Association between increased intestinal permeability and disease: A systematic review

Abstract

Objective: Increased intestinal permeability (IP) may play an important role in health and disease. The purpose of this review is to explore the association between IP and diseases frequently found within clinical practice. Design and methods: A systematic literature search was conducted up until July 2018 in MEDLINE, PubMed, EMBASE and AMED. A total of 48 articles met the inclusion/exclusion criteria. Results: IP is strongly associated with autoimmune disease and liver conditions, with the estimated prevalence of 25–87.5% and 17–65% respectively. IP also correlates with diabetes (30–65%), food allergies/hypersensitivity, irritable bowel syndrome (35.6%), polycystic ovary syndrome and autism (36.7%). Disease severity in addition to clinical symptoms of menstrual disorders, food allergy or hypersensitivity directly correlates with IP. Finally, the severity of IP appears to be exacerbated by the presence of dysbiosis, inflammation and glucose metabolism disorders. Conclusions: IP is a potentially influential factor that coincides with a variety of health conditions and diseases. IP should be considered as a factor in the pathophysiology and differential diagnosis for patient's presenting with autoimmune diseases, non-alcoholic fatty liver disease, liver cirrhosis, polycystic ovary syndrome, irritable bowel syndrome, diabetes, autism, food allergies and food hypersensitivity. Further research is required to determine if IP plays a pathogenic role in the progression and development of disease or whether the disease causes IP. While the clinical significance between IP and these diseases is unclear, the findings of the review suggest the treatment of IP in patients presenting with these conditions may warrant the consideration of clinicians.