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2007 ; 13
(48
): 6458-64
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Pathophysiology of increased intestinal permeability in obstructive jaundice
#MMPMID18161914
Assimakopoulos SF
; Scopa CD
; Vagianos CE
World J Gastroenterol
2007[Dec]; 13
(48
): 6458-64
PMID18161914
show ga
Despite advances in preoperative evaluation and postoperative care, intervention,
especially surgery, for relief of obstructive jaundice still carries high
morbidity and mortality rates, mainly due to sepsis and renal dysfunction. The
key event in the pathophysiology of obstructive jaundice-associated complications
is endotoxemia of gut origin because of intestinal barrier failure. This breakage
of the gut barrier in obstructive jaundice is multi-factorial, involving
disruption of the immunologic, biological and mechanical barrier. Experimental
and clinical studies have shown that obstructive jaundice results in increased
intestinal permeability. The mechanisms implicated in this phenomenon remain
unresolved, but growing research interest during the last decade has shed light
in our knowledge in the field. This review summarizes the current concepts in the
pathophysiology of obstructive jaundice-induced gut barrier dysfunction,
analyzing pivotal factors, such as altered intestinal tight junctions expression,
oxidative stress and imbalance of enterocyte proliferation and apoptosis.
Clinicians handling patients with obstructive jaundice should not neglect
protecting the intestinal barrier function before, during and after intervention
for the relief of this condition, which may improve their patients' outcome.