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Recent advances in the epithelial barrier theory

International Immunology 2024 53 citations ? Citation count from OpenAlex, updated daily. May differ slightly from the publisher's own count.
Yağız Pat, Duygu Yazıcı, Paolo D’Avino, Manru Li, Sena Ardıçlı, Özge Ardıçlı, Yasutaka Mitamura, Mübeccel Akdiş, Raja Dhir, Kari C. Nadeau, Ioana Agache, İsmail Öğülür, Cezmi A. Akdiş

Summary

This review explains the "epithelial barrier theory," which links the rise in allergies, autoimmune diseases, and other chronic conditions to environmental pollutants, including micro- and nanoplastics, that damage the protective lining of our skin, lungs, and gut. These pollutants can break down the tight junctions between cells, trigger inflammation, and allow harmful substances to enter the body, potentially contributing to the increase in chronic diseases seen worldwide.

The epithelial barrier theory links the recent rise in chronic non-communicable diseases, notably autoimmune and allergic disorders, to environmental agents disrupting the epithelial barrier. Global pollution and environmental toxic agent exposure have worsened over six decades because of uncontrolled growth, modernization, and industrialization, affecting human health. Introducing new chemicals without any reasonable control of their health effects through these years has led to documented adverse effects, especially on the skin and mucosal epithelial barriers. These substances, such as particulate matter, detergents, surfactants, food emulsifiers, micro- and nano-plastics, diesel exhaust, cigarette smoke, and ozone, have been shown to compromise the epithelial barrier integrity. This disruption is linked to the opening of the tight-junction barriers, inflammation, cell death, oxidative stress, and metabolic regulation. Consideration must be given to the interplay of toxic substances, underlying inflammatory diseases, and medications, especially in affected tissues. This review article discusses the detrimental effect of environmental barrier-damaging compounds on human health and involves cellular and molecular mechanisms.

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