Recovery strategies intestinal mucosal barrier

The surface of the intestinal tract in healthy people is free of bacteria in all segments of the intestine. Thus, the attachment of bacteria to epithelial cells is a sign of infection. Unlike the mucous membrane, the intestinal lumen is never sterile. The reason for this is the polymicrobial nature of the gut microbiota. In the intestine, segments such as the stomach or small intestine, where bacteria are actively suppressed, the microbiota is random in appearance, composition, and concentration. However, the situation is completely different in the colon, where the growth of bacteria increases and their suppression is suspended. The concentration and diversity of bacteria in the colon reaches astronomical numbers. Some of these bacteria are required for the colon to function. Many of the local bacteria in the colon are potential pathogens: Bacteroides, Enterobacteriaceae, Enterococci, and Clostridium histolyticum. Control of pathogens in the colon is achieved through an impenetrable mucus layer. Inflammatory bowel disease is a polymicrobial infection characterized by persistent disruption of the mucosal barrier, subsequent migration of bacteria to the mucous membrane, and overgrowth of a complex bacterial biofilm on the surface of the epithelium, resulting in invasive and cytopathological effects. As long as the mucosal barrier function is impaired, the inflammatory process cannot successfully remove bacteria from the mucosal surface, and inflammation itself is detrimental. Due to the inflammatory reaction, the composition and structure of the fecal microbiota changes. Based on the biostructure of the fecal casts, active Crohn’s disease and ulcerative colitis can be distinguished from each other and from other gastrointestinal diseases. The relationship between the gut microbiome and various dermatological diseases (psoriasis, acne, rosacea, atopic dermatitis) is discussed.

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