Intestinal permeability, food antigens and the microbiome: a multifaceted perspective

Area of Science:

• Gastroenterology and immunology, focusing on the gut barrier's complex interactions.

Background:

• The gut barrier, comprising microbiota, mucus, epithelium, and immunity, maintains homeostasis.
• Disruptions from diet, infections, or antibiotics can impair immunity and cause chronic diseases.
• Knowledge gaps exist regarding the multi-level interactions within the gut barrier.

Purpose of the Study:

• To review evidence linking food antigens, microbiota, and gut permeability in various gastrointestinal disorders.
• To explore the role of these factors in celiac disease, non-celiac wheat sensitivity, food allergies, eosinophilic gastrointestinal disorder, and irritable bowel syndrome.

Main Methods:

• This is a review article, synthesizing existing research and evidence.
• The review focuses on studies investigating the interplay between dietary antigens, gut microbiota composition, and intestinal permeability.

Main Results:

• Food antigens, gut microbiota, and intestinal permeability are key factors influencing immune responses and clinical outcomes.
• These elements play a significant role across diverse conditions including celiac disease, non-celiac wheat sensitivity, food allergies, EOGID, and IBS.
• Food elimination diets are often recommended for managing these conditions.

Conclusions:

• Despite unique clinical presentations, celiac disease, non-celiac wheat sensitivity, food allergies, EOGID, and IBS share common underlying mechanisms.
• The interaction between food antigens, gut microbiota, and intestinal permeability is crucial for immune regulation and disease development.
• Further research is needed to fully elucidate these complex interactions and inform therapeutic strategies.