Understanding the Epithelial Barrier in Inflammatory Bowel Disease

  • Emily M. Bradford
  • Emily S. Turner
  • Jerrold R. Turner
Chapter

Abstract

Appropriate function of the intestinal epithelial barrier is critical for maintaining a balance between potentially noxious luminal contents of the gut and the mucosal immune system. Defects in barrier function are associated with both Crohn’s disease and ulcerative colitis, and are also present in some healthy first-degree relatives. Impaired barrier function is associated with increased risk of Crohn’s disease relapse of patients in clinical remission. The tight junction, which seals the space between adjacent epithelial cells, is the primary determinant of permeability in the absence of epithelial injury, e.g., ulceration. The tight junction is formed by a complex of occludin, claudins, ZO-1, and the actin cytoskeleton; the interactions between components are dynamically regulated to modify paracellular flux. The functional properties of the tight junction are regulated both by physiological stimuli and by cytokines, e.g., TNF, IFNγ (gamma), and IL-13. Under pathological conditions, increased paracellular permeability in response to cytokine production may allow luminal material to access the lamina propria, further activating immune responses and continuing the cycle of barrier dysfunction and inflammation. This model predicts that the tight junction may play a central role in inflammatory bowel disease by balancing the mucosal immune response with the luminal microbiota. As such, the potential of the tight junction as a target for therapeutic intervention should be considered.

Keywords

MLCK Claudin-2 Tight junction Occludin ZO-1 Intestine Epithelial cell 

Notes

Acknowledgments

Work in the authors’ laboratory is supported by U.S. National Institutes of Health (R01DK61931, R01DK68271, P01DK67887, and F32DK091017), the University of Chicago Digestive Disease Research Core Center (NIH P30DK42086), the University of Chicago Cancer Center (P30CA14599), the University of Chicago Institute for Translational Medicine (NIH UL1RR024999), the U.S. Department of Defense (W81XWH-09-1-0341), the Broad Medical Research Foundation, and the Crohn’s and Colitis Foundation of America.

