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World J Gastroenterol. Apr 14, 2020; 26(14): 1564-1579
Published online Apr 14, 2020. doi: 10.3748/wjg.v26.i14.1564
Intestinal epithelial barrier and neuromuscular compartment in health and disease
Vanessa D’Antongiovanni, Carolina Pellegrini, Matteo Fornai, Rocchina Colucci, Corrado Blandizzi, Luca Antonioli, Nunzia Bernardini
Vanessa D’Antongiovanni, Matteo Fornai, Corrado Blandizzi, Luca Antonioli, Nunzia Bernardini, Department of Clinical and Experimental Medicine, University of Pisa, Pisa 56126, Italy
Carolina Pellegrini, Department of Pharmacy, University of Pisa, Pisa 56126, Italy
Rocchina Colucci, Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova 35131, Italy
Author contributions: D’Antongiovanni V and Pellegrini C equally contribute to the manuscript; D’Antongiovanni V, Pellegrini C, Antonioli L, Blandizzi C and Bernardini N conceived the manuscript and contributed to drafting; D’Antongiovanni V, Pellegrini C, Colucci R, Fornai M, Antonioli L, Blandizzi C and Bernardini N contributed to search and selection of abstracts, review of the full length articles and writing the final version of the manuscript. D’Antongiovanni V, Pellegrini C, Colucci R, Fornai M, Antonioli L, Blandizzi C and Bernardini N read and approved the final manuscript.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Matteo Fornai, PharmD, PhD, Assistant Professor, Unit of Pharmacology and Pharmacovigilance, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 55, Pisa 56126, Italy. matteo.fornai@unipi.it
Received: December 17, 2019
Peer-review started: December 17, 2019
First decision: January 16, 2020
Revised: March 4, 2020
Accepted: March 9, 2020
Article in press: March 9, 2020
Published online: April 14, 2020
Processing time: 118 Days and 23 Hours
Abstract

A number of digestive and extra-digestive disorders, including inflammatory bowel diseases, irritable bowel syndrome, intestinal infections, metabolic syndrome and neuropsychiatric disorders, share a set of clinical features at gastrointestinal level, such as infrequent bowel movements, abdominal distension, constipation and secretory dysfunctions. Several lines of evidence indicate that morphological and molecular changes in intestinal epithelial barrier and enteric neuromuscular compartment contribute to alterations of both bowel motor and secretory functions in digestive and extra-digestive diseases. The present review has been conceived to provide a comprehensive and critical overview of the available knowledge on the morphological and molecular changes occurring in intestinal epithelial barrier and enteric neuromuscular compartment in both digestive and extra-digestive diseases. In addition, our intent was to highlight whether these morphological and molecular alterations could represent a common path (or share some common features) driving the pathophysiology of bowel motor dysfunctions and related symptoms associated with digestive and extra-digestive disorders. This assessment might help to identify novel targets of potential usefulness to develop original pharmacological approaches for the therapeutic management of such disturbances.

Keywords: Digestive disease; Enteric nervous system; Intestinal epithelial barrier; Intestinal motility; Metabolic disorders; Neuropsychiatric disorders

Core tip: Current evidence suggests that impairments of intestinal epithelial barrier and enteric neuromuscular compartment might represent a common condition underlying the onset/progression of bowel functional disturbances in both digestive and extra-digestive diseases. In this review, we summarize the impact of morphological and molecular alterations occurring in intestinal epithelial barrier and enteric neuromuscular compartment on bowel motor and secretory functions in digestive and extra-digestive diseases. This assessment, beyond to provide insight on the pathophysiology of bowel motor dysfunctions, could pave the way to the identification of novel therapeutic targets for the management of bowel dysfunctions associated with digestive and extra-digestive disorders.