Jan 12;4(1):46-52. doi: 10.1021/acsinfecdis.7b00139. Epub 2017 Nov 10.


The intestinal epithelium provides a critical barrier that separates the gut microbiota from host tissues. Nonsteroidal anti-inflammatory drugs (NSAIDs) are efficacious analgesics and antipyretics and are among the most frequently used drugs worldwide. In addition to gastric damage, NSAIDs are toxic to the intestinal epithelium, causing erosions, perforations, and longitudinal ulcers in the gut. Here, we use a unique in vitro human primary small intestinal cell monolayer system to pinpoint the intestinal consequences of NSAID treatment. We found that physiologically relevant doses of the NSAID diclofenac (DCF) are cytotoxic because they uncouple mitochondrial oxidative phosphorylation and generate reactive oxygen species. We also find that DCF induces intestinal barrier permeability, facilitating the translocation of compounds from the luminal to the basolateral side of the intestinal epithelium. The results we outline here establish the utility of this novel platform, representative of the human small intestinal epithelium, to understand NSAID toxicity, which can be applied to study multiple aspects of gut barrier function including defense against infectious pathogens and host-microbiota interactions.

Keywords: NSAIDs; bacterial translocation; leaky gut; mitochondria; small intestine; superoxide.

Publication types

  • Letter
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Cell Membrane Permeability / drug effects*
  • Epithelial Cells / drug effects*
  • Epithelial Cells / metabolism*
  • Humans
  • Intestinal Mucosa / drug effects*
  • Intestinal Mucosa / metabolism*
  • Mitochondria / drug effects
  • Mitochondria / metabolism


  • Anti-Inflammatory Agents, Non-Steroidal