Inhibitors of intestinal barrier dysfunction

In the past decade, literature has increasingly pointed to a proximal intestinal barrier dysfunction and inappropriate paracellular permeability increase that precedes and correlates with inflammatory markers and/or disease expression in inflammatory bowel disease, celiac disease and irritable bowel syndrome. Exogenous and endogenous stimuli are known to induce paracellular permeability and disrupt barrier function. Recent identification of regulatory pathways that induce cytoskeletal reorganization, tight junction disassembly and paracellular permeability provide targets for therapeutic intervention in celiac disease. Here we review the identity, function and regulation of these pathways and propose various approaches to therapeutic intervention in celiac disease with the aim of inhibiting intestinal barrier dysfunction.