Intestinal permeability, “leaky gut”, is a condition of intestinal barrier dysfunction characterized by structural abnormalities, mucus degradation, and defective regulatory mechanisms, namely tight junctions (TJ), which are the predominant gatekeepers that selectively traffic water ions and small molecules between intestinal epithelial cells (paracellular passage). Increased intestinal permeability is associated with several diverse conditions including severe trauma or infection, multiple organ failure, neurodegeneration, obesity, mood disorders, metabolic imbalances (e.g., insulin resistance, non-alcoholic fatty liver disease), and particularly autoimmune and inflammatory bowel disease (IBD). With increased intestinal permeability, the immune system becomes overreactive due to constant stimulation by undigested macromolecules and bacterial endotoxins which freely access the bloodstream and circulate throughout the body. Dietary and lifestyle factors can damage intestinal barrier structure and function directly through inflammatory mechanisms, or disrupt the balance of healthy bacteria species that serve to maintain intestinal integrity.
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