EXPLORING INTESTINAL PERMEABILITY: CONCEPT, DIAGNOSIS, CONNECTION TO BOWEL DISEASE, AND IRON DEFICIENCY

Over the recent years, intestinal permeability has become a major feature of gut health. The objective of this paper is to present a literature-based overview of the current understanding on intestinal permeability. The concept of intestinal permeability started its development from the discovery of tight junctions — protein complexes that are separated between the epithelial cells. Histopathology is the main option of microscopic diagnosis, which allows to determine changes that occur in the tight junction, inflammation, and damaged epithelial cells. Additionally, intestinal fatty acid-binding protein I-FABP and zonulin are suggested as biomarkers of epithelial barrier abruption. As for visual detection, literature proposes capsule endoscopy and confocal laser endomicroscopy. Using the latter it is possible to produce images of small intestinal morphology and visualise the small intestinal luminal elements, cells, villi as well as crypts. However, advancements in digital capsule endoscopy are more applicable and aid in research of intestinal permeability and enteropathy, also giving promising results in treatment. Although damage to intestinal permeability can be classified as a certain enteropathy and then the association of some enteropathies with iron deficiency already has been established, direct association of iron deficiency and intestinal permeability is yet to be explored.