Biological and pathological aspects of the mammalian small intestinal permeability to macromolecules

The literature on the biology and pathology of mammalian small intestinal permeability to macromolecules is reviewed. In mammals, macromolecules may penetrate the epithelial layer of the small intestinal mucosa, especially in the neonatal period. The neonatal uptake and transport of immunoglobulins is important in the acquisition of passive immunity in the newborn. In the mature small intestine the uptake of macromolecules almost ceases, except in M-cells. Excessive uptake and transport of macromolecules has been demonstrated in several experimental and spontaneous gastrointestinal diseases, in which increased concentration of macromolecules in the small intestinal lumen and/or damage of one or more components of the small intestinal mucosal barrier is present. Finally, methods to study macromolecular permeation of the small intestine are discussed.