Current treatment strategies
Growing evidences show a clear association of gut leakage with several
diseases at extra-intestinal distinct organs including liver, lung,
brain and metabolic diseases like obesity, etc. Leaky gut syndrome is a
theory that intestinal permeability is not only a symptom of
gastrointestinal disease but an underlying cause that develops
independently. Currently, the suggested treatment options are probiotics
to restore gut barrier function. This treatment may help maintain the
health of gut lining by preventing overgrowth of pathogenic bacteria in
the gut. However, the ability of probiotics to recover intestinal
barrier function needs further investigation. The other treatment option
is prebiotics, usually plant fibers that might feed beneficial gut
bacteria. In contrast, avoiding dietary fats and sugars, which diminish
pathobionts, could support the growth of beneficial gut bacteria.
Moreover, a diet format, Low FODMAP Diet (stands for fermentable
oligosaccharides, disaccharides, monosaccharides, and polyols, which are
short-chain carbohydrates (sugars) that the small intestine absorbs
poorly) has been suggested for the treatment of irritable bowel syndrome
(IBS) and/or small intestinal bacterial overgrowth (SIBO). FODMAP foods
are assumed to aggravate the gut leakage, however, there are no
scientific evidences available. In addition, bacteria such as
aerotolerant lactobacilli or wound-associated Akkermansia
muciniphila might be critical for wound and anastomotic healing in the
gut [82]. Moreover, kinase inhibiting drugs like ruxolitinib were
found to alleviate inflammation, apoptosis, and intestinal barrier
leakage in UC via STAT3 [83]. Vitamin D and the amino acid
L-glutamine may specifically help repair gut lining [84, 85]
however, more evidence is required to conclude these experimental
findings. Nevertheless, there are certain limitations in treatment with
probiotics and dietary habits. For example, designed dietary habits are
considered difficult to follow with a modern lifestyle and the
probiotics might induce unfavorable gut dysbiosis and further exaggerate
the conditions. Fecal microbiota Transfer (FMT) has shown promising
effects in experimental studies [86], while a single clinical study
using total gastrointestinal flora transplantation showed a success rate
of 89.3% in attenuating leaky gut syndrome [87]. Therefore, there
is an urgent need to search for new therapeutic options to treat gut
leakage that stands as an underlying condition for several other
diseases.