References

  1. 1.
    Moehle C, Ackermann N, Langmann T, et al. Aberrant intestinal expression and allelic variants of mucin genes associated with inflammatory bowel disease. J Mol Med. 2006;84(12):1055–66.PubMedCrossRefGoogle Scholar
  2. 2.
    Shaoul R, Okada Y, Cutz E, Marcon MA. Colonic expression of MUC2, MUC5AC, and TFF1 in inflammatory bowel disease in children. J Pediatr Gastroenterol Nutr. 2004;38(5):488–93.PubMedCrossRefGoogle Scholar
  3. 3.
    Heazlewood CK, Cook MC, Eri R, et al. Aberrant mucin assembly in mice causes endoplasmic reticulum stress and spontaneous inflammation resembling ulcerative colitis. PLoS Med. 2008;5(3):e54.PubMedCrossRefGoogle Scholar
  4. 4.
    Van der Sluis M, De Koning BA, De Bruijn AC, et al. Muc2-deficient mice spontaneously develop colitis, indicating that MUC2 is critical for colonic protection. Gastroenterol. 2006;131(1):117–29.CrossRefGoogle Scholar
  5. 5.
    An G, Wei B, Xia B, et al. Increased susceptibility to colitis and colorectal tumors in mice lacking core 3-derived O-glycans. J Exp Med. 2007;204(6):1417–29.PubMedCrossRefGoogle Scholar
  6. 6.
    Johansson ME, Phillipson M, Petersson J, Velcich A, Holm L, Hansson GC. The inner of the two Muc2 mucin-dependent mucus layers in colon is devoid of bacteria. Proc Natl Acad Sci USA. 2008;105(39):15064–9.PubMedCrossRefGoogle Scholar
  7. 7.
    Pearson AD, Eastham EJ, Laker MF, Craft AW, Nelson R. Intestinal permeability in children with Crohn’s disease and coeliac disease. Br Med J (Clin Res Ed). 1982;285(6334):20–1.CrossRefGoogle Scholar
  8. 8.
    Ukabam SO, Clamp JR, Cooper BT. Abnormal small intestinal permeability to sugars in patients with Crohn’s disease of the terminal ileum and colon. Digestion. 1983;27(2):70–4.PubMedCrossRefGoogle Scholar
  9. 9.
    Hollander D. Crohn’s disease – a permeability disorder of the tight junction? Gut. 1988;29(12):1621–4.PubMedCrossRefGoogle Scholar
  10. 10.
    Schulzke JD, Bentzel CJ, Schulzke I, Riecken EO, Fromm M. Epithelial tight junction structure in the jejunum of children with acute and treated celiac sprue. Pediatr Res. 1998;43(4 Pt 1):435–41.PubMedCrossRefGoogle Scholar
  11. 11.
    Madara JL, Trier JS. Structural abnormalities of jejunal epithelial cell membranes in celiac sprue. Lab Invest. 1980;43(3):254–61.PubMedGoogle Scholar
  12. 12.
    Jenkins RT, Ramage JK, Jones DB, Collins SM, Goodacre RL, Hunt RH. Small bowel and colonic permeability to 51Cr-EDTA in patients with active inflammatory bowel disease. Clin Invest Med. 1988;11(2):151–5.PubMedGoogle Scholar
  13. 13.
    Bijlsma PB, Peeters RA, Groot JA, Dekker PR, Taminiau JA, Van Der Meer R. Differential in vivo and in vitro intestinal permeability to lactulose and mannitol in animals and humans: a hypothesis. Gastroenterol. 1995;108(3):687–96.CrossRefGoogle Scholar
  14. 14.
    Arslan G, Atasever T, Cindoruk M, Yildirim IS. (51)CrEDTA colonic permeability and therapy response in patients with ulcerative colitis. Nucl Med Commun. 2001;22(9):997–1001.PubMedCrossRefGoogle Scholar
  15. 15.
    Bjarnason I. Intestinal permeability. Gut. 1994;35(1 Suppl):S18–22.PubMedCrossRefGoogle Scholar
  16. 16.
    Keighley MR, Taylor EW, Hares MM, et al. Influence of oral mannitol bowel preparation on colonic microflora and the risk of explosion during endoscopic diathermy. Br J Surg. 1981;68(8):554–6.PubMedCrossRefGoogle Scholar
  17. 17.
    Vince A, Killingley M, Wrong OM. Effect of lactulose on ammonia production in a fecal incubation system. Gastroenterol. 1978;74(3):544–9.Google Scholar
  18. 18.
    Katz KD, Hollander D, Vadheim CM, et al. Intestinal permeability in patients with Crohn’s disease and their healthy relatives. Gastroenterol. 1989;97(4):927–31.Google Scholar
