[Alteration in intestinal epithelial permeability and its role in the pathogenesis of burn shock]

The intestinal epithelial barrier serves a dual role: to keep harmful external agents out of the body and to allow beneficial nutrients to enter the body. Tight junction (TJ) is of crucial importance for the barrier function. Over the past 15 years, some of the molecular events underlying the epithelial barrier regulation have been described. This forum introduces briefly the molecular structure of TJ and its regulation in gut barrier. It was shown that gut barrier function was impaired as early as 5 minutes post burn and became worst by 4 hours. In this forum the mechanism of gut barrier injury in burns is described, and it includes 4 aspects: the phosphorylation of TJ protein and perijunctional actin-myosin ring, the reduction of TJ proteins expression, the endocytosis of TJ proteins, and the apoptosis and necrosis of the epithelial cells. It is well known that the increase in gut permeability promotes bacterial translocation in burns. Moreover, a new auto-digestion theory of gut in shock and MODS was recently raised. Therefore, protection against gut barrier damage has again been recognized as a therapeutic target in shock and MODS treatment.