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Gut Permeability

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Book cover The Splanchnic Circulation

Part of the book series: Update in Intensive Care and Emergency Medicine ((UICM,volume 23))

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Abstract

The gut is comprised of a series of unique organs that absorb nutrients, electrolytes, and water and simultaneously secrete other electrolytes and water while it also retards the progress of ingested food down its length. The gut is continuously challenged with contents that vary both in their volume and composition. It limits the absorption of large, potentially harmful molecules such as antigens and toxins while absorbing smaller nontoxic substances with either a nutritional or caloric value [1]. The intestinal mucosa acts as a protective barrier between the external and internal milieu through which molecules of various size cross either by active or passive transport mechanisms which vary as a function of the anatomical region of the gut in question [2, 3]. This barrier is armored by intraluminal factors [4, 5], interepithelial factors [3], and extraintestinal factors [6]. The structure of the surface epithelium with its local mucosal immune system is the main pillar of the barrier [7]. Intraluminally, gastric acid, pancreatic and intestinal enzymes, intestinal motility, and the mucous coat covering the microvilli combined with secretory antibodies and colonization-resisting flora each strengthen the intestinal barrier and limit the proliferation and systemic dissemination of enteric pathogens. This system is supported by third-line defenses represented by the lymphoid system of the gut, liver, spleen, and systemic immunoglobulins which clear translocated pathogens and particles.

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Authors
  1. T. Hassanein
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  2. D. H. van Thiel
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  3. A. Gurakar
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Editors and Affiliations

  1. Dept. of Anesthesiology and Critical Care Medicine, University of Pittsburgh, 604 Scaife Hall, 15261, Pittsburgh, PA, USA

    Michael R. Pinsky

  2. Clinical Pharmacology and Critical Care Medicine, Cochin Port-Royal University Hospital, 27 rue du Faubourg St. Jaques, F-75679, Paris, France

    Jean-Francois Dhainaut

  3. Servei des Medicina Intensiva Parc Tauli, Consorci Hospitalari Parc Tauli, E-08208, Sabadell, Spain

    Antonio Artigas

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Hassanein, T., van Thiel, D.H., Gurakar, A. (1995). Gut Permeability. In: Pinsky, M.R., Dhainaut, JF., Artigas, A. (eds) The Splanchnic Circulation. Update in Intensive Care and Emergency Medicine, vol 23. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79715-6_11

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  • DOI: https://doi.org/10.1007/978-3-642-79715-6_11

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