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Epithelial Barrier Theory: The Role of Exposome, Microbiome, and Barrier Function in Allergic Diseases
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This review presents the epithelial barrier theory, which proposes that damage to the body's protective barriers is a key driver of allergic diseases. Researchers identified numerous environmental factors including microplastics, nanoparticles, detergents, and processed food additives that can weaken epithelial barriers in the skin, lungs, and gut. The study suggests that the rising prevalence of allergies may be linked to increasing exposure to barrier-disrupting substances in our modern environment.
Allergic diseases are a major public health problem with increasing prevalence. These immune-mediated diseases are characterized by defective epithelial barriers, which are explained by the epithelial barrier theory and continuously emerging evidence. Environmental exposures (exposome) including global warming, changes and loss of biodiversity, pollution, pathogens, allergens and mites, laundry and dishwasher detergents, surfactants, shampoos, body cleaners and household cleaners, microplastics, nanoparticles, toothpaste, enzymes and emulsifiers in processed foods, and dietary habits are responsible for the mucosal and skin barrier disruption. Exposure to barrier-damaging agents causes epithelial cell injury and barrier damage, colonization of opportunistic pathogens, loss of commensal bacteria, decreased microbiota diversity, bacterial translocation, allergic sensitization, and inflammation in the periepithelial area. Here, we review scientific evidence on the environmental components that impact epithelial barriers and microbiome composition and their influence on asthma and allergic diseases. We also discuss the historical overview of allergic diseases and the evolution of the hygiene hypothesis with theoretical evidence.
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