Mucus protectors: Promising therapeutic strategies for inflammatory bowel disease

Med Hypotheses. 2018 Nov:120:55-59. doi: 10.1016/j.mehy.2018.08.013. Epub 2018 Aug 18.

Abstract

Inflammatory bowel disease (IBD) is a group of intestinal non-specific inflammatory diseases with unclear pathogenesis, characterized with the impaired intestinal mucosal barriers and the activated immune system. Mucus layer is the vital protector over the intestinal epithelia cells (IECs). Mucus layer with impaired function could not provide isolated protection for IECs and thus proteases and pathogens from the gut lumen attacked and damaged the epithelial layer. Clinical manifestation and histopathology suggest that IBD might be a self-digestive inflammatory disease caused by digestive enzymes. In this review, we specifically focus on the role of intestinal mucosal barriers and aim to summarize the relationship among mucus layer, self-digestion and inflammation in IBD. We also propose a "Two Hits" Self-Digestion theory to explain the role of self-digestion in IBD and assess the application of mucus protectors to treat IBD.

Keywords: Inflammation; Inflammatory bowel disease (IBD); Intestinal epithelial cells (IECs); Mucus layer; Self-digestion.

MeSH terms

  • Animals
  • Cytokines / metabolism
  • Enzymes
  • Gastrointestinal Microbiome
  • Glycoside Hydrolases / metabolism
  • Humans
  • Hydrogen-Ion Concentration
  • Hydrolases
  • Immune System
  • Inflammation
  • Inflammatory Bowel Diseases / therapy*
  • Intestinal Mucosa / metabolism*
  • Mucus*
  • Peptic Ulcer / physiopathology
  • Peptide Hydrolases / metabolism
  • Protease Inhibitors / metabolism

Substances

  • Cytokines
  • Enzymes
  • Protease Inhibitors
  • Hydrolases
  • Glycoside Hydrolases
  • Peptide Hydrolases