Table 2.
Summary of the literature on conditions that result in stress to the intestinal barrier, with documented effects on intestinal permeability or biochemical evidence of mucosal damage, and restoration with a dietary, non-pharmacological intervention
Barrier stressor; Clinical scenario | Specific Study | Effects on Barrier Function | Dietary Intervention and Its Effects | Reference # | |
---|---|---|---|---|---|
Intestinal permeability | Mucosal Damage | ||||
Endurance exercise Marathon runners with fecal occult blood or bloody diarrhea | Biking challenge | Urine iohexol (MW 821Da) ↑ | Serum I-FABP ↑, zonulin ↓ | 70 | |
Running challenge | LRR ↑ and correlated with core temperature (e.g. >39°C) | ND | 71 | ||
Biking challenge | LRR ↑ | Serum I-FABP ↑ | Citrulline (vs alanine) reversed ↑serum I-FABP and gastric hypoperfusion without effect on LRR | 72 | |
Biking challenge | ND | Serum I-FABP ↑ | Sucrose (vs. nitrate) reversed ↑ serum I-FABP no Δ gastric hypoperfusion | 73 | |
7 runners, 2 boxers, 3 rugby | LRR ↑ | ND | Nurticeutical colostrum vs. placebo reduced LRR ↑ and apoptosis of cell lines in vitro | 74 | |
NSAID enteropathy: NSAIDs cause small bowel ulcers and inflammation | Diverse NSAIDs e.g. indomethacin | 51CrEDTA, saccharides | ND | 75–77 | |
Indomethacin | LRR ↑ | ND | Zinc carnosine (vs. placebo) reduced LRR and increased HT29 cell proliferation (vs. ZnSO4) | 78 | |
Aspirin | increased colon permeability: urine SLR and sucralose | ND | Bifidobacterium BB-12 and adolescentis (IVS-1) and galacto-oligosaccharide prebiotic reduce colon permeability | 79 | |
Pregnancy with or without obesity | Increased serum zonulin and increased serum LPS, associated with metabolic risk markers | ND | 80 | ||
High serum zonulin | ND | n-3 PUFAs, fiber, and a range of vitamins and minerals: reduced high serum zonulin; greater richness of gut microbiota | 81 | ||
No effects on serum zonulin or LPS | ND | Probiotics and/or LC-PUFA | 82 |
Da=dalton; I-FABP=intestinal fatty-acid binding protein; LC-PUFA=long chain polyunsaturated fatty acids; LPS=lipopolysaccharide; LRR=lactulose-rhamnose ratio; ND=not determined; NSAIDs=nonsteroidal anti-inflammatory drugs; PUFA=polyunsaturated fatty acids; SLR=sucralose to lactulose ratio