研究进展

文献综述 REVIEW

肠黏膜屏障在炎症性肠病中作用机制的研究进展

毛靖伟，　王英德

毛靖伟，　王英德，　大连医科大学附属第一医院消化内科　辽宁省大连市　１１６０１１

作者贡献分布：　本文综述由毛靖伟与王英德完成；　王英德审校．通讯作者：　王英德，　教授，　硕士生导师，　１１６０１１，　辽宁省大连市中山路２２２号，　大连医科大学附属第一医院消化内科．　ａｌｂｅｒｔｗｙｄ＠ｙａｈｏｏ．ｃｏｍ．ｃｎ电话：　０４１１－８３６３５９６３－３１６２

收稿日期：　２００９－１２－０５　　　修回日期：　２０１０－０１－１７接受日期：　２０１０－０１－２６　　　在线出版日期：　２０１０－０３－０８

Advances in understanding the pathogenesis of mucosal barrier dysfunction in

inflammatory bowel disease

Jing-Wei Mao, Ying-De Wang

Jing-Wei enterology, Mao, Ying-De Wang, Department of Gastro-University, Dalian 116011, Liaoning Province, China

the First Affiliated Hospital of Dalian Medical Correspondence to:of Gastroenterology, the First Affiliated Hospital of Dalian Professor Ying-De Wang, Department Medical Liaoning Province, China. albertwyd@University, 222 Zhongshan Road, Dalian 116011, Received: Accepted: 2009-12-05 2010-01-26 Revised: Published online: 2010-01-17

2010-03-08

Abstract

Inflammatory bowel disease (IBD) is a chron-ic nonspecific intestinal inflammatory disease whose pathogenesis is closely associated with the alterations in mucosal barrier function. Normal mucosal barrier can not only main-tain the stability of enteric flora and prevent the translocation of microbes and endotoxin but also play an important role in intestinal immune defense against microbes. Functional impairment of mucosal barrier has been noted in IBD. In this article, we will review the recent advances in understanding the pathogenesis of mucosal barrier dysfunction in IBD.

Key Words: Inflammatory bowel disease; Mechani-cal barrier; Immunologic barrier; Biological barrier

Mao the JW, Wang inflammatory pathogenesis YD. of mucosal Advances barrier in understanding Zazhi 2010; 18(7): 695-698

bowel disease. Shijie Huaren dysfunction Xiaohua in

摘要

炎症性肠病(inflammatory bowel disease, IBD)是肠道慢性非特异性炎症, 黏膜屏障与IBD的关系密切. 正常的肠黏膜屏障能维持肠道内菌群的稳定、防止肠道内细菌及毒素的移位以及对微生物进行适当的免疫防御反应起重要作用. 而当发生IBD时存在肠黏膜屏障功能的障碍. 本文就肠黏膜屏障功能在IBD中作用机制的研究进展作一综述.

关键词：　炎症性肠病；　机械屏障；　免疫屏障；　生物屏障

毛靖伟，　王英德．　肠黏膜屏障在炎症性肠病中作用机制的研究进展．　世界华人消化杂志　　２０１０；　１８（７）：　６９５－６９８

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0 引言

炎症性肠病(inflammatory bowel disease, IBD)包括溃疡性结肠炎(ulcerative colitis, UC)、克罗恩病(Crohn's disease, CD), 发病率逐年增高, 而其发病机制还未完全阐明, 但可以肯定肠黏膜屏障功能失调参与了IBD的发生, 无论UC或CD均存在肠黏膜屏障功能障碍. 肠黏膜屏障主要包括机械屏障、免疫屏障及生物屏障. 机械屏障由肠上皮细胞、肠黏液组成; 免疫屏障即肠道免疫防御系统主要由分泌性免疫球蛋白(secretory immunoglobulin, SIgA)和肠相关淋巴组织(gut associated lympathic tissue, GALT)构成; 肠道正常菌群构成了肠道的生物屏障. 1 机械屏障

1.1 肠上皮细胞的屏障功能 完整的肠上皮细胞能阻止细菌及毒素等大分子渗透至肠黏膜固有层, 激活固有层免疫细胞维护肠黏膜屏障功能的稳定, 避免了黏膜异常免疫反应的发生. CD患者一级亲属存在肠上皮通透性异常, 说明肠黏膜屏障功能在IBD中具有遗传易感性[1].

肠上皮细胞屏障功能主要依赖肠上皮细胞间的紧密连接. 上皮细胞紧密连接由紧密连接蛋白构成, 这些蛋白主要包括闭锁蛋白、

■背景资料

正常的肠黏膜屏障能维持肠道菌群稳定、防止肠道内细菌及毒素的移位对肠腔内微生物进行适当的免疫耐受及防御反应. 炎症性肠病(IBD)是肠道的慢性非特异性炎症, 发病率逐年增高, 发病机制未完全阐明. 但可以肯定, 肠黏膜屏障功能失调参与了IBD的发生.

■同行评议者

夏冰, 教授, 武汉大学中南医院消化内科