  19. 19.
    May GR, Sutherland LR, Meddings JB. Is small intestinal permeability really increased in relatives of patients with Crohn’s disease? Gastroenterol. 1993;104(6):1627–32.Google Scholar
  20. 20.
    Buhner S, Buning C, Genschel J, et al. Genetic basis for increased intestinal permeability in families with Crohn’s disease: role of CARD15 3020insC mutation? Gut. 2006;55(3):342–7.PubMedCrossRefGoogle Scholar
  21. 21.
    Ogura Y, Bonen DK, Inohara N, et al. A frameshift mutation in NOD2 associated with susceptibility to Crohn’s disease. Nature. 2001;411(6837):603–6.PubMedCrossRefGoogle Scholar
  22. 22.
    Irvine EJ, Marshall JK. Increased intestinal permeability precedes the onset of Crohn’s disease in a subject with familial risk. Gastroenterol. 2000;119(6):1740–4.CrossRefGoogle Scholar
  23. 23.
    Wyatt J, Vogelsang H, Hubl W, Waldhoer T, Lochs H. Intestinal permeability and the prediction of relapse in Crohn’s disease. Lancet. 1993;341(8858):1437–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Hartsock A, Nelson WJ. Adherens and tight junctions: structure, function and connections to the actin cytoskeleton. Biochim Biophys Acta. 2008;1778(3):660–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Hermiston ML, Gordon JI. Inflammatory bowel disease and adenomas in mice expressing a dominant negative N-cadherin. Science. 1995;270(5239):1203–7.PubMedCrossRefGoogle Scholar
  26. 26.
    Barrett JC, Hansoul S, Nicolae DL, et al. Genome-wide association defines more than 30 distinct susceptibility loci for Crohn’s disease. Nat Genet. 2008;40(8):955–62.PubMedCrossRefGoogle Scholar
  27. 27.
    Schmitz H, Barmeyer C, Fromm M, et al. Altered tight junction structure contributes to the impaired epithelial barrier function in ulcerative colitis. Gastroenterol. 1999;116(2):301–9.CrossRefGoogle Scholar
  28. 28.
    Prasad S, Mingrino R, Kaukinen K, et al. Inflammatory processes have differential effects on claudins 2, 3 and 4 in colonic epithelial cells. Lab Invest. 2005;85:1139–62.PubMedCrossRefGoogle Scholar
  29. 29.
    Blair SA, Kane SV, Clayburgh DR, Turner JR. Epithelial myosin light chain kinase expression and activity are upregulated in inflammatory bowel disease. Lab Invest. 2006;86(2):191–201.PubMedCrossRefGoogle Scholar
  30. 30.
    Zeissig S, Burgel N, Gunzel D, et al. Changes in expression and distribution of claudin 2, 5 and 8 lead to discontinuous tight junctions and barrier dysfunction in active Crohn’s disease. Gut. 2007;56(1):61–72.PubMedCrossRefGoogle Scholar
  31. 31.
    Amasheh S, Meiri N, Gitter AH, et al. Claudin-2 expression induces cation-selective channels in tight junctions of epithelial cells. J Cell Sci. 2002;115(Pt 24):4969–76.PubMedCrossRefGoogle Scholar
  32. 32.
    Weber CR, Raleigh DR, Su L, et al. Epithelial myosin light chain kinase activation induces mucosal interleukin-13 expression to alter tight junction ion selectivity. J Biol Chem. 2010;285(16):12037–46.PubMedCrossRefGoogle Scholar
  33. 33.
    Clayburgh DR, Barrett TA, Tang Y, et al. Epithelial myosin light chain kinase-dependent barrier dysfunction mediates T cell activation-induced diarrhea in vivo. J Clin Invest. 2005;115(10):2702–15.PubMedCrossRefGoogle Scholar
  34. 34.
    Marchiando AM, Shen L, Graham WV, et al. Caveolin-1-dependent occludin endocytosis is required for TNF-induced tight junction regulation in vivo. J Cell Biol. 2010;189(1):111–26.PubMedCrossRefGoogle Scholar
  35. 35.
    Poritz LS, Garver KI, Green C, Fitzpatrick L, Ruggiero F, Koltun WA. Loss of the tight junction protein ZO-1 in dextran sulfate sodium induced colitis. J Surg Res. 2007;140(1):12–9.PubMedCrossRefGoogle Scholar
  36. 36.
