La perméabilité intestinale dans les maladies métaboliques : porosité, ou étanchéité ?

The intestinal barrier shows selective permeability allowing nutrient absorption while restricting the entry of antigens derived from food and bacteria via intercellular junctions. In clinics, intestinal passive permeability is measured by the proportion of oral inert sugars that are recovered timely in the urines. The intestinal permeability is largely increased during active phases of inflammatory bowel diseases (IBD) but appears moderately augmented in chronic inflammation in obesity, type 2 diabetes, and hepatic steatosis. However, a transient increase of intestinal permeability could trigger a higher transepithelial transfer of endotoxins and consequent inflammation. Lipids in food increase intestinal permeability. Relevant biomarkers of intestinal permeability are still lacking. None of the strategies that aimed to restore intestinal barrier function has shown efficiency in the context of metabolic diseases.