    Schwarz BT, Wang F, Shen L, et al. LIGHT signals directly to intestinal epithelia to cause barrier dysfunction via cytoskeletal and endocytic mechanisms. Gastroenterol. 2007;132(7):2383–94.CrossRefGoogle Scholar
  37. 37.
    Al-Sadi R, Ye D, Dokladny K, Ma TY. Mechanism of IL-1beta-induced increase in intestinal epithelial tight junction permeability. J Immunol. 2008;180(8):5653–61.PubMedGoogle Scholar
  38. 38.
    Al-Sadi R, Ye D, Said HM, Ma TY. Cellular and molecular mechanism of interleukin-1beta modulation of CACO-2 intestinal epithelial tight junction barrier. J Cell Mol Med. Apr 7 2010.[Epub ahed of print].Google Scholar
  39. 39.
    Tedde A, Laura Putignano A, Bagnoli S, et al. Interleukin-10 promoter polymorphisms influence susceptibility to ulcerative colitis in a gender-specific manner. Scand J Gastroenterol. 2008;43(6):712–8.PubMedCrossRefGoogle Scholar
  40. 40.
    Glocker EO, Kotlarz D, Boztug K, et al. Inflammatory bowel disease and mutations affecting the interleukin-10 receptor. N Engl J Med. 2009;361(21):2033–45.PubMedCrossRefGoogle Scholar
  41. 41.
    Kuhn R, Lohler J, Rennick D, Rajewsky K, Muller W. Interleukin-10-deficient mice develop chronic enterocolitis. Cell. 1993;75(2):263–74.PubMedCrossRefGoogle Scholar
  42. 42.
    Madsen KL, Malfair D, Gray D, Doyle JS, Jewell LD, Fedorak RN. Interleukin-10 gene-deficient mice develop a primary intestinal permeability defect in response to enteric microflora. Inflamm Bowel Dis. 1999;5(4):262–70.PubMedCrossRefGoogle Scholar
  43. 43.
    Hale LP, Gottfried MR, Swidsinski A. Piroxicam treatment of IL-10-deficient mice enhances colonic epithelial apoptosis and mucosal exposure to intestinal bacteria. Inflamm Bowel Dis. 2005;11(12):1060–9.PubMedCrossRefGoogle Scholar
  44. 44.
    Narushima S, Spitz DR, Oberley LW, et al. Evidence for oxidative stress in NSAID-induced colitis in IL10−/− mice. Free Radic Biol Med. 2003;34(9):1153–66.PubMedCrossRefGoogle Scholar
  45. 45.
    Gradel KO, Nielsen HL, Schonheyder HC, Ejlertsen T, Kristensen B, Nielsen H. Increased short- and long-term risk of inflammatory bowel disease after salmonella or campylobacter gastroenteritis. Gastroenterol. 2009;137(2):495–501.CrossRefGoogle Scholar
  46. 46.
    Olson TS, Reuter BK, Scott KG, et al. The primary defect in experimental ileitis originates from a nonhematopoietic source. J Exp Med. 2006;203(3):541–52.PubMedCrossRefGoogle Scholar
  47. 47.
    Woodfin A, Reichel CA, Khandoga A, et al. JAM-A mediates neutrophil transmigration in a stimulus-specific manner in vivo: evidence for sequential roles for JAM-A and PECAM-1 in neutrophil transmigration. Blood. 2007;110(6):1848–56.PubMedCrossRefGoogle Scholar
  48. 48.
    Laukoetter MG, Nava P, Lee WY, et al. JAM-A regulates permeability and inflammation in the intestine in vivo. J Exp Med. 2007;204(13):3067–76.PubMedCrossRefGoogle Scholar
  49. 49.
    Su L, Shen L, Clayburgh DR, et al. Targeted epithelial tight junction dysfunction causes immune activation and contributes to development of experimental colitis. Gastroenterol. 2009;136(2):551–63.CrossRefGoogle Scholar
  50. 50.
    Boirivant M, Amendola A, Butera A, et al. A transient breach in the epithelial barrier leads to regulatory T-cell generation and resistance to experimental colitis. Gastroenterol. 2008;135:1612–23.CrossRefGoogle Scholar
  51. 51.
    Arrieta MC, Madsen K, Doyle J, Meddings J. Reducing small intestinal permeability attenuates colitis in the IL10 gene-deficient mouse. Gut. 2009;58(1):41–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Emily M. Bradford
    • 1
  • Emily S. Turner
    • 1
  • Jerrold R. Turner
    • 1
  1. 1.Department of PathologyUniversity of ChicagoChicagoUSA

Personalised recommendations